Do breast implants influence the detection/prognosis of breast cancer?

While the sensitivity of screening mammography is about 20% lower among asymptomatic women with breast implants than among those without, such women actually have fewer false-positive screening results and may have a slightly better prognosis when breast cancer is found. The findings come from a prospective cohort study of over 800 women with and without breast augmentation.

Traditionally, most experts believed that breast augmentation interfered with interpretation of mammography and led to poorer breast cancer prognoses, but the inclusion of displacement views in mammography screening for women with augmentation, which are performed while the breast tissue is pulled forward and the breast implant is pushed back, has largely leveled the playing field.

Among asymptomatic women with breast augmentation, researchers calculated a sensitivity and specificity for screening mammography of 45% and 97.7%, respectively. Among asymptomatic women without breast implants, sensitivity and specificity were 66.8% and 96.7%, respectively.

While both sensitivity and specificity were lower in symptomatic women with augmentation than among those without, tumors tended to be of similar stage, size, estrogen-receptor status, and nodal status in both groups. In fact, the women with augmented breasts tended to have lower grade tumors than those without.

Theories for this finding include that masses are located earlier in women with implants because these women have lower native breast volume, that implants provide a firmer platform on which to palpate, and that women with augmentation are more breast aware and/or body conscious and notice changes and/or seek medical attention sooner than unaugmented counterparts.

Miglioretti DL, Rutter CM, Geller BM, et al. Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA. 2004;291:442-450.

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