Both silicone gel and saline breast implants may rupture, or existing ruptures may be exacerbated, during compression for screening mammography. In fact, during a 9-year period, at least 33 cases of implants rupturing during mammography were reported to the Food and Drug Administration and at least 17 more were reported in the medical literature, according to agency researchers.
It is unclear whether compression ruptures the implant itself or the scar capsule, converting an intracapsular rupture into an extracapsular one. Regardless, over time as an implant remains in place, pressure resistance and implant strength decrease, which places older implants at greater risk of rupture. Capsular contracture, capsular thickness, and calcification can also increase risk.
Because implants can decrease the amount of breast tissue that is visual on mammography by about 80%, modified positioning techniques, such as the Eklund or pinch technique, are often employed. Such methods, which involve pulling the breast tissue away from the implant and compressing the tissue with up to 45 pounds of force, need to be employed extremely carefully to avoid implant rupture.
Brown SL, Todd JF, Luu HMD. Breast implant adverse events during mammography: reports to the Food and Drug Administration. J Women's Health. 2004;13:371-378.