Radiological challenges of breast cancer screening in women with breast implants

In the United States, 365,000 people would have undergone breast augmentation in 2021.¹ Emerging research comparing the use of digital breast tomosynthesis (DBT) in women with and without breast implants found a 22% lower cancer detection rate in women with breast implants. Yet, there are currently no imaging guidelines specifically tailored to screening for breast cancer in patients with breast implants.

To recent Society of Breast Imaging (SBI) Conference, Stephen Rose, MD, pointed out that breast implants can hide between nine and 44 percent of glandular tissue during imaging. In a recent video interview, Dr. Rose said there are a number of factors, ranging from implant age and fibrosis to implant size, implant-related scarring and to breast size, which may affect the interpretation of breast imaging in patients with breast implants.

In retrospective research presented at the SBI conference, Dr. Rose and colleagues reviewed data from 350,845 DBT exams (including 20,929 DBT exams for women with breast implants) performed at 49 community outpatient imaging centers in 2019 In addition to the aforementioned reduced cancer detection rate in women with implants, Dr. Rose and colleagues found that women with breast implants had an almost 5.5% increase in ductal carcinoma in situ (DCIS) and a 4.8% higher incidence of positive lymph node involvement in detected cancers.

(Editor’s note: For related content, see “Breast reconstruction: current principles and emerging concepts in imaging” And “Study highlights the use of contrast mammography in women with breast implants. »

Is it time to develop imaging guidelines more specific to nuances and additional imaging needs for women with breast implants?

“Apart from the same guidelines that we use for women without breast implants, there really haven’t been any specific guidelines from our companies suggesting we do more (for women with breast implants),” noted the Dr. Rose, founder and president of Rose. Imaging specialists. “This has all been anecdotal recommendations and it’s not like it’s an insignificant number of patients. In some of our populations, 10-15% have implants. »

For more on Dr. Rose, watch the video below.

Reference

1. The aesthetic society. National Aesthetic Plastic Surgery Database Statistics 2020-2021. Available at: https://cdn.theaestheticsociety.org/media/statistics/2021-TheAestheticSocietyStatistics.pdf. Accessed June 14, 2023.