At 51 years of age, Judy Aberman decided to fulfill her dream of getting breast implants. Just one year later, during a routine mammogram, Judy found out that she had breast cancer and had to have one breast removed. It is Judy’s belief that the implant had pushed the cancer cells forward against the skin and made it possible for the mammogram to detect them. Her breast was full of cancer that had gone undetected for years. Today, Judy is thankful for her implants as they literally saved her life. Unfortunately, Judy’s story is not the norm.
As women, we all strive to look our very best. Appearances are everything, even if it might lead to some unhealthy risks. Many women turn to breast augmentation as a way to make themselves feel and look more attractive. According to the American Society of Plastic Surgeons 2009 statistics, breast augmentation was the third most performed cosmetic surgery by ASPS member surgeons. Together, they performed 289,328 breast augmentation procedures in 2009, a 6% increase from the previous year.
But what about those risks? Plastic surgeon Dr. Ted Eisenberg, labeled as Philadelphia’s #1 cosmetic breast surgeon, says, “It’s been reported that mammograms are a little harder to read, especially when they are in front of the muscle (sub-glandular). Because this procedure is so common in the United States, many radiology departments will routinely ask if you have implants so they can prepare for the mammogram. In addition, extra views are taken and the implants are displaced during the procedure to assist in a better reading.” Dr. Eisenberg recommends that mammograms be routinely performed annually from age 40 on. If a patient has a mother or sister with breast cancer, he will recommend a mammogram at any age. “I always recommend that a woman see her gynecologist for routine breast care and, of course, any clinical findings like lumps or masses should always be evaluated for the possibility of cancer prior to the elective surgery.”
Peggy Steinert, a registered Radiologic Technologist specializing in mammography at a Women’s Health clinic in Minneapolis, MN is adamant in her personal views that breast implants may interfere with early breast cancer detection. She shares her thoughts on how breast implants make it more challenging to obtain mammogram images. When imaging augmented breasts; twice as many pictures need to be taken, exposing the woman to increased radiation dose during the mammogram. “While I understand that women want to feel good about themselves, they may not understand that implants create challenges in obtaining and interpreting mammograms. While the implants can be displaced during imaging, small cancerous lesions can still be masked or hidden behind the opaque breast implant. Women should be aware that breast cancer is the second most commonly diagnosed cancer to affect women. I am a huge advocate for breast health and this causes me to strongly recommend that women thoroughly research the risks and benefits before considering any surgery as well as undergoing a preoperative mammogram to check for existing breast cancer should they decide that breast implants are right for them.”
Dr. Jennifer Gass, assistant director of the Breast Health Center at the Women and Infants Hospital of Rhode Island in Providence, recommends that if a woman is considering breast implants, she should see a board-certified plastic surgeon. “I prefer retro-pectoral implants for imaging and long-term positioning, that is behind the muscle. For women who have implants, they should be screened on the same schedule as all women, according to their personal risk factors. They can be screened safely with Eklund (push-up views). Just as part of the breast may be difficult to get on the mammogram in women without implants, women with implants may be challenging to the technologist.”
Dr. Ashley Stuckey, a fellowship-trained specialist in breast and gynecologic oncology who also works at the Breast Health Center says, “Women with implants make mammography more difficult; the implant contents are radiopaque and can obscure small lesions. In addition, they make it harder to evaluate all parts of the breast and makes compression more difficult. Standard imaging technique in women with implants involves four views, rather than the usual two per breast. Positioning is important. The implant is pushed out of view to allow for as much visualization of the breast tissue as possible.” Dr. Stuckey also states that the type of implant is just as important. If a woman is considering breast implants, she should have a thorough consultation with her plastic surgeon and be aware of the possible difficulties associated with the implants. Breast implants that are placed behind the pectoral muscle are easier to position.
According to Breastcancer.org, in the United States alone, 1 in 8 women will be diagnosed with breast cancer each year. About 90% of breast cancers are due not to heredity, but to genetic abnormalities that happen as a result of the aging process and life in general. It is estimated that approximately $8.1 billion is spent in the United States each year on breast cancer treatment. About 70% of women diagnosed with breast cancer have no risk factors for it at all.
Judy Aberman is a walking miracle and is alive and well today because she chose to get breast implants. Due to the findings of cancer in one of her breasts, it needed to be removed. After several reconstructive surgeries had been performed, Judy still has her implants. She won’t tell you which one is the reconstructive breast, and neither will I! Judy was well aware of the fact that implants made it harder to get a clear reading for mammograms when she made the decision to have the surgery. Some w oman who have been diagnosed with breast cancer refuse mastectomies for fear of disfiguring themselves. Although Judy lost her breast, using one of the leading breast reconstruction doctors in the Chicago area, Dr. Gregory Turowski from New Horizons Center for Cosmetic Surgery, she still maintained her confidence and femininity. When asked if she would have had the implants put in had she known there was cancer growing inside of her, she replied, “Absolutely! I only wish I would have done it sooner!” Had she done it sooner, it is possible that the cancer would have been discovered sooner and quite possibly, it could have saved her breast.
While breast implants do not cause cancer, for most women, they can certainly inhibit the chances for early detection of breast cancer. It has been stated that as much as 9% to 20% of the breast can be hidden from the mammogram when a woman has breast implants. If a woman chooses to follow through with her choice to have breast augmentation surgery, first consider the risks and be well informed. Talk to your gynecologist and have a thorough breast examination done before having the procedure. Take into consideration the types of implants, as well as their placement, that can make it easier to read during a mammogram. If you are a woman 40 years of age or older, make sure you follow through with your mammogram once a year as recommended, or as often as your doctor recommends.