In The News

Implants: A hindrance and a help
Implants create obstacles in breast cancer diagnosis, but also can aid in detection.

By Scott Martindale
The Orange County Register
September 17, 2006

Breast implants have been blamed for a laundry list of problems: internal scarring, allergic reactions, inconclusive mammograms, even deaths.

But the popular cosmetic surgery is not all bad. In fact, breast implants can make it easier to detect cancerous lumps.

Doctors say that implants flatten breast tissue like a pancake. When the tissue is flatter, it's also thinner – a major advantage when searching for lumps, especially ones buried deep inside the breast tissue.

"That's an advantage of having an implant. It's much easier for people to feel abnormalities," said Dr. Hootan Daneshmand of the Silhouette Plastic Surgery Institute in Foothill Ranch.

No study, however, has shown that implants improve survival rates, and doctors do not recommend breast augmentation to aid in cancer detection.

Implants make mammograms more difficult to read because they block parts of the breast tissue. The low doses of X-rays used in mammography are unable to penetrate the artificial, fluid-filled sacs.

Trained technicians know how to work around the problem using a technique called implant displacement. After taking the two standard images of each breast, a mammographer pushes the implant back against the chest wall and pulls the breast forward over the implant. This allows for better views of the front portion.

"In Orange County, a lot of women have breast implants, so most places know how to work around it," said Dr. Lisa Curcio of Advanced Breast Care Specialists in Mission Viejo.

The implant-displacement technique, however, is not foolproof. In women with implants behind the chest muscle – now the most common place for the surgery – about 10 percent of breast tissue cannot be visualized.

When the implant is in front of the chest muscle, the loss of visibility goes up to as much as 30 percent of the breast tissue.

Additionally, because implants cause internal scarring in the breast, the hard scar tissue also can interfere with capturing adequate pictures. The scarring makes the implant less mobile and more difficult to push aside for pictures.

When mammograms are inconclusive, doctors turn to two other techniques: ultrasound and magnetic resonance imaging, or MRI. Using these methods in conjunction with mammograms makes up for any visibility loss caused by the implants, doctors say. 

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