BREAST-CANCER DIAGNOSIS IN WOMEN WITH SUBGLANDULAR SILICONE GEL-FILLED AUGMENTATION IMPLANTS

PURPOSE: To determine whether breast augmentation implants interfere with detection of breast cancer and to characterize the projections that offer an improvement in the detection of disease. MATERIALS AND METHODS: The mammographic examinations, clinical presentation, and pathologic findings were retrospectively reviewed in 18 patients who underwent breast augmentation with silicone gel-filled implants. RESULTS: At diagnosis, 16 patients (89%) had palpable abnormalities. Standard mammographic views were negative in 17 patients (94%). Modified implant compression views (used with implant displacement) showed abnormalities in 12 patients (67%). Sixteen (89%) of the 18 patients had invasive carcinomas, and seven (39%) had positive axillary lymph nodes. CONCLUSION: Standard mammographic views are inadequate for breast cancer screening in patients with silicone gel-filled implants. Although additional modified compression views offer a moderate improvement in breast cancer detection, imaging with tangential mammographic views, sonography of palpable areas, and breast physical examination in conjunction with mammography will offer additional benefit in breast cancer detection.