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BookwormsInHeat · 08-16-2005, 09:08 PM

My wife looked into implants (I've managed to discourage her so far - I think her breasts are perfect). Here's what we learned about mammography.

Most people are encouraged to have a "screening" mammogram once a year starting at age 40 (start earlier if you have sister or mother with breast cancer).

A screening mammogram is rather informal. In most places, appointments are easy to schedule. You go in, they take 4 pictures, you leave (hopefully a few minutes later in a well run clinic).

When the radiologist reads the mammograms, most of the time the images are normal or unchanged, and you get a letter to come back in a year.

About 5-10% of the time, there are calcifications or slightly unusual looking breast tissue that make the radiologist uncomfortable, and you need to come back for a "diagnostic mammogram."

A diagnostic mammogram usually involves special views (magnification views, different angles). Sometimes the radiologist will want to perform an ultrasound to get a better look at some areas. All this may take the better part of an hour or more for an appointment, because the radiologist reads all the films while you're still there, and keeps getting views until they can either clear the images or request a biopsy (which they will schedule within a week or two). They will talk individually with every patient receiving a diagnostic mammogram and summarize their impression on the spot.

As you can imagine, diagnostic mammograms are more time-consuming and expensive (depending on your insurance) than regular screening mammograms.

If you have implants, you can still have mammography. It doesn't matter whether your implants are saline or silicone, behind the chest muscles or in front. Any kind of implant has some small risk of rupture during compression for mammography and you will need to sign a release waiver that you accept that risk. The mammograms will always be diagnostic mammograms rather than screening mammograms, so when you have implants you commit yourself to the longer procedure for as long as you have the implants.

Mammography with implants is still very helpful screening, but it is a little less sensitive than mammography without implants. There is some risk of not seeing a cancer as well because it is obscured by the implant, or because the breast tissue is compressed. (Fat in the breast is very helpful for reading mammograms and women with fatty breasts are easiest to find cancers in.) Plus, surgery makes some scarring and changes in the breast that are sometimes difficult to distinguish from cancer, and that may mean a biopsy that otherwise might not have been necessary.

Implants do not last forever. Average life span of an implant is roughly 10 years. They have various cosmetic problems (shifting, change in texture, ball in a sock appearance) with age, and they rupture. There are lots of types of rupture. A saline implant will pop and basically evaporate. A silicone implant may rupture and spread silicone in breast tissue, which causes scarring (not generally visible or dangerous but on occasion can be). You should plan on having the implants either removed or replaced or revised every 10 years (more or less).

Silicone implants do not cause connective tissue disease. That was a myth perpetrated by trial lawyers long after science had definitive evidence to the contrary. They will eventually be approved again in the United States, but are not currently FDA approved here.

Hope that's helpful.

08-16-2005, 09:08 PM	#19 (permalink)
BookwormsInHeat Registered Join Date: Apr 2005 Posts: 6 Location: Salt Lake City Status: Couple	Re: What to expect from breast implants. My wife looked into implants (I've managed to discourage her so far - I think her breasts are perfect). Here's what we learned about mammography. Most people are encouraged to have a "screening" mammogram once a year starting at age 40 (start earlier if you have sister or mother with breast cancer). A screening mammogram is rather informal. In most places, appointments are easy to schedule. You go in, they take 4 pictures, you leave (hopefully a few minutes later in a well run clinic). When the radiologist reads the mammograms, most of the time the images are normal or unchanged, and you get a letter to come back in a year. About 5-10% of the time, there are calcifications or slightly unusual looking breast tissue that make the radiologist uncomfortable, and you need to come back for a "diagnostic mammogram." A diagnostic mammogram usually involves special views (magnification views, different angles). Sometimes the radiologist will want to perform an ultrasound to get a better look at some areas. All this may take the better part of an hour or more for an appointment, because the radiologist reads all the films while you're still there, and keeps getting views until they can either clear the images or request a biopsy (which they will schedule within a week or two). They will talk individually with every patient receiving a diagnostic mammogram and summarize their impression on the spot. As you can imagine, diagnostic mammograms are more time-consuming and expensive (depending on your insurance) than regular screening mammograms. If you have implants, you can still have mammography. It doesn't matter whether your implants are saline or silicone, behind the chest muscles or in front. Any kind of implant has some small risk of rupture during compression for mammography and you will need to sign a release waiver that you accept that risk. The mammograms will always be diagnostic mammograms rather than screening mammograms, so when you have implants you commit yourself to the longer procedure for as long as you have the implants. Mammography with implants is still very helpful screening, but it is a little less sensitive than mammography without implants. There is some risk of not seeing a cancer as well because it is obscured by the implant, or because the breast tissue is compressed. (Fat in the breast is very helpful for reading mammograms and women with fatty breasts are easiest to find cancers in.) Plus, surgery makes some scarring and changes in the breast that are sometimes difficult to distinguish from cancer, and that may mean a biopsy that otherwise might not have been necessary. Implants do not last forever. Average life span of an implant is roughly 10 years. They have various cosmetic problems (shifting, change in texture, ball in a sock appearance) with age, and they rupture. There are lots of types of rupture. A saline implant will pop and basically evaporate. A silicone implant may rupture and spread silicone in breast tissue, which causes scarring (not generally visible or dangerous but on occasion can be). You should plan on having the implants either removed or replaced or revised every 10 years (more or less). Silicone implants do not cause connective tissue disease. That was a myth perpetrated by trial lawyers long after science had definitive evidence to the contrary. They will eventually be approved again in the United States, but are not currently FDA approved here. Hope that's helpful.