After several years, the patient returns and requests a mammogram. She is now 35 years old, and her sister was recently diagnosed with breast cancer. Which of the following is the most appropriate statement regarding silicone breast implants and mammographic screening for breast cancer?

Question

After several years, the patient returns and requests a mammogram.  She is now 35 years old, and her sister was recently diagnosed with breast cancer.  Which of the following is the most appropriate statement regarding silicone breast implants and mammographic screening for breast cancer?

Quizplus · Accepted Answer

Explanation: Regular mammograms have consistently been shown to reduce morbidity and mortality from breast cancer. Mammographic screening plays an important role in detecting lesions in early stages, thereby improving the chances of a complete cure. It is recommended that all women, including those with breast implants, should obtain regular screening mammograms starting at age 40-50 years (earlier if there are risk factors) per the guidelines. When the US Food and Drug Administration reapproved silicone breast implants in 2006, they recommended magnetic resonance imaging every 2 or 3 years over the lifetime of the implant to screen for asymptomatic implant rupture, which could lead to scarring within the breast. (Choice A) The presence of capsule contraction can interfere with obtaining good-quality imaging. The capsule around the implant can also develop small calcifications that may appear similar to the microcalcifications seen in cancerous tissue. This can rarely lead to a false-positive result, requiring further investigation. (Choice C) There have been some concerns that a silicone implant may obscure a cancerous lesion during routine mammographic screening. This has never been proven in clinical studies; thus, it does not warrant more frequent screening efforts. (Choice D) There is no evidence that radiation exposure affects the stability of breast implants. Educational objective: Women with breast implants should continue to have screening mammograms at regular intervals.

After Several Years, the Patient Returns and Requests a Mammogram