Breast Implants and Mammography in Ajax

“I can’t have a mammogram, I have implants.” It is a surprisingly common belief, and it leads some women to put off breast screening for years. In most cases it is not true. Women with breast implants can and do have mammograms. The examination is simply adapted a little, and it works best when the people taking the images know about the implants in advance.

This article explains why implants change the way a mammogram is done, what information is useful to share, what may be different on the day, and which questions belong with your health-care provider. It is general information for women in Ajax, Pickering, Whitby and across Durham Region. Every situation is a little different, so please call the clinic to confirm the details for your own appointment.

If you would like a general overview of how a mammogram appointment runs, including clothing and deodorant tips, our first mammogram guide covers those basics. Here we focus only on what implants change.

Myth versus reality

A few misunderstandings come up again and again. Clearing them up first makes the rest easier to follow.

• Myth: Implants mean mammograms are not possible. In reality, mammography is commonly performed on women with implants, whether they were placed for cosmetic reasons or as part of reconstruction.
• Myth: Compression will burst an implant. Technologists take particular care with implants, and the technique is adjusted to work around them. Concerns about your own implants are still worth raising with your provider and with the technologist before the exam begins.
• Myth: The mammogram will check whether my implants are intact. Mammography is designed to look at breast tissue. It is not the main test for assessing implants themselves. If you have questions about the condition of an implant, your provider can advise which type of imaging, if any, makes sense.
• Myth: If I have implants, I don’t need screening. Implants do not replace or remove the breast tissue that screening is designed to look at. The reasons for screening still apply.

Why implants change the examination

On a mammogram, X-rays pass through the breast and create an image based on how much each type of tissue blocks them. Breast tissue lets some X-rays through, which allows the radiologist to see its structure.

Implants, whether saline or silicone, block X-rays much more than breast tissue does. On the image, an implant appears as a bright, solid area. Any breast tissue directly in front of or behind it can be hidden from view.

To see as much breast tissue as possible, the technologist usually takes more than the standard set of pictures.

Standard views

These are taken with the implant in place, so the whole breast and the implant are included in the picture.

Displacement views

For these, the technologist gently eases the implant back toward the chest wall and draws the breast tissue forward, in front of it. The breast tissue can then be compressed and imaged with less of the implant in the way. This technique is widely used and is a normal part of mammography for women with implants.

How easily the implant can be moved back depends on a number of things, including where it sits and how the surrounding tissue has healed. Sometimes displacement views are straightforward, and sometimes they are more limited. Either way, the technologist will work with you to get the clearest images possible.

Because of these extra views, the appointment may take a bit longer than a standard screening mammogram. It helps to leave some extra time in your day.

What to tell the clinic when you book

Mentioning your implants at the time of booking gives the clinic a chance to plan the appointment properly. When you call, let the team know:

1. That you have breast implants. This is the most important point.
2. Roughly when they were placed. Approximate dates are fine.
3. Whether they were placed for cosmetic reasons or as part of reconstruction. Women who have had reconstruction after breast cancer surgery may need a different type of appointment, so your provider’s input is especially important.
4. Any problems you have had or been told about, such as concerns about rupture, pain, firmness or changes in shape.
5. Where your previous mammograms were done, if you have had them, so earlier images can be found for comparison.

Whether your appointment can be booked as a routine screening or needs a referral from your health-care provider depends on your circumstances. The clinic can tell you what applies when you call, so please confirm before your visit.

Information worth finding before your visit

Some women know a great deal about their implants; others have only a vague memory of the details from many years ago. Anything you can gather is helpful, but none of it is mandatory. Useful details include:

• whether the implants are saline or silicone
• whether they sit in front of the chest muscle or behind it
• the name of the surgeon or clinic who placed them
• whether they have ever been replaced or removed

If you have an implant card or paperwork from your surgery, it can be worth looking for. If you do not, that is common. Simply share what you know.

What to tell the technologist on the day

Even if you mentioned your implants when booking, please tell the technologist again before the examination starts. A quick conversation at the beginning helps them plan how to position you and which views to take.

This is also the moment to share anything that is bothering you:

• any area of the breast that is tender or sore
• any change you have noticed in the shape, feel or position of an implant
• any worries about compression

Mammography technologists are trained to adapt the examination for implants, and they would much rather hear your concerns before they begin. If anything feels uncomfortable during positioning or compression, say so. They can often adjust.

Preparation for the rest of the visit is the same as for any mammogram: skip deodorant, antiperspirant and powder on your chest and underarms, wear a two-piece outfit, and bring your health card.

When imaging is about a concern, not routine screening

Screening is meant for breasts that feel normal. If you have noticed something different, contact your doctor or health-care provider before booking anything. This includes:

• a new lump in the breast or underarm
• skin changes, such as dimpling or redness
• nipple changes or discharge
• a sudden or gradual change in the shape or size of a breast
• pain, swelling or hardening around an implant

Your provider can examine you and decide what kind of imaging is appropriate. Depending on the situation, that might involve a diagnostic mammogram, an ultrasound, or other imaging arranged through a referral. Ultrasound uses sound waves rather than X-rays and is sometimes used to look more closely at a specific area of breast tissue.

Other breast surgeries to mention

Implants are not the only kind of breast surgery that can affect how mammograms look. Please also tell the clinic and the technologist if you have had:

• a breast reduction or breast lift
• a biopsy or removal of a lump
• surgery or radiation for breast cancer
• implants removed in the past

Surgery can leave scar tissue or changes in the shape of the tissue that are completely expected, but knowing about them helps the radiologist interpret the images correctly. A simple note with the type of surgery and approximate dates can be very helpful.

Planning the visit around your day

A few practical touches can make the appointment feel calmer, especially if it is your first mammogram since having implants.

• Allow extra time. Because additional views are often needed, avoid booking right before an important meeting or school pickup.
• Choose a comfortable point in your cycle. If you still have periods and your breasts tend to feel tender beforehand, a date shortly after your period may be more comfortable.
• Bring your notes. A short written summary of your implant details and any other breast surgery saves trying to remember dates on the spot.
• Consider a Saturday. Our Ajax clinic is open Saturday from 8:00am to 3:30pm as well as weekdays, which some women find easier to fit around work.

Knowing in advance that the appointment may run a little longer can take away much of the stress, whether you live in Ajax or are travelling from a neighbouring town.

Questions to bring to your health-care provider

Some questions are better answered by your doctor or nurse practitioner than by the imaging clinic. Consider asking:

• Am I a candidate for routine screening, or should my mammograms be arranged differently?
• How often should I be screened, given my history?
• Is there any reason to check the condition of my implants, and if so, what test would you suggest?
• If I have had reconstruction, what kind of breast imaging is recommended for me?

The answers will depend on your personal history, which is why general articles like this one cannot replace that conversation.

Booking with confidence

Having implants should not be a reason to skip breast imaging. With a little advance notice and a clear conversation on the day, the examination can be adapted to you.

Rossland Diagnostic Clinic is an OBSP-registered site at Unit 102, 300 Rossland Road East in Ajax, with free parking and ground-floor access. You can read more on our mammography page. Before booking, please call us at 905-426-3111 so we can confirm how your appointment should be arranged, or request an appointment online and mention your implants in your message.