Breast Implants and cancer risk for a 30 year old

Breast augmentation has now been proven to be safe for women desiring breast enhancement. Yet because of the general public’s increased breast cancer incidence, breast augmentation patients often have understandable concerns. Below is a question I received from a 30+ year old patient of mine who had silicone implants placed 2 years ago. She is an intelligent and strong independent woman who lives a very active and healthy lifestyle.

Her recent facebook message to me:

Hi Dr. Tom!! *HUGS* I have a question…I just found out that my mom’s side of the family has also dealt with breast cancer and I know when we were talking about my breast augmentation you had asked if it was family history and which side of the family. So, now that I know it’s on both sides of my family (grandma and great grandma on dad’s side and great grandma on mom’s side), where does that leave me? Should I start getting Mammograms now; especially now that I have implants and it may be harder to detect? I’m a little concerned and would like some comfort/info on what I should be doing and just how high risk am I? As always, Dr. Tom, Thanks a bunch! I miss one of my most favorite peeps 😉 _______Anonymous

My reply:

Hello ______,
I share our mutual admiration. I miss seeing you as well. Maybe we should have you come in annually for a breast check not just from a breast augmentation follow up but also to perform a thorough breast exam.

As you know that I was previously a general surgeon that dealt with breast cancer for over 20 years. The additional news that your grandmothers and great grandmother had breast cancer do not definitely increase your risk of breast cancer. If they were post menopausal when they developed the breast cancer it only slightly increases your risk of breast cancer. If your mother and sisters developed breast cancer prior to menopause then your risk would be higher.

Implants do NOT increase your risk of breast cancer. In one study there was actually a slightly less (but not significant) decrease in breast cancer. Implants do decrease the sensitivity of mammograms but in a 20-30 something young lady like yourself, mammogram sensitivity is diminished in general. A MRI would be much more sensitive if you had a suspicious area of concern.

I would suggest you just become very familiar with your breasts’ architecture by breast self exam. A baseline mammogram in your mid-30’s and then annualy once you reach age 40.

As an aside, for patients with silicone implants the manufacturer recommends that a MRI be performed after 3 years post implant then every 2 years thereafter to detect possible implant rupture. The added benefit is the theoretic early detrection of early breast cancer. Unfortunately at this time I believe that most health insurers do not cover this MRI cost.

______, just relax a little, see your primary care MD (gynecologist) for an annual breast exam, learn to examine your own breasts and follow the manufacturer’s recommendations. I of course would be happy to see you annually besides the added benefit of us catching up on life and other fun things!

All the best,
Dr. Tom