Breast Cancer Screening After Reconstruction
Breast cancer screening after breast reconstruction depends on the type of surgery you have undergone

If you have had a mastectomy, you will not need to have routine mammograms to screen for breast cancer. However, if you have had breast-conserving surgery, you will need to undergo mammograms of the affected breast.

Breast cancer screening after breast reconstruction depends on the type of surgery you have undergone:

  • Bilateral mastectomy: If you had a bilateral mastectomy, you do not need to undergo routine mammograms.
  • Unilateral mastectomy: If you had a mastectomy on only one breast, it is essential to get a mammogram of the untreated breast because there is a risk of developing cancer on the other side.
  • Breast-conserving surgery: If you had breast-conserving surgery, you will need to get mammograms of the treated breast.
  • Flap reconstruction: If you had flap reconstruction and notice a lump, it be due to benign fat necrosis, which is caused by the formation of dead cells following the reconstruction procedure. Occasionally, you may require a mammogram, ultrasound, or aspiration biopsy.
  • Implant reconstruction: If you had implant reconstruction and notice a lump, it may be due to the capsular contracture caused by the formation of a hard tissue capsule around the implant.
  • Lumpectomy: If you had a lumpectomy but have healthy breasts, it is recommended to get routine annual mammograms.

What is breast reconstruction?

Breast reconstruction is done to reshape breasts that are surgically removed (mastectomy or lumpectomy) as a part of cancer treatment. Breast reconstruction procedures use silicone or saline implants or flap tissue from the body.

Breast reconstruction can be done immediately after breast cancer surgery or a few months or years later. Benefits of breast reconstruction include:

  • Restores breast symmetry, making both breasts look similar in shape and size.
  • Helps women feel better about their bodies

Breast cancer screening for healthy breasts with implants

To balance out the reconstructed breast, the healthy breast may need a silicone implant. Silicone implants will not allow mammogram X-rays to pass through them. 

In such cases, the technician may take different views of the breast. These are called implant displacement views. They gently move the implants toward the chest wall and bring the breast tissue forward to capture better images. This helps them capture better images of the front part of the breast.

Breast cancer screening for high-risk women

Undergoing breast cancer screening after reconstruction is not advised, but there are no rules against doing so. For example, if you have a family history of cancer or your doctor suspects an increased risk of a local occurrence, breast cancer screening may be recommended even if its benefits are not proven.

MRIs generally work better in such cases than mammograms because they offer clear images. However, the drawback of MRI screening is that it is more susceptible to having false positives.

QUESTION

A lump in the breast is almost always cancer. See Answer

Breast cancer screening after nipple-sparing mastectomy

Nipple-sparing mastectomy is a procedure in which the entire breast tissue is removed and the nipple is preserved. If you have undergone this type of procedure, consult your physician about whether cancer screening is required.

If your physician recommends screening tests, seek the advice of your physician to understand what type of screening is recommended, such as a mammogram, MRI, ultrasound, or combination tests.

Generally, it is recommended to do breast cancer screening tests 6 months after the reconstruction procedure and essential to inform your technician about the type of implants you received.

MRI screening for silicone implant rupture

For silicone implants done for breast reconstruction, the FDA recommends getting MRI screening 3 years after receiving the implants and then every 2 years for the rest of your life. 

This can detect ruptures if they occur. If a silicone rupture occurs, the gel leaks out of the silicone implant, and you will not be able to notice it.

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Medically Reviewed on 10/20/2022
References
Image Source: iStock image

Screening After Breast Reconstruction. https://www.breastcancer.org/treatment/surgery/breast-reconstruction/screening-after-reconstruction

Are Mammograms Needed After Breast Reconstruction? https://www.foxchase.org/blog/are-mammograms-needed-after-breast-reconstruction

Mammograms After Breast Cancer Surgery. https://www.cancer.org/cancer/breast-cancer/screening-tests-and-early-detection/mammograms/having-a-mammogram-after-youve-had-breast-cancer-surgery.html