Risk of silicone rupture during mammography is low, but there is

The fear of bursting the silicone implant during the mammogram is common among women with the implant. The risk of rupture exists, but it is rare and restricted to the encapsulated implant, which is old and worn out, according to experts heard by the Sheet. Nowadays, the prosthesis has no expiration date and is changed if necessary.

“We recommend that women with breast implants have a normal check-up. Ideally, an imaging exam is done once a year to see the characteristics and integrity of the prosthesis. The same exam will look for lesions in the breast”, says Patricia Marques, plastic surgeon and member of the Brazilian Society of Plastic Surgery.

The doctor reinforces that the concern with the prosthesis should not be a priority, but the detection of breast cancer.

“It is essential to go to the gynecologist and perform the tests he asks for. We need to do breast cancer screening, because it is very common in women and aggressive”, points out the plastic surgeon.

According to Inca (National Cancer Institute), breast cancer is the leading cause of cancer death in the female population in all regions of Brazil, except in the North, where cervical cancer occupies this position. In the country, excluding non-melanoma skin tumors, the disease is the most frequent in women from all regions, with higher rates in the South and Southeast. For the year 2022, 66,280 new cases were estimated.

Mammography in those who have a silicone prosthesis can be performed normally. The procedure does not interfere with the quality or safety of the result.

When there is no implant, four views are made, two on each side. In silicone patients, twice as many x-rays are taken — the basic ones and another four with a maneuver called Eklund.

“In this maneuver, the radiography technique pulls the breast tissue forward, pushes the prosthesis backwards and tries to place only the tissue in the mammography unit, without the prosthesis. These additional views help us to better see the breast tissue removing the silicone field”, says Flora Finguerman, a radiologist specializing in breast diagnosis, from Alta Diagnósticos, of the Dasa network.

If the implant is recent, the guideline is to wait six months for the procedure to be performed. Instead, the doctor may order a breast ultrasound – but only in this case. Lilian Fiorelli, a gynecologist specializing in female sexuality and urogynecology at USP (University of São Paulo), reinforces that mammography is the most important exam for the detection of breast cancer.

“Ultrasonography does not replace mammography, but it comes to complement, because it can help in the detection of some nodules. Sometimes, in the mammogram, some images appear that cause doubts if it is a nodule or cyst, and the ultrasound can identify because it sees different colors between them The MRI also helps, but it does not detect some lesions. It can see things that the patient does not look for”, says Fiorelli.

If the woman has any palpable lumps or complaints, a mammogram is performed even if the implant is recent. It is essential that the radiology technician is aware of the existence of the implant.

“There are two questions that women often ask: does the presence of silicone increase the risk of having breast cancer? The answer is no. And the other is whether silicone can harm the mammogram. Usually not, precisely because we have more incidences” , points out Finguerman.

“Each woman is different. Sometimes, she has little tissue and puts a silicone that occupies the entire area of ​​the breast. It is even difficult to perform the maneuver. In these cases, when we cannot see the tissue well on the mammogram, we suggest complementing it with breasts, for example”, concludes the radiologist.

Regarding self-examination, the experts said that silicone does not prevent the effectiveness of the procedure, on the contrary. The prosthesis facilitates palpation, as it pushes the mammary gland forward and helps to highlight the presence of nodules or changes.

“We guide the patient towards self-knowledge. She needs to know what her breast is like. From the moment you put on a prosthesis and palpate the breast, get to know what the region is like. This makes it easier to identify any changes”, guides Fiorelli.

Silicone and breast disease

Patrícia Marques says that the prosthesis can be a triggering factor for diseases, such as silicone or Asia (Adjuvant-Induced Autoimmune Syndrome), and anaplastic giant cell lymphoma.

Autoimmune and inflammatory, Asia has joint and body pain, fatigue, sleep disturbances and hair loss, among others. Manifestations appear after placing the silicone.

Anaplastic giant cell lymphoma forms an accumulation of inflammatory fluid around the implant. It is a rare disease with cure rates above 90%, but it depends, however, on the prosthesis explant.