My name is Dr. David Mattos. I’m a plastic surgeon at Long Island Plastic Surgical Group. A mammogram is an x-ray that we take of the breast and a specific x-ray of the breast, because what it normally does is it actually compresses the breast tissue in a way that allows us to better visualize the breast and help us either screen or diagnose breast cancer.
For most women, the right age to get a mammogram or start getting screening mammograms is about 40 years of age. There are some women who are higher risk, either genetically or because of a family history of breast cancer who do have to start getting imaging, whether it’s a mammogram or another form of imaging, earlier in their lives in order to screen for the possibility of developing breast cancer. But that can be guided really based on the discussion with your doctor. That’s really how they should always go about it.
The National Comprehensive Cancer Network generally recommends patients get mammograms on an annual basis starting from 40 years of age. There can be some variation in terms of other imaging that you may have to get as necessary for breast cancer screening, but that again depends on your risk profile. It’s going to be guided by a discussion that you have with your physician.
Women who have breast implants can definitely get mammograms, and it’s something we’ve been doing for a long time. The way they obtain the mammograms are slightly different, simply because they have to obtain additional views in order to account for the implant. These views are called implant displacement views, where they simply try to mobilize the implant slightly up against the chest wall so that they can then focus the imaging on the breast tissue itself. But it’s something that they’ve been doing for a long time, and many centers are very accustomed to doing it.
There have been some reported incidents in the literature of mammograms in the past causing implants to rupture. The reality is that it is a very unusual and a very rare event. I believe that especially as implants have become newer and better developed, today’s implants are usually less likely to sustain a rupture from a mammogram. So it’s typically not something that we worry about. Overall, they’re very, very reliable.
Most of the society guidelines that we have for mammogram don’t necessarily specify 3D versus 2D mammograms. The standard is still considered 2D. But as newer imaging modalities such as the 3D mammogram have developed, there have been some indications that seem to be better visualized in the 3D mammograms. Specifically, those three would be, one, patients who have very dense breasts. Two, one of the other benefits is that they’ve seen that the recall rate, meaning after you have a mammogram, the chance that you could get called back for a suspicious finding or something that they can’t tell what it is, is lower. And three, some patients who have very, very early stage cancers are more likely to be caught in the 3D mammograms than they are in the 2D mammograms. The reality is that guidelines overall still haven’t changed simply because there hasn’t been a proven … It has not yet been proven to change the mortality benefit of a patient long term who have imaging with the 3D mammogram.
The reason why mammograms are so important, it comes down to saving patients’ lives. The whole purpose of a mammogram is to be able to detect a cancer before it has otherwise been detected. The earlier we find out that women have a breast cancer, the higher the likelihood is that we will be able to treat them successfully and save their lives so that they can live a long life even after the development of breast cancer.