31 July 2019

Take 4: Special cases of breast imaging

Clinical Women

Mammography is generally safe for patients with breast implants, despite the chance they may occasionally rupture, experts say.

Dr Elizabeth Lazarus, a breast radiologist from Spectrum Medical Imaging in Randwick, Sydney, says implants already leaking silicon or saline may be at increased risk of leaking with a mammogram.

“But still, implants are safe to be done under mammography, and mammograms are great at detecting microcalcification which MRI and ultrasound both can’t detect – that’s why we still have mammograms,” she says.

Conversely, MRI is very sensitive at detecting breast carcinoma and is appropriate if the patient has already been diagnosed and needs to find out the extent of the cancer.

In addition, lobular carcinoma, which is often multicentric or bilateral, can be scanned by MRI to find out whether the rest of the breast (or the other breast) is affected.

“The problem with MRI is that there are false positives, so sometimes it’s so sensitive it detects masses which turn out to be benign,” Dr Lazarus says.

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