How Does Breast Surgery Affect Cancer Screenings?
Type of surgery determines if you need a mammogram
Type of surgery determines if you need a mammogram
Breast surgery — whether cosmetic or reconstructive — can be a life-changing event. It can improve your body image, or even signal the end of a battle with breast cancer.
However, one question that often arises is how does breast surgery affect cancer screenings like mammograms? This is important because regular screenings help find breast cancer early.
“It’s understandable to have concerns about mammogram screenings after breast surgery. That’s why it’s important to choose a breast care center that has experienced staff that routinely works with prior breast surgeries,” says Louis Rivera, MD, a surgical oncologist at Scripps Cancer Care and Scripps Clinic.
Mammograms are recommended for women at average risk starting at age 40 to check for breast cancer. Women at high risk should have exams sooner and more often.
How breast surgery affects mammograms
Breast surgery can change the shape of your breasts. This can make it harder for radiologists to interpret mammogram images.
If you’ve had breast surgery, tell your health care provider about your procedure before your mammogram.
Keep in mind your breast tissue may look different after surgery. You might also have scar tissue that can affect the clarity of mammogram images.
Here are some ways different types of breast surgery can affect cancer screenings:
1. Mammogram after a breast lift
A breast lift is a surgery that changes the shape of your breasts. This can make your past mammograms less useful for future comparisons. Your doctor may recommend getting a new baseline mammogram about six months after your surgery.
“The new baseline will become the new standard that your doctor will use to compare future screenings against and identify changes,” says Dr. Rivera.
“Overall, your mammography experience shouldn’t change following a breast lift. The compression machine will not ‘undo’ your lift or cause your breasts to sag,” Dr. Rivera adds. “An experienced mammography technician will still be able to get the views needed without causing you undue discomfort.”
2. Mammograms after breast implants
Breast augmentation usually involves the use of implants to enhance breast size and shape. However, breast implants can make mammograms more challenging. The implants can obscure breast tissue, making it hard to detect abnormalities.
Having breast implants should not stop you from being able to get a mammogram or breast cancer screening. Women with breast implants should find a breast cancer center or expert experienced in mammograms and implants.
“These experts should know how to take X-rays that show as much breast tissue as possible. Usually, they will gently push the implant back against your chest wall and pull your breast tissue forward over it,” Dr. Rivera says.
In a regular screening mammogram, X-ray pictures of each breast are taken from two different angles. If you have implants, more X-rays are needed. These extra X-ray pictures are called implant displacement views. They help capture better images of the front part of each breast.
3. Mammograms after breast reduction
A breast reduction involves the removal of breast tissue and can affect mammograms. After the procedure, your breasts may change and scar tissue can form. It is helpful to get a new baseline mammogram about six months after surgery. These scans will serve as the new standard for your doctor during future screenings.
“Your mammogram experience post-reduction shouldn’t be any different than what you experienced before surgery. If anything, you might find the procedure to be more comfortable since there is less tissue to compress,” Dr. Rivera says.
4. Mammograms after breast cancer surgery/reconstruction
Nearly all women with breast cancer will have surgery at some point as part of their treatment, according to the American Cancer Society. The type of surgery will affect whether you need to get mammograms in the future.
A lumpectomy — a procedure to remove cancerous tissue — is often an option for a woman in early-stage cancer. This surgery is also called breast conserving surgery. Women still need regular mammograms.
Radiation therapy often follows a lumpectomy. A patient might choose breast reconstruction with silicone or saline implants. They may also decide on breast reduction to make their breasts more even after surgery.
Because these treatments can change your breast tissue and skin, you should get a new mammogram, sometimes called a surveillance mammogram, six to 12 months after your treatment ends. Your doctor will use this new baseline mammogram to compare and look for changes in future screenings.
“After a lumpectomy, your mammogram screenings will take place annually as before the procedure,” Dr. Rivera says. “Sometimes the frequency will be adjusted if a shorter interval is required to monitor a specific area of concern.”
Dr. Rivera says he requests diagnostic mammograms for five years after treatment.
“This type of mammogram includes additional views of the lumpectomy area in addition to the typical screening views,” he says.
Some patients benefit from enhanced screening with breast ultrasounds or breast MRIs, he says. “Ask your doctor if you need enhanced screening with additional or more frequent studies or if it’s okay to get them annually.”
If both breasts are removed during a double mastectomy, there is no breast tissue to scan and no mammogram is necessary. However, some women still need screenings after a mastectomy. This includes women who have had a unilateral mastectomy, where one breast remains to be screened.