20 février, 2005 16:39
Fake breasts hinder tests for cancer
By Jessica Heslam
Sunday, February 20, 2005
As the number of breast implants skyrockets, Bay State doctors say giving mammograms to women with fake breasts takes double the time.
``Implants are a nuisance for detecting breast cancer,'' said Dr. Daniel Kopans, director of the Breast Imaging Division at Massachusetts General Hospital. ``We do a pretty good job; the problem is they can get in the way.''
While local doctors who do mammograms haven't yet seen a big increase in the number of women with breast implants, women who got them in their 20s and 30s are starting to show up for mammograms, a special X-ray of the breast used to detect breast cancer. Mammograms are given to women beginning around age 40.
The number of women in New England who got breast implants rose from 500 in 1992 to a whopping 36,539 in 2003, according to the American Society of Plastic Surgeons.
In the past, women with implants often avoided mammograms for fear of ruining the implants, but that thinking has changed, doctors said. Breast cancer deaths have decreased by 20 percent since 1990 because of increased mammogram screening.
Doctors have developed techniques to examine the breasts of women with implants, including the implant-displacement view. This involves pushing the implant backwards against the chest and pulling the breast forward into the machine.
``By pushing them against the chest wall, we can bring the breast forward and get a pretty good look at most of the breast tissues, but not as good as if there is no implant,'' Kopans said.
Doctors also have to take two sets of images, one with the implant in normal position and one with it out of view.
``It's a little more radiation,'' added Dr. Max Bermann, associate radiologist at Faulkner
Hospital. ``Theoretically, the less X-ray exposure the better.''
More and more women are getting the implant put behind the chest wall muscle, which makes it easier to do mammograms, doctors said.
When the implant is put behind the chest muscle, it obscures the least amount of breast tissue, said Dr. Elsie Levin, director of the Faulkner-Sagoff Breast Imaging and Diagnosis Centre.
While their West Coast counterparts see many more fake breasts, doctors here get their fair share. Of the 25,000 women who got mammograms last year at Massachusetts General
Hospital, 473 had implants. Bermann sees about two a day.
