Review Question - QID 102614

Women with breast implants should undergo breast cancer screening at the same schedule as women without breast implants. Since this woman is younger than 50 with no significant risk factors and no family history of breast cancer, no testing is indicated at this time.

Women may have breast implants for any number of reasons. There is a noted correlation of certain types of cancer (anaplastic large cell lymphoma) in patients with silicone implants. The screening recommendations for women with breast implants (that are stable and not causing issues) is the same as for women without breast cancer, which include mammography starting at age 50. Women with first degree relatives that have been diagnosed with breast cancer could begin screening earlier than the typical age of 50 depending on their history. Additionally, women who place higher value on the potential benefits versus the harms of earlier screening may choose to begin mammography between age 40-49. However, screening may lead to false-positive results and unnecessary biopsies.

Incorrect Answers:
Answer 1: BRCA genetic testing is not a routine screening test; however, it can be performed in patients for whom there is concern for familial breast/ovarian cancer.

Answer 2: Mammography recommendations for patients with or without breast implants are the same with recommendations being that screening should start at age 50.

Answer 4: Sentinel node biopsy would be indicated after an abnormal mammogram has been found and after a biopsy of the abnormal lesion.

Answer 5: Ultrasound is the screening test of choice for a mass found in the breast of a young woman since young women have denser breasts that are better imaged by ultrasound.

Bullet Summary:
Patients with or without breast implants (that are stable and without issue) should have mammography that begins at age 50, unless they are at increased risk for breast cancer (in which case screening may begin earlier).