Abstract
BackgroundWomen with aesthetic prostheses must be included in the target population of mammography screening programmes. Breast implants are radiopaque and partially obscure the breast tissue. This can be avoided with the use of the Eklund technique, which causes an increased radiation exposure. In this study, augmented women undergoing a dedicated protocol within a population-based screening programme were compared according to selected indicators with the standard screening population. Essential dosimetric parameters and their time trend were also assessed.Materials and methodsThe study was conducted in a screening centre in Milan in the years 2009–2016. The screening protocol for women with breast implants included a double-read mammography with the Eklund views, ultrasound and clinical breast examination.ResultsA total of 28,794 women were enrolled, including 588 (2%) women with breast implants and 28,206 (98%) undergoing the standard screening protocol. The invasive assessment rate was 9.0‰ for women with breast implants vs. 15‰ in the standard cohort. The surgical referral rate was 2.2% vs. 0.9%. The detection rate was similar in the two groups (4.0 and 4.5‰, respectively). There were significant differences in the average glandular dose according to the mammography equipment. The use of the Eklund views increased over time.ConclusionsScreening of augmented women according to a specific protocol in the contexts of population-based programmes is feasible. Observed differences in screening indicators relative to the standard screening population require further research. The increasing use of Eklund views probably results from quality assurance measures associated with screening programmes.
Highlights
Breast augmentation is one of the most frequently performed aesthetic surgeries among women
This study is the first to report screening indicators and dosimetric parameters collected in sessions of a breast cancer screening programmes (BSP) dedicated to augmented women in Italy and elsewhere
Despite the limitations of this study, our experience shows that the management of these patients is feasible and can improve over time—provided that they are referred to a specialized centre where the staff is properly trained and the mammography system is up-to-date and subjected to quality control programme
Summary
Breast augmentation is one of the most frequently performed aesthetic surgeries among women. Breast implants are radiopaque and partially obscure the breast tissue This can be avoided with the use of the Eklund technique, which causes an increased radiation exposure. In this study, augmented women undergoing a dedicated protocol within a population-based screening programme were compared according to selected indicators with the standard screening population. The screening protocol for women with breast implants included a double-read mammography with the Eklund views, ultrasound and clinical breast examination. Results A total of 28,794 women were enrolled, including 588 (2%) women with breast implants and 28,206 (98%) undergoing the standard screening protocol. The invasive assessment rate was 9.0‰ for women with breast implants vs 15‰ in the standard cohort. Conclusions Screening of augmented women according to a specific protocol in the contexts of population-based programmes is feasible. The increasing use of Eklund views probably results from quality assurance measures associated with screening programmes
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