Mammograms and Other Breast Imaging Tests

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Mammograms in special circumstances

Mammograms for younger women

Mammograms can be more difficult to read in younger women, because their breast tissue is more often dense and this can hide a tumor on an x-ray.

For some younger women who are at high risk for developing breast cancer (due to a gene mutation, a strong family history, or previous radiation to the chest for cancer), the American Cancer Society recommends screening with yearly breast MRIs and mammograms beginning at age 30 and continuing for as long as the woman is in good health. But because the evidence about the best age at which to start screening is limited, this decision should be based on discussions between patients and their health care providers, taking into account personal circumstances and preferences.

Our document called Breast Cancer: Early Detection gives more details about the American Cancer Society breast cancer screening recommendations. It also tells you more about figuring out your breast cancer risk.

Mammograms for women with breast implants

Women who have implants are a special challenge for mammogram screening. The x-rays used for imaging the breasts cannot go through silicone or saline implants well enough to show the breast tissue that is over or under it. This means that the part of the breast tissue covered up by the implant will not be seen on the mammogram.

In order to see as much breast tissue as possible, women with implants have 4 extra pictures (2 on each breast) as well as the 4 standard pictures taken during a screening mammogram. In these extra x-ray pictures, called implant displacement (ID) views, the implant is pushed back against the chest wall and the breast is pulled forward over it. This allows better imaging of the front part of each breast. Implant displacement views are more difficult (and can be less comfortable) in women who have had hard scar tissue form around the implants (contractures). They are easier in women whose implants are placed underneath (behind) the chest muscle.

Although these women do have more pictures taken at each mammogram, the guidelines for how often women with implants should have screening mammograms are the same as for women without them. (See Breast Cancer: Early Detection for the American Cancer Society’s breast cancer screening guidelines.)

A ruptured (burst) implant can sometimes be diagnosed on a mammogram, but a ruptured implant will often look normal. Magnetic resonance imaging (MRI), on the other hand, is extremely good at finding an implant rupture. See the next section of this document for more information on MRI.

Very rarely, mammograms can cause an implant to rupture. It’s important to tell the technologist before your mammogram if you have implants.

Last Medical Review: 12/08/2014
Last Revised: 10/20/2015