Screening and diagnosis of breast cancer in augmented women

Cosmetic breast enlargement surgery has become common in Japan. There are some reports suggesting that implants can interfere with mammography (MMG) and may lead to delayed breast cancer diagnosis, even when implant-displaced MMG (Eklund technique) is performed. Screening MMG was recommended in a notification issued by the Japanese Ministry of Health, Labor and Welfare in 1999, and MMG is just coming into widespread use in Japanese breast cancer screening. Recent reports suggest that screening MMG may not be appropriate in augmented women, but breast self-examination may be effective in these women. Ultrasonography (US) may be useful in screening augmented women without risk of rupturing the implant. In appropriate cases, magnetic resonance imaging should be considered as an adjunct to MMG and US. The question of whether augmented women should not undergo core needle biopsy because of the possibility of damage to the implant should be considered. This review discusses diagnostic methods for augmented women and suggests the optimal screening method for augmented women. The challenge of the screening and diagnosis of breast cancer in augmented women is important in order to detect more of their cancer at a preclinical stage, because we can expect to see breast cancer in augmented women with increasing frequency over the next decade.