Mammograms With Breast Implants: What Changes, What to Tell the Clinic and How Accurate They Are
MSc, MD Ho Cao Vu
Medical practice licence No. 028475/BYT-CCHN, issued by the Ministry of Health of Vietnam on 28 June 2018. Specialist in General Surgery and Plastic & Aesthetic Surgery, with over 15 years of experience in plastic and aesthetic surgery and over 20 years of general surgical experience in benign breast disease, breast cancer, abdominal wall and abdominal surgery at Cho Ray Hospital.
Updated October 2026 — cross-checked against the American Cancer Society’s guidance on mammograms for women with breast implants, the JAMA cohort study of mammography accuracy after breast augmentation and the FDA’s risks and complications page.
Women with breast implants often ask whether they still need mammograms, whether the scan can damage an implant, and whether implants make cancer harder to find. The short version is that screening still applies, the technique is adapted, and the accuracy is lower than in women without implants, but not in the way many people fear. This article sets out what the main sources say and where the evidence runs out.
Do women with breast implants still need mammograms?
Yes. The American Cancer Society says that women with implants should still have regular screening mammograms at the ages and intervals recommended for everyone else. The one exception it names is a woman who had both breasts removed (a bilateral mastectomy) before the implants were placed, because there is then no breast tissue left to screen in the usual way.
Having implants does not change the age at which screening starts or how often it is offered. If you are unsure which schedule applies to you, that is a question for your own doctor, because it depends on your age and history rather than on the implants.
Why implants make mammograms harder to read
A mammogram is an X-ray image, and an implant sits in the same space as the tissue the radiologist is trying to see. The American Cancer Society states that both silicone and saline implants can make it hard for the doctor to see the breast tissue lying in line with them. Part of the breast is, in effect, partly hidden behind the implant on a standard image.
This is the reason the technique changes for women with implants, and it is also the reason accuracy is lower, as the research below shows.
What extra pictures are taken
Women with implants usually have the standard screening views plus additional images called implant displacement (ID) views, a method described by Eklund and colleagues in 1988. In an ID view the implant is pushed back towards the chest wall and the breast tissue is pulled forward over it before compression. This lets the radiologist see the front part of each breast more clearly.
According to the American Cancer Society, women with implants have four extra pictures, two on each breast, in addition to the four standard screening images. The additional views are harder to perform and can be more uncomfortable if scar tissue (capsular contracture) has formed around the implants. They are easier to obtain when the implants lie beneath the chest muscle. If you have had tightness or hardening of the breast, our article on capsular contracture explains what it is and how it is assessed.
What the research shows about accuracy
The most cited study is a prospective cohort in JAMA by Miglioretti and colleagues, using seven mammography registries in the United States. It included women with breast cancer diagnosed between 1995 and 2002 (137 with augmentation and 685 without) and more than 985,000 women without cancer, of whom 10,533 had augmentation.
Among women with no symptoms, screening mammography detected 45.0% of cancers in women with augmentation (95% confidence interval 29.3% to 61.5%) compared with 66.8% (60.4% to 72.8%) in women without implants, a statistically significant difference. In plain terms, mammography missed more cancers when implants were present.
Two other findings matter as much. Implants did not raise the false-positive rate; specificity was 97.7% in women with augmentation against 96.7% without, so false alarms were not more frequent. And the cancers found were similar between the groups in stage, size, hormone-receptor status and lymph-node involvement, with the authors concluding that augmentation did not affect prognostic tumour characteristics.
These results come with limits. The group of women with augmentation who developed cancer was small, which is why the confidence interval is wide. The data were collected between 1995 and 2002, so they do not describe imaging as it is performed today. The study did not report whether extra views, ultrasound or MRI close the gap.
Can a mammogram damage an implant?
The American Cancer Society says that very rarely the mammogram process can rupture an implant, and the FDA lists compression during a mammogram among the possible causes of rupture. The American Cancer Society gives this as a reason to tell the facility about the implants before the scan, not a reason to avoid screening. The sources reviewed here do not give a rate for this event, so no percentage is quoted. Other causes of rupture are covered in our article on why implants rupture.
A different kind of false alarm: calcium deposits
Scar tissue around an implant can harden and form calcium deposits. The FDA notes that these deposits can be mistaken for cancer during mammography, resulting in additional surgery. This does not contradict the JAMA finding that false-positive rates were not higher in women with implants; it is a reminder that an unusual finding should be compared with earlier images and, where needed, assessed with further imaging before a decision about surgery is made. Telling the radiologist how long you have had the implants helps with that comparison.
Mammography is not the test for the implant itself
Checking whether a silicone gel implant has ruptured without symptoms is a different question from screening for cancer. The FDA states that magnetic resonance imaging (MRI) is the most effective method for detecting silent rupture, and that ultrasound is an acceptable alternative for people without symptoms. A mammogram is not one of the methods it names for this purpose. Our articles on silent rupture and on the FDA’s screening recommendation explain when these checks are advised.
How to prepare for the appointment
Tell the clinic about your implants when you make the appointment, and tell the technologist again before the scan begins. The American Cancer Society recommends saying so at the time of booking so that you can ask whether the facility has experience with implants. A few practical questions are worth asking:
- Does the centre routinely take implant displacement views?
- Will the radiologist who reads the images know about the implants?
- If the breasts are firm or tight from scarring, can extra time be allowed?
Bring the details of your surgery if you have them, including the date, whether the implants are above or below the muscle, and the implant type. This helps the technologist plan the views.
Frequently asked questions
Will implants cause more false alarms? No. In the JAMA study, the false-positive rate was not higher in women with augmentation; specificity was slightly higher.
Does it hurt more with implants? The extra images can be uncomfortable, especially if scar tissue has formed around the implants. They tend to be easier when the implants are beneath the muscle.
Should I skip mammograms to protect my implants? No. The American Cancer Society advises that women with implants should still have regular screening mammograms, and it presents the rare risk of rupture as a reason to inform the facility, not to avoid screening.
Does a lower detection rate mean implants cause cancer? No. The JAMA study measured how well mammography detects cancer, not whether implants affect the chance of developing it, and tumour stage and size were similar in the two groups. Separately, the FDA states that it has not found an association between silicone gel-filled implants and breast cancer.
Conclusion
Women with breast implants should keep up regular screening mammograms. The technique changes to include extra implant displacement views, and in one large registry study mammography detected fewer cancers in women with augmentation, though it did not produce more false alarms and the tumours found were of similar stage. The practical steps are to tell the clinic about the implants when booking and again on the day, to ask whether extra views are routine, and to keep implant checks as a separate matter from cancer screening.
References
- American Cancer Society — Mammograms for Women with Breast Implants (last revised 23 July 2026) — https://www.cancer.org/cancer/types/breast-cancer/screening-tests-and-early-detection/mammograms/mammograms-for-women-with-breast-implants.html
- U.S. Food and Drug Administration — Risks and Complications of Breast Implants (updated 14 December 2023) — https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants
- Miglioretti DL, Rutter CM, Geller BM, Cutter G, Barlow WE, Rosenberg R, Weaver DL, Taplin SH, Ballard-Barbash R, Carney PA, Yankaskas BC, Kerlikowske K. Effect of breast augmentation on the accuracy of mammography and cancer characteristics. JAMA 2004;291(4):442–450 — https://doi.org/10.1001/jama.291.4.442
- Eklund et al. Improved imaging of the augmented breast. American Journal of Roentgenology 1988 — cited by the American Cancer Society page above; not read directly.
