A mammogram is a common test that can help detect breast cancer in its earliest stages. But if you’ve had a breast reduction, does that mean you should get a mammogram?
The answer depends on your age, size of your breasts, and your doctor’s recommendations.
If you have had a reduction, you may be at increased risk for developing breast cancer. The American Cancer Society recommends that women who have had a reduction begin regular screening at age 40—the same time they would begin screening if they hadn’t had a reduction.
Women who have had a reduction are also recommended to have an annual breast exam by their doctor or nurse practitioner every year starting at age 20. In this post, we will discuss how long should I wait to have a mammogram after breast reduction and can scar tissue in breast cause abnormal mammogram.
Abnormal Mammogram After Breast Reduction
Getting Mammograms After Breast Surgery
Medical Imaging
Mammograms are one of the best ways to detect cancer early, which is when it is the easiest to treat and provides the most successful results. Health professionals recommend routine mammograms for women aged 40 and over — women aged 30 and over if there is a history of breast cancer in the family.
Since radiologists examine the breast tissue for cancerous cells, people who have had breast surgery may wonder if they still need to get regular mammograms. The short answer is: Yes.
Are Routine Mammograms Necessary After Breast Surgery?
As long as there is breast tissue present, there is a risk of breast cancer. Most breast surgeries do not remove the breast tissue, and that tissue may still harbor any abnormalities.
Getting mammograms after breast surgery is especially smart if you’ve had breast augmentation or a breast lift. These procedures often entail repositioning or removing the breast tissue, which changes both the internal and external image of the breast. Because of these changes, any previous mammograms become void, since the breast tissue no longer looks the same.
A mammogram after breast surgery will be necessary to get a clearer idea of what the healthy breast looks like and to create a baseline to compare all future mammograms to. In the case of double mastectomies, future mammograms may not be necessary, because this procedure removes both breasts, leaving no tissue for examination.
Generally speaking, the experience of getting a mammogram won’t change much after breast surgery. It will still consist of the same examination with the technologist taking two images of each breast. Specific breast surgeries, like having breast implants, for example, may require more imaging or further testing to better see the breast tissue.
Mammograms After Different Breast Surgeries
The reasons for breast surgeries vary from cosmetic to health concerns, but the bottom line remains that mammograms after breast surgery can save lives. The changes in breast tissue, as well as potential scar tissue, will change what the breast looks like, requiring either additional tests or new tests, depending on the type of breast surgery had.
Lumpectomy
A lumpectomy — also called a breast-saving surgery — involves removing a cancerous lump or tumor, along with some healthy cells. After a lumpectomy, there is usually still more radiation to complete before the patient can enter remission. Radiation from chemotherapy can change the skin as well as the breast tissue, so a new baseline mammogram will be necessary after treatment.
About six months to a year after treatments, the patient can begin getting regular mammograms again, with the baseline mammogram being the one against which her health care providers will compare all future mammograms.
Sometimes, to even out the shape of the breasts, people elect to have implants or a breast reduction, both of which are procedures that still require routine mammograms going forward. “Routine” can be every year or even every six months, depending on what plan your doctor thinks is best for you.
Breast Lift or Reduction
Both a breast lift — technically known as a mastopexy — and a breast reduction change the shape of the breasts as well as the breast tissue inside. In either case, the doctor may request two mammograms: one before and one after. The one after is crucial, since it will act as the baseline mammogram — the new standard by which the health care team will measure all future mammograms.
The baseline mammogram after breast reduction or mastopexy, will occur approximately six months after the procedure. However, studies have revealed that it may be harder to detect cancerous cells after a breast reduction, suggesting that further imaging may be necessary. Mammograms alone after a breast lift, on the other hand, should be sufficient for breast cancer screening.
Breast Implants
Contrary to popular belief, mammograms are still an essential screening tool, even with breast implants. There will be a slight difference in the process to test for cancer without rupturing the implants.
The main issue with mammograms after breast implants is that the silicone or saline used in most breast implants make it difficult to examine the breast tissue underneath. If the implants sit atop the pectoral muscle, this process is a little easier. Otherwise, the procedure requires a technologist with experience in testing on breast implants.
The technologist will need to shift the implant so the breast tissue is more visible, and they will need to know how much compression to use, since it will be less than the amount used for natural breasts. Additional images will also be necessary to get the clearest images, but even despite all that, the doctor may require more imaging, such as an MRI or an ultrasound.
Mastectomy
Depending on the type of mastectomy you have, you may not need routine mammograms afterward. A mastectomy is the complete removal of the breast and its tissue, and since a mammogram is an examination of breast tissue, it becomes redundant if no such tissue exists, such as in a double mastectomy.
A single mastectomy is the complete removal of only one breast, which means the other breast remains intact, tissue and all, and will need regular mammograms. Similarly, a nipple-sparing mastectomy leaves some breast tissue behind, which needs to undergo regular testing.
Mammograms after a mastectomy mostly apply only to a single mastectomy or a nipple-sparing mastectomy.
A mammogram after a mastectomy is necessary on the remaining breast, where breast tissue remains. Mammograms after a single mastectomy are especially crucial, since the chances of developing cancer in the remaining breast are higher.
In a nipple-sparing mastectomy — technically known as a subcutaneous mastectomy — the surgeon leaves the nipple and a bit of the tissue behind it intact. Enough of the breast tissue remains that routine mammograms are a smart routine procedure.
Breast Reconstruction
If you’ve opted for breast reconstruction after a mastectomy, there’s a good chance you won’t need routine mammograms — as long as there is no breast tissue left to examine.
Just like if you’ve had a double mastectomy and then gotten silicone implants, your original surgery will have removed your breast tissue, so further mammograms won’t be necessary. But if you’ve only had a single mastectomy and gotten a silicone implant on that side while the other side remains unaltered, you’ll need routine mammograms on the side with natural breast tissue.
Sometimes, surgeons can complete a breast reconstruction using tissue from another part of your body, in which case routine mammograms may not be necessary if no breast tissue remains. However, sometimes your doctor might recommend a mammogram or other image testing for several reasons, including having a high risk of reoccurrence or if there is a questionable abnormality.
Schedule Your Next Mammogram
If you’re due for a routine mammogram or need to get a baseline mammogram after breast surgery, Envision Imaging is here to help. Our team of trained technologists aims to provide first-class diagnostic services and excellent patient care.
Breastfeeding After Breast Surgery
Myth: Women cannot breastfeed after getting breast implants or a breast reduction.
Truth: When pregnant or planning to have children, many women who have had breast surgery (breast augmentation or reduction) question whether they will be able to breastfeed. Despite what some women may assume, the answer is often yes.
“The most misunderstood thing about breast surgery is the anatomy,” says Dr. Gedge Rosson, director of breast reconstruction at Johns Hopkins.
During breast augmentation surgery, breast implants are placed between your chest wall and your breast, avoiding interference with the breast ducts or mammary glands from which milk is excreted. While some glandular tissue is removed during breast reduction, in most cases enough breast tissue is left to enable milk production after surgery.
However, while breast surgery doesn’t mean you can’t breastfeed, there is no guarantee that the mother will have a full supply of milk, says Nadine Rosenblum, a nurse and lactation consultant with The Johns Hopkins Hospital prenatal lactation program. Milk supply may also be limited if the type of incision used during breast surgery severs the nerves in the breast and nipple that are stimulated by nursing.
Consult with your reconstructive surgeon and a lactation consultant before your surgery.
Waiting until after you have children to have breast augmentation, reduction or breast lift surgery may help decrease the need for further adjustments or revisions, as your breast tissue may be altered after a pregnancy.
Breastfeeding with breast implants
Most women with breast implants are able to breastfeed, though there are a few exceptions. Whether you’re able to breastfeed depends on the original state of your breasts before surgery and possibly the type of incision used.
Breast implants may affect the amount of breast milk you’re able to produce. But in some, milk supply isn’t affected at all.
You may also worry about the effect breastfeeding will have on your implants. It’s normal for your breasts to change in shape and size during pregnancy and after breastfeeding. Breastfeeding won’t affect your implants, but the size and shape of your breasts overall may be different.
Read on to learn more about breastfeeding with implants.
Effect of implants on breastfeeding
Implants are usually placed behind the milk glands or under the chest muscles, which doesn’t affect milk supply. However, the location and depth of the incision used for your surgery may affect your ability to breastfeed.
Surgery that keeps the areola intact is less likely to cause problems. The areola is the dark area around your nipple.
The nerves around your nipples play an important role in breastfeeding. The sensation of a baby suckling on the breast increases the levels of the hormones prolactin and oxytocin. Prolactin triggers the production of breast milk, while oxytocin triggers the letdown. When these nerves are damaged, sensation is reduced.
Incisions made under the breast or through the armpit or belly button are less likely to interfere with breastfeeding.
Is it safe to breastfeed with implants?
According to the Centers for Disease Control and PreventionTrusted Source, there haven’t been any recent clinical reports of problems in babies of mothers with silicone implants.
There are no methods for accurately detecting silicone levels in breast milk. However, a 2007 study that measured silicon levels didn’t find higher levels in breast milk in mothers with silicone implants compared to those without. Silicon is a component in silicone.
There’s also no evidence of increased riskTrusted Source of birth defects in babies born to mothers with breast implants.
Breast implants do pose some risks to the person, though, such as:
possibility of needing additional surgeries for corrections or removal
capsular contracture, which occurs when scar tissue forms around the implant causing squeezing
changes in breast and nipple sensation
breast pain
rupture of implants
Tips for breastfeeding
There are things you can do to help increase your milk production and help your baby get all the nourishment they need.
Here are some tips to help you breastfeed with implants:
- Breastfeed often
Breastfeeding your baby 8 to 10 times per day can help establish and maintain milk production. The sensation of your baby suckling your breast triggers your body to produce milk. The more often you breastfeed, the more milk your body will make.
Even if you’re only able to produce a small amount of milk, you’re still providing your baby with antibodies and nutrition at each feeding.
Breastfeeding from both breasts can also increase your milk supply.
- Empty your breasts regularly
Emptying your breasts plays an important role in milk production. Try using a breast pump or manually expressing milk after feedings to increase milk production.
A 2012 study found that pumping both breasts simultaneously resulted in increased milk production. It also increased the calories and fat in breast milk.
You can also hand-express or pump into a bottle to feed your baby breast milk if they won’t latch.
- Try herbal galactagogues
There are certain herbs believed to helpTrusted Source naturally increase breast milk production, such as:
fennel
milk thistle
fenugreek
There’s a lack of scientific evidence to back up the effectiveness of herbal galactagogues. Some studiesTrusted Source have found that fenugreek may help increase milk supply, though.
Some people also use lactation cookies. These can be bought online or made at home to try to help increase milk production. These cookies often contain ingredients such as:
- whole oats
- flax seed
- brewer’s yeast
- wheat germ
- herbal galactagogues
Research is limited on the effectiveness of lactation cookies on increasing breast milk production, though. The safety of these for infant exposure has also not been rigorously studied.
- Make sure your baby latches properly
A proper latch can help your baby get the most out of feedings.
The key to a proper latching is ensuring your baby takes enough of your breast into their mouth. This begins with making sure their mouth is wide open when they latch on. Your nipple should be far enough into your baby’s mouth so their gums and tongue cover an inch or two of your areola.
Begin by making sure your baby is positioned well, then guide them toward your breast. Holding your breast just behind the areola with your thumb and forefinger in a “C” position can make it easier for your baby to latch on.
You may consider seeing a lactation consultant, too. They’re usually available through your hospital or doctor’s office. They can observe your feedings and give feedback on your baby’s latch and position.
You can also find local consultants through La Leche League.
- Supplement with formula
If you’re producing small amounts of milk, speak to your baby’s pediatrician or a lactation consultant about supplementing your breastfeeding with formula.
Look for signs that your baby is getting enough milk, such as:
- slow and steady sucking with deep jaw movements while on the breast
- six or more wet diapers and three or more soiled diapers per day
- stools that change from black meconium to yellow, seedy stools
- Your baby’s weight is another indicator of adequate or inadequate milk supply. Most babies lose 7 to 10 percent of their weight in the first two to four days of life before they begin to gain weight.
Tell your baby’s pediatrician if you’re concerned about your milk production or your baby’s weight gain.
How Long Should I Wait To Have A Mammogram After Breast Reduction
It’s important to ensure that your breasts have healed before obtaining a mammogram. It is advised to postpone getting a mammogram for six to twelve months.
Can Scar Tissue In Breast Cause Abnormal Mammogram
radial scarring
Complex sclerosing lesions are another name for radial scars. They are typically discovered when a breast biopsy is performed for another reason. During a mammogram, radial scars can occasionally be seen as a deformation of the healthy breast tissue.
Takeaway
Most women are able to breastfeed with implants. Talk to your doctor or lactation consultant about your concerns. Remember that your baby can benefit from any amount of breast milk you’re able to produce, and supplementing with formula is an option if needed.
