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Breast augmentation may interfere with mammography interpretation

The JAMA Network Journals

Breast augmentation may interfere with the interpretation of mammography examinations for asymptomatic women, however, there is no evidence that women are diagnosed with more advanced cancers compared with women without augmentation, according to a study in the January 28 issue of The Journal of the American Medical Association (JAMA).

Breast augmentation (implants) is the third most common type of plastic surgery performed for cosmetic reasons in the United States with 268,888 procedures performed in 2002, according to background information provided by the authors.

Diana L. Miglioretti, Ph.D., from the Group Health Cooperative, Seattle, and colleagues, evaluated data from seven U.S. mammography registries that participate in the Breast Cancer Surveillance Consortium. The researchers compared data between women with and without augmentation to determine mammography accuracy and tumor characteristics to determine if there was a difference between the two groups.

"Among asymptomatic women, the sensitivity of screening mammography based on the final assessment was lower in women with breast augmentation versus women without (45 percent versus 66.8 percent)," the authors report. The authors define sensitivity of mammography as the proportion of positive mammograms among women diagnosed with breast cancer within one-year of their examination. "And specificity was slightly higher in women with augmentation (97.7 percent vs. 96.7 percent)." Specificity was defined as the proportion of negative mammograms among women without cancer. The authors state that the prognostic characteristics of tumors (stage, size, estrogen-receptor status, and nodal status) were not significantly different in women with breast augmentation compared with those without augmentation.

"Although the sensitivity of screening mammography is lower in asymptomatic women with breast augmentation, there is no evidence that this results in more advanced disease at diagnosis compared with women without augmentation. Women with breast augmentation should be encouraged to have routine screening mammography at recommended intervals," the authors conclude. (JAMA. 2004;291:442-450. Available post-embargo at


Editor's Note: Dr. Miglioretti is a statistical consultant for Silimed Inc., which manufactures breast implants. This work was supported by the National Cancer Institute (NCI)-funded Breast Cancer Surveillance Consortium cooperative agreement.

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