If you have breast implants — either saline or silicone — you can and should continue to have regular mammograms. The screening process is slightly different and takes a little longer, but it remains the foundation of breast cancer screening for women with implants.
This guide walks through what is different about a mammogram with implants, the safety of the procedure for the implant itself, and what additional imaging your doctor may suggest.
Do implants affect what a mammogram can see?
Yes — implants block X-rays, so the breast tissue behind and to the sides of the implant is hidden on a standard mammogram view. To see around them, the mammographer takes two sets of images:
- Standard views: Two views of each breast with the implant in place. These show the front layers of breast tissue.
- Eklund (implant displacement) views: The mammographer gently pushes the implant back toward the chest wall while pulling the breast tissue forward over the compression plate. This brings the natural tissue into view without compressing the implant itself.
So a mammogram with implants typically produces eight images instead of four — two standard plus two Eklund per breast.
What happens during the procedure?
- You undress from the waist up and put on a gown.
- The mammographer asks where your implants are placed — most are behind the breast tissue but in front of the chest muscle (subglandular), while some are behind the muscle (submuscular). Submuscular implants are usually easier to image around.
- Standard views are taken first.
- For the Eklund views, the mammographer carefully manipulates the implant backward and the breast tissue forward. This step takes a little longer than a routine mammogram.
- Compression is firm but gentle. The mammographer is trained not to over-compress the implant.
The whole appointment usually takes 25 to 40 minutes — a bit longer than a standard screening exam.
Can compression damage my implant?
Implant rupture from a mammogram is very rare
Modern implants are designed to tolerate the compression of a mammogram. The risk of rupture from a properly performed mammogram is extremely low — far lower than the risk of missing a breast cancer by skipping the exam. If you have any concerns about the integrity of an older implant, mention it to your mammographer beforehand.
If you have any current implant pain, recent surgery, or a concern about a leak, tell the mammographer before the exam so they can adjust the pressure and consider whether a different imaging test is more appropriate first.
Do I need to prepare differently because I have implants?
Preparation is the same as any mammogram:
- No fasting is required.
- Avoid deodorant, perfume, lotion, or powder on your chest and underarms.
- Wear a two-piece outfit.
- Tell the imaging centre when you book that you have implants, so they can allocate extra time and assign a mammographer experienced with Eklund views.
- Bring your implant surgery records if you have them. Knowing the year, type, and placement helps both the mammographer and the radiologist.
Will the mammogram show problems with the implant itself?
A mammogram is mainly for finding cancer in breast tissue, not for assessing the implant. Some signs of implant rupture or capsular contracture can appear on a mammogram, but the dedicated test for implant integrity is a breast MRI or sometimes a breast ultrasound. The FDA in the United States recommends an MRI 5 to 6 years after silicone implant placement and every 2 to 3 years after that — a useful framework even outside the US.
Are there extra screening tests if I have implants?
Many doctors recommend pairing a mammogram with a whole-breast ultrasound for women with implants, especially if you have dense breasts. Ultrasound can sometimes reveal lesions that sit close to the implant where mammographic visibility is limited. Discuss what is appropriate for you with your doctor.
Is the radiation dose higher because there are more views?
Slightly. Because eight views are taken instead of four, the cumulative radiation is roughly double a standard screening exam — but still very small in absolute terms, and still well within international safety limits. The diagnostic benefit far outweighs this additional dose for women at screening age.
What if my centre is not experienced with implant mammograms?
Implant mammography is a specific technique that requires training and practice. If you have implants, ask the imaging centre when you book whether their mammographers are trained in Eklund views. A centre that does this routinely will say so without hesitation. If the answer is unclear, consider a centre with more volume.
Conclusion
Breast implants do not exempt you from breast cancer screening — if anything, the standard screening schedule becomes more important because implants make the breasts slightly harder to image. With a trained mammographer using Eklund views and (often) a complementary ultrasound, women with implants can get the same high-quality screening as anyone else.