Management of women with breast implants
BreastScreen Australia's policy for managing women with breast implants.
Services within BreastScreen Australia will screen women with Breast Implants providing they meet age criteria and other eligibility criteria applying in various state programs.
The usual two year screening interval will apply, unless an earlier mammogram is indicated for reasons stipulated in the existing early recall policies of state programs.
Screening location
Women with breast implants will be recruited to a screening unit with facilities for on-site processing. Women attending a screening service without on-site processing should be informed of the limitations and consequences of this. Services with associated screening units that do not have on-site processing will have procedures in place to divert women to an alternative screening unit, preferably within the National Program.Management through the screening pathway
Prior information
Services need to ensure that frontline staff have received training about and are familiar with policies relating to screening women with implants.
Services will have discrete procedures in place, as far as possible, to identify women with breast implants before the time of their appointment. A longer appointment time will be scheduled to allow for the extra mammography views required.
Every effort will be made to give women with breast implants information concerning mammography screening and breast implants before their appointment. They should be given enough time to make an informed decision about participating in screening.
Services may suggest that women attend their General Practitioner prior to their screening appointment to establish that screening mammography through BreastScreen Australia is suited to their particular circumstances.
Top of page
Consent
Services will have a consent form which is suitable for women with breast implants. state and territory Coordination Units must check the medico-legal status of these consent forms.Women with implants should not be asked to sign the consent form until they have been provided with the information listed in 'Information for Women with Breast Implants'.
Women who do not sign the consent form will be offered counselling, but not admitted for screening.
Imaging
Mammography will be carried out by radiographers with specific training in screening women with implants. Radiographers should use the procedures outlined in the protocol, 'Mammographic Technique for Imaging the Augmented Breast'.Mammographically detected implant problems
Services will have protocols in place for informing women as soon as possible if the mammogram shows implant damage. If the woman agrees, their General Practitioner will also be informed.Protocols will specify when and by whom women will be informed of implant damage and outline referral procedures.
Top of page
Post screening assessment
All women with implants, regardless of the result of their screening mammogram will be asked to attend assessment. This attendance is desirable so that women with implants may receive counselling:- regarding the limitations and risks associated with screening in the presence of implants.
- to encourage clinical examination of the breast at intervals recommended by their General Practitioner or breast specialist.
- to encourage attending their usual breast specialist at regular intervals if their implants have been inserted following surgery for breast cancer.
Unsuited to breast cancer screening
For a small number of women with breast implants, mammography is a poor screening tool. It may be physically impossible to take a mammogram (eg. they have negligible breast tissue over the implant) or inadequate quality of the films may be identified by the radiologist at the time of reading (eg. there is silicone contained in a fibrous capsule around the implant).If it is determined by clinical examination or by the radiologist at the time the films are read, that a woman is not suited to screening mammography, state protocols should be in place to provide counselling, refer the woman for assessment (within the Program or with her General Practitioner) and facilitate her discharge from the Program. The order of these events is dependent upon the point at which the decision is made that the woman is unsuited to mammography screening.
Page currency, Latest update: 01 September, 2006