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Effects of Breast Augmentation on Accuracy of Mammography—Reply
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In Reply: We agree with Dr Steiner and colleagues that the accuracy of mammography in women with breast augmentation may be influenced by implant placement, presence of capsular contracture, and type of views obtained. Unfortunately, we did not have information on these factors in our study. The studies mentioned by Steiner et al examined measurable tissue area and mammogram quality, not mammography accuracy. One study not mentioned by Steiner and colleagues found no difference in the sensitivity of pretreatment mammography by implant position. Sensitivity was 65.7% for subglandular implants compared with 66.7% for subpectoral implants.1
Although mammography does not detect cancer as well in women with breast augmentation, we found no evidence that this results in more cancers diagnosed at a more advanced stage. We believe that women with augmentation should be encouraged to continue to receive screening mammography, but should not be reassured by a negative mammogram result if . . . [Full Text of this Article]
Diana L Miglioretti, PhD
Center for Health Studies
Group Health Cooperative
Seattle, Wash
Karla Kerlikowske, MD
Department of Veterans Affairs
University of California, San Francisco
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