Oct 20, 2021 9:00 AM

Read time: 3 minutes


Provider helps patient get positioned for a mammogram

Huntsman Cancer Institute (HCI) and University of Utah Health (U of U Health) recommend all women receive a breast cancer screening (mammogram) every year, starting at age 40. Mammograms are the best way to find breast cancer early, when it is easier to treat. Some women wonder whether a mammogram will work for their breast type.

Breast radiologist Phoebe Freer, MD, answers common questions women ask her about whether mammograms work for small breasts, dense breasts, and breasts with implants.

Can you have a mammogram if you have small breasts?

Yes. A mammogram takes pictures of breasts as long as there is some amount of tissue to place on the paddle. In most cases, women who have not had their breasts removed can have their breast tissue placed on the machine for a mammogram.

If you have had a mastectomy (surgery to remove the breast tissue), you probably will not need mammograms. In rare cases, breast tissue remains after a mastectomy. Those patients may be able to have a mammogram.

Do mammograms work on dense breasts?

It can be a bit harder to detect breast cancer in dense breasts. Dense breast tissue and abnormal masses both look white on a mammogram. Women with denser breasts are at a slightly increased risk of getting cancer.

When you get a mammogram, your radiologist will tell you if you have dense breasts. The radiologist will let you know if you need a different screening plan. This may include breast MRI. Breast MRI is not recommended as standard screening. However, it may be recommended for women with dense breasts and women who are at high risk for cancer.

Breast screening with ultrasound is not usually recommended. Studies show ultrasound finds some cancers not seen on mammograms, but it also has a much higher rate of finding changes that are not cancer. This may lead to additional follow-ups and unnecessary biopsies.

Your radiologist will talk with you about the best screening plan if you have dense breasts.

Is a 3D mammogram better for dense breasts?

Yes. A 3D mammogram (tomosynthesis) creates a better picture of the breast. Studies show tomosynthesis is better at detecting cancers in women with dense breasts compared to mammograms. HCI and U of U Health facilities all offer tomosynthesis as normal practice.

Can I have a mammogram with breast implants?

Yes. If you have breast implants, keep getting annual mammograms. Implants may make it harder for a mammogram to detect breast cancer, but mammograms are still the best screening test.

How does a mammogram work if you have breast implants?

The technologist takes four images of each breast: two with the implant in the image, and two with the implant pushed out of the image. This gets as much breast tissue in the mammogram image as possible. 

If you have implants, and you are at high risk for breast cancer and meet other criteria, your doctor may recommend MRI screening as well. We do not normally recommend screening breast MRI for patients with breast implants who are at average risk for breast cancer.

Should I be worried about my textured implants causing cancer?

Reports show that a very small number of people with textured implants were diagnosed with a rare blood cancer called anaplastic large cell lymphoma (ALCL). This lymphoma is treatable and has a relatively good prognosis. The typical treatment is removal of the implant. If you have textured implants and you notice swelling, pain, or a lump in your breasts, tell your doctor.

All women with textured implants should get annual mammograms.

Talk to your doctor if you have questions about breast cancer screening. You can contact the Cancer Learning Center at Huntsman Cancer Institute if you have questions about any cancer topic:

breast cancer cancer screening health education

Cancer touches all of us.

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