Letters Section Editor: Stephen J. Lurie,
MD, PhD, Senior Editor.
To the Editor: Dr Miglioretti and colleagues1 concluded that breast augmentation decreases the
sensitivity but not the specificity of screening mammography. In the absence
of information on implant type and placement (ie, subglandular or subpectoral)
and prevalence of capsular contracture, however, it is difficult to know how
to apply these results. For example, Silverstein et al2 reported
that women with subglandular implants had a 49% mean decrease in measurable
tissue area using compression mammography and a 39% mean decrease using displacement.
Women with submuscular implants had a 28% decrease in measurable tissue with
compression mammography as compared with a 9% decrease using displacement.
Steiner DJ, Schwager RG, Lewittes DJ. Effects of Breast Augmentation on Accuracy of Mammography. JAMA. 2004;291(17):2073. doi:10.1001/jama.291.17.2073-a