To the Editor.—The major point of the article by Silverstein et al1 in the June 1988 issue of the Archives entitled "Breast Cancer in Women After Augmentation Mammoplasty" seems to be that augmentation mammoplasty with silicone-gel—filled implants make film-screen mammography, our best diagnostic tool, less sensitive. I must politely disagree.
In conjunction with our mammographer, G. William Ecklund, MD, we have shown that state-of-the-art mammographic cancer surveillance is possible in augmented breasts if specialized techniques are utilized.
Selected patients who have undergone augmentation mammoplasty during the past several years have demonstrated to us the advantages of modified patient positioning and compression techniques to optimize breast tissue visualization (Figure). Five views are routinely utilized for each breast: the standard mediolateral oblique and vertical craniocaudal repeated standard views with anterior compression and a 90° mediolateral compression view. Magnified views, focal compressed magnified views, and the use of lead markers have
MILLER SH. Cancer Surveillance After Augmentation Mammoplasty. Arch Surg. 1989;124(1):134. doi:10.1001/archsurg.1989.01410010144031