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How can you tell the difference between breast hardening from augmentation or cancer?

Q:

I've had my implants since I was 23; I'm now 36.  My right breast is starting to feel more firm than the left one.  I don't notice it so much when I'm leaning forward but lying on my back is when it feels much firmer.  I can't tell whether this would be a capsular problem or firmness of the breast caused by cancer.  Please advise.

A:

Both breast cancer and implant capsular contracture feel firm. The trick is to determine if the firmness is round and smooth like an implant would be and in the proper place. The normal breast tissue can usually be felt above this. Inflammatory breast cancer, however, can also be smooth and round. Therefore, you need an expert examining your breasts and possibly a mammogram or MRI to tell if this is a peri-implant capsular contracture or a breast cancer. Make an appointment with a plastic surgeon immediately.

R. T. Buchanan, MD

A:

Thank you for your question. You have your implants in for 13 years and if capsular contracture is the issue, most likely this affects the whole breast. If it is a possible cancerous grows, this most commonly affects a smaller area on the breast. You do not state if you have silicone gels or saline implants. You need to make an appointment with your plastic surgeon to be evaluated and examined. He/she will recommend the appropriate treatment based on their observation/examination. You might need a mammogram or MRI of the breasts to help guide the diagnosis. Do not panic, it is not an emergency, but you need to act on it within the next 1-2 weeks. This will also put your mind at ease and avoid unneccessary worries. Good luck.

G. Marosan, MD

A:

Susan,

Thank you for your important question. Capsular contracture is by far the most common cause of firmness in patients with breast implants. However there are forms of breast cancer that can cause firmness although they are usually associated with inflammation and redness.

The most important thing for you to do is to see your doctor soon and have an examination. Based on your exam he or she will order appropriate diagnostic tests.

A:

You have your implants for thirteen years. Patients with breast implant must have yearly follow up with their  plastic surgeon. The firmness in the breast after breast implants most probably is capsular contracture. There are other conditions that can cause the firmness as well, but this needs to considered after physical examination. Seromas can cause firmeness, hematoma. After physical examination a mammogram, or better an MRI can give you a diagnosis, or a pth to follow to reach a diagnosis. I understand your concerns about breast cancer, but usually very few breast cancers can cause general firmness of the breast, it is usually associated with skin changes as well.

Consult your plastic surgeon and after examination can proceed with appropriate diagnostic tests and then a plan of treatment

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