Q: I have a family history of breast cancer. My grandmother had breast cancer and my aunt is currently being treated with chemotherapy for breast cancer. I have been considering breast implants because one of my breasts is larger than the other. Would having breast implants increase my risk of breast cancer?

A: Getting breast implants may interfere with your doctor's ability to detect breast cancer, because breast implants can interfere with mammography. This could cause a dangerous delay in diagnosis.

Because of that problem, women who have breast implants need specialized mammograms for the rest of their lives. Unfortunately, most women do not get specialized mammograms, and many women with implants avoid mammograms entirely because they are afraid the implants will break.

If there is a cancer tumor growing, breast implants might hide it from view, and it might not be seen until it gets bigger. That can lead to a delay in treatment. And early detection and treatment are the best weapons against breast cancer. If breast cancer is detected and treated at its earliest stages, 90 to 95% of women are healthy 10 years later. That number drops to 40% if the cancer is more advanced and has spread.

Mammograms are imperfect, missing approximately 15% of breast cancers in a natural breast. According to Dr. Wendie Berg, Director of Breast Imaging at the Department of Radiology of the University of Maryland, that error rate is much higher for women with breast implants. Even when specialized mammography techniques are used, approximately 28% of cancers would not be visible. Mammography is even less accurate for women with capsular contracture (a common condition where scar tissue tightens around the implant, making the breast feel hard) or very large implants relative to the size of their natural breast tissue.

You are right to be thinking about whether breast implants might increase your risk for breast cancer. Although there are no studies that show that implants increase the risk of getting breast cancer, implants do cause a significant problem with breast cancer detection. If one in eight of the approximately 1.5-2 million women who have implants get breast cancer in their lifetime, it is likely that the cancer diagnoses of 20,000 to 40,000 of those women will be delayed because their implants interfere with mammography.