Mammograms in Cosmetic Breast Surgery

Abstract

Introduction: The use of preoperative and postoperative mammograms in cosmetic surgery has never been standardized. This article discusses the medical benefits and legal issues of preoperative and postoperative mammograms in cosmetic breast surgery. Method: Review of the literature and a retrospective review of case. Results: The purpose of a preoperative mammogram is to detect any significant disorder of the breast(s) before cosmetic surgery so that the problem can be resolved before or during surgery. After cosmetic breast surgery, routine mammograms (6 to 12 months after surgery) help to formulate a baseline for the future detection of breast cancer. The changes that result from cosmetic breast surgeries, such as architectural scars, calcifications that form around an implant or around fat necrosis, and tissue thickenings make it more difficult to distinguish surgery artifacts from cancerous tumors. Discussion: It is the surgeon's choice whether to order a mammogram before cosmetic breast surgery on a patient under the age of 40. Patients under the age of 40 who refuse to have a requested preoperative mammogram may be safely operated upon, but the refusal should be noted in the medical record. This will help to protect the physician if there is future litigation. It is also the physician's choice whether to do cosmetic breast surgery on patients over the age of 40 who refuse a preoperative mammogram. Conclusion: Whether a mammogram is performed or not, the patient should be fully informed of the possible consequences of missing a significant abnormality early before surgery and that an implant or cosmetic surgery may reduce the chance of early detection of cancer.