Technical
Problems with the Breast Examination
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From Love SM: Dr. Susan Love's breast book, ed
2, Reading, Mass, 1995, Addison-Wesley.
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Women with implant reconstruction (usually
a saline-filled bag inserted under the pectoral muscles of the
chest) should have an examination in which changes in the implant
shape suggesting adhesions are noted. Native tissue reconstruction
is an extensive surgical procedure in which tissue is taken
from gluteal, lattisimus dorsi, or abdominal areas to form breast
mounds. This native tissue is not at risk for breast cancer,
but the surgical sites are, and they should be thoroughly examined.
Women who have had breast augmentation or
reduction should have routine CBEs performed as already described.
However, a woman with breast augmentation should have screening
mammograms done at a mammographic facility that reads many such
mammograms. The mammogram requisitions for these women should
clearly state that they have had augmentation surgery.
If the breast examination is difficult because
of augmentation or reduction surgery, very dense or extremely
large breasts, or the presence of multiple biopsy site scars,
the patient should be referred to a surgeon for evaluation (Cady).
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