High Risk for Breast Cancer

I've had silicone breast implants for 20 years. My breast tissue is very dense, and the implants are on top of the muscle. Mammograms are longer a solution for me, because its just too difficult to get an accurate read. I would like to know if there is a test that I can take to detect cancer cells? What type of specialist should I seek to discuss possibly having them safely removed or replaced with a saline solution.  Thank you.

[PaulMD]

Hi there.

I agree that mammograms and even MRI may have difficulty in evaluating the breast with silicone implants.  Ultrasound examination can be done in lieu of these tests but the accuracy is also somewhat limited and the reporting of results is not standardized as compared to mammogram.  I suggest you still discuss this option (ultrasound) with your doctors if it can be applicable for your.  You may consult a plastic surgeon regarding your plan of substituting saline for your silicone implants.  Regards.