Breast Cancer and Janice Dickinson: Silicone Dilemmas Part I

Janice Dickinson went public a few months ago about having breast cancer.   It seems that there is a celebrity or public person every week who goes public with their breast cancer story. It shouldn’t be surprising. Celebrities and public figures are not immune from breast cancer. After all, it is the most common form of cancer that women develop

What was striking about Janice Dickinson’s public story is that she zeroed in, perhaps unwittingly, on the problems of implants in diagnosing breast cancer. Perhaps it is her openness about her implants in general that made this possible. Earlier, she was featured on “Botched,” a reality TV show that followed her through an operative revision of her implants and a cancer scare. In her latest interview she expressed regrets at having implants in the first place.

Dr. Steven Sferlazza, a mammography specialist at Lenox Hill Radiology in New York City, highlights the problems that implants pose for diagnosing breast cancer. “Performing mammograms on patients with implants is difficult. It takes twice as long to do the study. It exposes the patient to twice as many x-ray exposures. It involves manipulating the implant and the breast tissue to get a decent picture. Much depends on the amount of breast tissue that remains and the mobility of the implant. Invariably, areas of the breast usually visualized on normal mammography are not as well seen. Cancers can be missed.”

Supplementary breast sonography and MRI can help, though each has its limitations and downsides. Dr. Sferlazza  continues, “All in all, there is no perfect imaging study for women with implants. Problems can be missed. Implants are a challenge.”

With all the attention Ms. Dickinson’s implants have received, she has hopefully brought to public attention the dilemmas the radiologist has to confront and the risks patients are taking. Regrets aside, she is starting radiation with her implants intact, which poses another problem for the radiotherapist. I will address this in a later post.

Just from watching, reading about, and listening to Janice Dickinson, I have a feeling breast cancer should not mess with her….