Breast reconstruction may cause inaccurate cardiac imaging results

Breast reconstructive surgery can hinder radiologists’ ability to interpret cardiovascular imaging exams, experts reported recently. They called on the specialty, and other doctors, to investigate which tests can best assess this vulnerable population.

More than 50% of women treated for invasive breast cancer opt to have breast implants following their mastectomy, with demand only projected to increase. But these patients often face a higher risk of developing cardiovascular disease, making accurate cardiac imaging diagnoses crucial.

Additionally, most breast cancer research has focused on outcomes, but surviving the disease now also requires optimizing cardiovascular health, Massachusetts General Hospital radiologists cautioned in JAMA Cardiology. They called on rads, oncologists, manufacturers, regulators and others to collaborate on a solution.

“We need to identify the optimal imaging tests that would detect heart problems in women with implants and minimize the potential for missed or incorrect cardiovascular diagnoses,” explained Ron Blankstein, MD, associate director of the Cardiovascular Imaging Program at Brigham and Women’s Hospital and professor of Medicine and Radiology at Harvard Medical School.

One “pivotal” question is determining if breast implants or image quality among those who underwent reconstruction surgery leads to unnecessary invasive testing, missed diagnoses, or increased mortality, the team explained.

To understand this, future research should compare rates of cardiovascular diagnoses among a matched group of patients with breast cancer with and without implants.

Finally, the authors did note that cardiac imaging exam problems are infrequent but maintained it’s important to determine which tests can best ensure accurate work-ups.

“With a shift toward implant-based reconstruction, and an undefined diagnostic accuracy in some cases, technological reevaluation of cardiovascular imaging in women with breast implants is warranted,” the team concluded.

You can read the full viewpoint article here.

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Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.

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