Sister has breast cancer so am I at increase risk ot cancer with BA or being missed with BA?

I got the call this morning and my sister said bad news I have breast cancer and I was just in shock and all I could say is I am so sorry. She has had regular mamography and last one was 1 year 3 mos ago and they  saw nothing and she discovered a small soft not hard lump on her left breast and was painful  to touch and also noticed her lymph nodes were swollen,sURE enough Cancer was found in her left breast and few lymph nodes Kaiser docs told her most likely not signs of cancer but guess what it was. She found it. My confidence in mamograms is shaken due to fact that my aunt and now sister was not deteted via mamogram Both were soft and painful. My aunt had a mamogram 3 mos prior to her discovering a pea size soft mass and it grew to size of softball and she died 3 mos later of rapid moving breast cancer
I am just 3 weeks post BA. My sister is 56 and I am 50. Before I had BA I had a digitial mamagram and a ultra sound and halo test and I had informed my doc that I had a aunt that died of fast moving breast cancer at 56 Question is screening for breast cancer post BA? I was told that with BA breast cancer is harder to find. but does not increase your chance of breast cancer I sure hope not. I will be letting my docs know of the current events but is their anything more I can be doing then just a ticking time bomb for cancer undectiable via mamograms??
I do not know what stage cancer my sister has yet  and the couse of treatment but they feel she will need surgery and chemo but not sure which one first, She will be going in for a full ct scan to see if it has spead any further than her lymph nodes, Hard to beleive a mamogram did not pick up the cancer she did not have a digitial mamogram but I have. Hard to beleive a very tiny spot that was the size of a baby asprin has already traveled to her lumph nodes. I wonder do I need to be screen every 6 mos? Question will be asked to my docs, I am freaking out big time and so scared for my sister. Any advice or words or wisdom regarding breast cancer would help.
Lisa

Lisa, THANK YOU for this post.   I'm very, very sorry to hear about your sister and understanding of your concern for yourself.  I hope her course of treatment is thorough and as comfortable as possible and all is erradicated asap.  I had a digital last week and they found a 7mm "something", probably a cyst, in my left breast, which they now tell me was there 2 yrs ago too.   I was impressed with the digital mamm and all that you could see but not at all with the U/S, which couldn't even find it.  I've had pain in it, radiating to the nipple from the lymphs in my armpit several years, which is why they progressed to the U/S this time.   They are dismising it once again saying "no growth, no worry".   Now, after reading your post, I think I'm gonna have a few more questions on "why" the U/S sees nothing.     **** happens and Murphy's law usually rules my house....  Maybe if its a fluid filled cyst vs. solid it doesn't show up? maybe the tech wasn't thorough enough?  I want a breast reduction.  I need to know how it will all play out with that "something" in there.  Is it cut out with the reduction? Not affected? or, will disturbing it set something off??    

Lisa,

A big factor in accurate mamography is whether your implants are submuscular or not.  If they are submuscular, then the accuracy of the mamography and the interpretation greatly increases.  There's a lot of stuff you can Google about this.  I decided against implants but when I was considering them I was advised by the mamo tech at my hospital to make sure I got the submuscular implants for mamography purposes.  

Hopefully they caught your sister's cancer in time.  Donna

That's not exactly correct. Mammographers differ on how much if any difference there is b/w subglandular & submuscular placement for how hard the image is to interpret. I've heard this topic addressed at a number of our meetings, and a number of experienced mammographers have said they felt it made no difference to them as to the implant placement if there was not capsular contracture present.

Implants create a "shadow" where 15-25% of breast tissue is not quite as easy to see. We have LOTS of data at this point showing that there is no delay in diagnosis from this, and that the implant actually makes manual exam easier. It's been well documented that we find more palpable tumors in this group. A consensus statment from radiologists would suggest MRI in women who have suboptimal mammograms with implants in. Most will be fine with traditional mammograms & ultrasound.

Opinions differ.  I believe what I was told by my experts at my hospital. 

I agree that opinions differ among radiologists and there has been no controlled clinical trial to settle this.  I was trying to clarify that it is not quite so black & white. Keep in mind, though that "under the muscle implants may only be 10-50% under the muscle in augmentation patients as the pectoralis muscle retracts superiorly in many patients with the techniques most often used ("dual plane" implantation). The post weight loss patient would be even more prone as their lower pole breast skin tends to "bottom out" more with lower-settling implants

Nice to see that you are keeping up with the most accurate information, Dr Oliver.  It does go against the more simplified version I "Googled" however !

Experienced radiologists (and several published reports like the old http://www.ncbi.nlm.nih.gov/pubmed/1404718) say that it's the presence or absence of capsular contracture  that makes the biggest difference in the ability to read a mammogram in a woman with implants.  My 5 years of rotations at M.D. Anderson confirmed this years ago.

Placement beneath the muscle is also a factor that does help  the doc visualize the breast tissue better but its not the simple "under the muscle = good over the muscle = bad" picture we hear about so often.

So my take home message to patients (which is after all, what it's all about) is  "Watch for and report to me capsular contracure"  instead of "you're under the muscle so your mammograms will be easier to read." I like being proactive and ever-suspicious when it comes to tumor detection.

Update as my sister has stage 3 and is in her duct work and progestrone driven and was told that even with mamo and ultrasound it could be missed early and not seen tell later  and that a mri is best way to detect this type of rare cancer. It appears my aunt and sister have the same type of cancer fast moving. She is currently undergoing  a scan to detectect if it is elsewhere in her body. I was talking to my doc office today and said they will most likely order a mri, My breast/ducts are lumpy so I will have to be more careful in the future of breast self exam, she could only feel a tiny mass but the ultrasound picked it up as a inch size mass I must admit having the very full implants does make it more smooth surface to detect any lumps on breast.. I was told they do mamogram differently with BA pts. I got alot to learn thanks everyone for imput will keep everyone posted
Lisa

Sorry to hear about your sister ! All my hopes for her recovery and cure. 

The question is whether or not you (but first your sister) should you be screened for the BRCA gene mutation.  Families with breast cancer amongst primary relatives (mothers, daughters, sisters) or multiple cancers esp ovarian may carry the gene, which predisposes an individual to develop these cancers.

There is question about who should be tested, and what to do with the result.  The gene confers a RISK for developing a cancer, and does not mean that you WILL develop one.

Here is some NCI info, and you will want to talk to your doc about this:

http://www.cancer.gov/cancertopics/factsheet/risk/brca

Mammograms and self-exam are of course going to be part of your program too, to detect any abnormality.  Absent capsular contracure, you should be able to have adequate screening.

Best