Mammography in Patients with Pacemaker: A Limitation for Breast Cancer Diagnosis?

Introduction: Pacemaker may limit the effectiveness of a mammogram in several ways. The aim of this study is to summarize our institution experience with mammograms among patients with a cardiac pacemaker, focusing on the utility of the diagnostic workup among patients with newly-diagnosed ipsilateral breast cancer.

Methods: A retrospective search of all mammography reports between January 2011 and April 2021 was conducted for identifying cases of patients with a pacemaker. Demographic and clinical characteristics as well as mammography derived quality parameters and findings were categorized and statistically compared.

Results: The incidence of pacemaker concurrence in mammographic examination, although apparently slightly under-documented, is rare, accounting for only 0.33% of cases. Population mean age was 71.7 y, and most patients (79%) had a left-sided pacemaker. The pacemaker was much more likely to be visible on the medio-lateral-oblique (96%) than on cranio-caudal view (10%), on the axilla rather than the breast, and retro-pectorial rather than the pre-pectorial region (p

Conclusion: A pacemaker in patients undergoing mammography may lead to decreased diagnostic efficacy. Adherence to screening and the use of adjunct imaging such as ultrasound and contrast-enhanced spectral-mammography may further counteract its limitation on mammography programs