Breast Imaging and Intervention during Pregnancy and Lactation

Area of Science:

• Radiology
• Oncology
• Women's Health

Background:

• Pregnancy and lactation induce significant breast changes, complicating cancer screening and diagnosis.
• Delayed diagnosis of pregnancy-associated breast cancer is linked to adverse patient outcomes.

Purpose of the Study:

• To outline safe and effective imaging protocols for breast cancer screening and diagnosis in pregnant and lactating individuals.
• To highlight the importance of differentiating physiologic breast changes from neoplastic conditions.

Main Methods:

• Utilizing ultrasound (US) as the primary imaging modality for symptomatic pregnant women, followed by mammography if indicated.
• Employing age- and risk-based diagnostic imaging strategies for lactating women, including US and mammography.
• Recommending against breast MRI during pregnancy due to gadolinium contrast concerns.

Main Results:

• Ultrasound is the preferred initial imaging tool for pregnant women with clinical symptoms.
• Diagnostic imaging for lactating women mirrors that of nonpregnant individuals, with modality choice dependent on age.
• Breast MRI is permissible for high-risk screening and staging in lactating women.

Conclusions:

• Tailored imaging protocols can safely address breast cancer screening and diagnosis challenges during pregnancy and lactation.
• Understanding imaging characteristics of pregnancy-related breast changes is vital for accurate diagnosis.
• Biopsy is recommended for suspicious findings or unresolved masses during these periods.