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ACR Appropriateness Criteria® Breast Imaging During Lactation.

, Basak E Dogan1, Lonie R Salkowski2

  • 1UT Southwestern Medical Center, Dallas, Texas.

Journal of the American College of Radiology : JACR
|March 26, 2026
PubMed
Summary

Imaging lactating women is safe and effective, with no need to defer procedures like mammography or MRI. Breastfeeding can continue during most imaging and biopsy procedures, minimizing disruption.

Keywords:
AUCAppropriate Use CriteriaAppropriateness Criteriabreast lumpbreast screeningbreastfeedinglactationmastitispregnancy-associated breast cancer

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Area of Science:

  • Radiology and Imaging
  • Women's Health
  • Breastfeeding Medicine

Background:

  • Lactation presents unique challenges for breast imaging due to physiological changes.
  • Existing guidelines may not adequately address imaging needs during lactation.
  • Accurate assessment is crucial for timely diagnosis and treatment in lactating women.

Purpose of the Study:

  • To provide evidence-based guidance for imaging lactating women.
  • To define the roles of mammography, ultrasound, and MRI in lactating patients.
  • To offer recommendations on safety and continuity of breastfeeding during procedures.

Main Methods:

  • Systematic analysis of medical literature from peer-reviewed journals.
  • Adaptation of established methodology principles (e.g., GRADE).
  • Utilizing the RAND/UCLA Appropriateness Method for procedure evaluation.

Main Results:

  • Imaging should not be deferred due to lactation; established techniques are applicable.
  • Gadolinium contrast and nuclear medicine procedures pose negligible infant risk.
  • Image-guided biopsies are safe and effective, with discussed lactation-specific risks.

Conclusions:

  • Standardized imaging protocols can minimize diagnostic delays in lactating women.
  • Breastfeeding can often be preserved during diagnostic and interventional procedures.
  • These guidelines support multidisciplinary decision-making for optimal patient care.