Breast imaging recommendation in pregnant and lactating women

Author(s): Dr Sau Lee Chang, Dr Justice Reilly

Hospital: NHS Tayside, NHS Lanarkshire

Reference: RAD Magazine, 49, 572, 11


There are significant physiological changes during pregnancy and lactation. One of the main changes is the increasing proliferation of the milk ducts secondary to hormonal stimulation. This subsequently increases the density and volume of breast tissue, which may compromise imaging diagnostic sensitivity, especially in mammography examinations. In addition, there are concerns about radiation and contrast exposure to the mother and the fetus when considering breast imaging. In view of these factors, some practitioners may advise delayed imaging or breastfeeding cessation. However, pregnancy-associated breast cancer (PABC) is not uncommon and accounts for three per cent of breast cancer diagnoses. Many women are BRCA carriers or have a significant family history of breast cancer. Postponing imaging may potentially delay diagnosis as well as causing emotional and physical distress to those who are told they are ineligible for surveillance imaging for a prolonged period.

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