There is no role for MRI as the initial imaging evaluation in the diagnostic workup of palpable lumps in pregnant patients. Sestamibi MBI There is no role for MBI as the initial imaging evaluation in the diagnostic workup of palpable lumps in pregnant patients. Variant 6: Clinically suspicious nipple discharge during pregnancy. Initial imaging. Isolated bloody nipple discharge without associated palpable mass may occur in up to 20% of pregnant women and is most commonly due to benign causes. The proliferative epithelial changes and associated increased breast Breast Imaging of Pregnant and Lactating Women Mammography and DBT There is wide variation in degree of mammographic density during pregnancy, and many studies have shown that mammograms have a sensitivity of 74% to 100% in the diagnostic setting [25,28]. This is particularly true for the detection of suspicious calcifications that may be detected despite mammographically dense breast tissue and that may be sonographically occult [7,24]. Mammography is not contraindicated during pregnancy, and the dose to the fetus is negligible. The fetal radiation dose from a 4-view mammogram is <0.03 mGy, and no teratogenic effects have been demonstrated below 50 mGy [43]. Diagnostic mammograms with retroareolar magnification views may be of benefit as the initial examination in pregnant women with persistent nipple discharge or as an adjunct to diagnostic breast US. US Breast Although there are no studies specifically evaluating diagnostic US for nipple discharge in pregnant women, retroareolar sonographic evaluation should be the first-line imaging examination to look for papilloma or other breast masses as the cause of pathologic nipple discharge regardless of patient age. The peripheral compression technique, 2-handed compression technique, and the rolled nipple technique described by Stavros may increase the ability of breast US to detect the cause for bloody nipple discharge [47].
Breast Imaging of Pregnant and Lactating Women. There is no role for MRI as the initial imaging evaluation in the diagnostic workup of palpable lumps in pregnant patients. Sestamibi MBI There is no role for MBI as the initial imaging evaluation in the diagnostic workup of palpable lumps in pregnant patients. Variant 6: Clinically suspicious nipple discharge during pregnancy. Initial imaging. Isolated bloody nipple discharge without associated palpable mass may occur in up to 20% of pregnant women and is most commonly due to benign causes. The proliferative epithelial changes and associated increased breast Breast Imaging of Pregnant and Lactating Women Mammography and DBT There is wide variation in degree of mammographic density during pregnancy, and many studies have shown that mammograms have a sensitivity of 74% to 100% in the diagnostic setting [25,28]. This is particularly true for the detection of suspicious calcifications that may be detected despite mammographically dense breast tissue and that may be sonographically occult [7,24]. Mammography is not contraindicated during pregnancy, and the dose to the fetus is negligible. The fetal radiation dose from a 4-view mammogram is <0.03 mGy, and no teratogenic effects have been demonstrated below 50 mGy [43]. Diagnostic mammograms with retroareolar magnification views may be of benefit as the initial examination in pregnant women with persistent nipple discharge or as an adjunct to diagnostic breast US. US Breast Although there are no studies specifically evaluating diagnostic US for nipple discharge in pregnant women, retroareolar sonographic evaluation should be the first-line imaging examination to look for papilloma or other breast masses as the cause of pathologic nipple discharge regardless of patient age. The peripheral compression technique, 2-handed compression technique, and the rolled nipple technique described by Stavros may increase the ability of breast US to detect the cause for bloody nipple discharge [47].