If a suspicious finding is seen by US, mammography is also recommended to evaluate for additional suspicious findings, particularly microcalcifications that may be occult by US. 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]. There are no studies specifically evaluating DBT in this patient population. DBT may improve visualization of breast masses in pregnant women. The increased breast density seen in younger women and in the hormonally altered breast of pregnant women is more likely to conceal small lesions; therefore, this population may benefit from the ability of 3-D mammography to decrease the masking effect of dense breast tissue. US Breast PABC most commonly presents as a palpable mass, and breast US is recommended as the first-line imaging modality in pregnant and lactating women regardless of age [9,10,23,25,26,36]. Breast US can define benign etiologies for palpable masses that require no further evaluation, such as simple cysts or galactoceles. Breast US has the highest sensitivity for diagnosis of PABC in the setting of a palpable mass with 100% sensitivity reported in many studies [24-28,45,46]. Several authors have cautioned that PABC may have benign features, including parallel orientation, circumscribed margins, and posterior acoustic enhancement [7,24,26]. MRI Breast It is well established that IV gadolinium chelates cross the placenta and enter the fetal circulation. Although there are no reported adverse fetal effects due to IV gadolinium in the pregnant mother, there is the potential for the dissociation of free toxic gadolinium ion with limited data in this patient population. Guidelines regarding gadolinium administration during pregnancy are outlined in detail in the ACR Manual on Contrast Media [33].
Breast Imaging of Pregnant and Lactating Women. If a suspicious finding is seen by US, mammography is also recommended to evaluate for additional suspicious findings, particularly microcalcifications that may be occult by US. 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]. There are no studies specifically evaluating DBT in this patient population. DBT may improve visualization of breast masses in pregnant women. The increased breast density seen in younger women and in the hormonally altered breast of pregnant women is more likely to conceal small lesions; therefore, this population may benefit from the ability of 3-D mammography to decrease the masking effect of dense breast tissue. US Breast PABC most commonly presents as a palpable mass, and breast US is recommended as the first-line imaging modality in pregnant and lactating women regardless of age [9,10,23,25,26,36]. Breast US can define benign etiologies for palpable masses that require no further evaluation, such as simple cysts or galactoceles. Breast US has the highest sensitivity for diagnosis of PABC in the setting of a palpable mass with 100% sensitivity reported in many studies [24-28,45,46]. Several authors have cautioned that PABC may have benign features, including parallel orientation, circumscribed margins, and posterior acoustic enhancement [7,24,26]. MRI Breast It is well established that IV gadolinium chelates cross the placenta and enter the fetal circulation. Although there are no reported adverse fetal effects due to IV gadolinium in the pregnant mother, there is the potential for the dissociation of free toxic gadolinium ion with limited data in this patient population. Guidelines regarding gadolinium administration during pregnancy are outlined in detail in the ACR Manual on Contrast Media [33].