Because of the concerns regarding gadolinium crossing the placenta and limited data regarding its safety in this setting, screening breast DCE-MRI is not recommended in pregnant women with any breast cancer risk profile. Sestamibi MBI There is no role for MBI in breast cancer screening during pregnancy. Mammography and DBT Mammography is not contraindicated during pregnancy. The fetal radiation dose from a 4-view mammogram is <0.03 mGy. No teratogenic effects have been demonstrated below 50 mGy [43]. There are no studies specifically evaluating DBT in this patient population. 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. Ductal and lobular hyperplasia, combined with increased water content and decreased stromal fat, may increase mammographic density throughout pregnancy. A small study has shown that the anticipated changes in breast density are less pronounced during pregnancy than during lactation, and that most pregnant patients had scattered or heterogeneously dense fibroglandular tissue [44]. Many studies have shown that mammograms may be diagnostic in 74% to 100% of pregnant women [7,24-28]. With current digital techniques and increased use of DBT, the ability to detect breast cancer with mammography in pregnant patients may improve. There are several studies that report screen-detected PABC in a small number of patients [7,24]. US Breast Throughout pregnancy, there is progressive ductal and lobular hyperplasia as well as increased duct ectasia. These changes lead to prominent hypoechoic ducts and lobules with diffuse decreased breast echogenicity [9,10]. There are no studies available at this time evaluating the use of screening whole-breast US during pregnancy.
Breast Imaging of Pregnant and Lactating Women. Because of the concerns regarding gadolinium crossing the placenta and limited data regarding its safety in this setting, screening breast DCE-MRI is not recommended in pregnant women with any breast cancer risk profile. Sestamibi MBI There is no role for MBI in breast cancer screening during pregnancy. Mammography and DBT Mammography is not contraindicated during pregnancy. The fetal radiation dose from a 4-view mammogram is <0.03 mGy. No teratogenic effects have been demonstrated below 50 mGy [43]. There are no studies specifically evaluating DBT in this patient population. 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. Ductal and lobular hyperplasia, combined with increased water content and decreased stromal fat, may increase mammographic density throughout pregnancy. A small study has shown that the anticipated changes in breast density are less pronounced during pregnancy than during lactation, and that most pregnant patients had scattered or heterogeneously dense fibroglandular tissue [44]. Many studies have shown that mammograms may be diagnostic in 74% to 100% of pregnant women [7,24-28]. With current digital techniques and increased use of DBT, the ability to detect breast cancer with mammography in pregnant patients may improve. There are several studies that report screen-detected PABC in a small number of patients [7,24]. US Breast Throughout pregnancy, there is progressive ductal and lobular hyperplasia as well as increased duct ectasia. These changes lead to prominent hypoechoic ducts and lobules with diffuse decreased breast echogenicity [9,10]. There are no studies available at this time evaluating the use of screening whole-breast US during pregnancy.