Sestamibi MBI There is no role for MBI in breast cancer screening during pregnancy. Variant 5: Pregnant women with a palpable breast mass. Initial imaging. The most common presentation of PABC is a palpable mass. Therefore imaging evaluation of a palpable lesion in a pregnant or lactating woman should not be delayed [7,20,23,24]. Given the challenge of clinical examination in pregnant and lactating patients, diagnostic breast imaging, particularly breast US, plays a crucial role in characterizing the features of palpable lesions and in determining appropriate management. US has the highest sensitivity for the diagnosis of PABC [24-28]. Furthermore, due to the predominantly young patient age and the decreased sensitivity of mammography in the setting of dense breast tissue, breast US is the first-line imaging examination in pregnant and lactating patients. If breast US is negative, or if there are suspicious sonographic findings, additional imaging with mammography or DBT may be indicated. Breast Imaging of Pregnant and Lactating Women Mammography and DBT Mammography has slightly decreased sensitivity compared to breast sonography in this clinical setting, ranging from 74% to 90% [7,24-27] in most studies. One recent study has reported 100% sensitivity of mammography that may in part be explained by use of full-field digital technique rather than film screen mammography [28]. The advanced stage of PABC may also contribute to the moderate sensitivity of diagnostic mammography given the physiologic increased breast density in these patients that may compromise mammography. Therefore, although diagnostic mammography is not recommended as the initial examination in patients with a palpable mass, there is a role for diagnostic mammography as an adjunct to US. If US does not show an etiology for the palpable mass, diagnostic mammography should be done to look for malignant calcifications or architectural distortion.
Breast Imaging of Pregnant and Lactating Women. Sestamibi MBI There is no role for MBI in breast cancer screening during pregnancy. Variant 5: Pregnant women with a palpable breast mass. Initial imaging. The most common presentation of PABC is a palpable mass. Therefore imaging evaluation of a palpable lesion in a pregnant or lactating woman should not be delayed [7,20,23,24]. Given the challenge of clinical examination in pregnant and lactating patients, diagnostic breast imaging, particularly breast US, plays a crucial role in characterizing the features of palpable lesions and in determining appropriate management. US has the highest sensitivity for the diagnosis of PABC [24-28]. Furthermore, due to the predominantly young patient age and the decreased sensitivity of mammography in the setting of dense breast tissue, breast US is the first-line imaging examination in pregnant and lactating patients. If breast US is negative, or if there are suspicious sonographic findings, additional imaging with mammography or DBT may be indicated. Breast Imaging of Pregnant and Lactating Women Mammography and DBT Mammography has slightly decreased sensitivity compared to breast sonography in this clinical setting, ranging from 74% to 90% [7,24-27] in most studies. One recent study has reported 100% sensitivity of mammography that may in part be explained by use of full-field digital technique rather than film screen mammography [28]. The advanced stage of PABC may also contribute to the moderate sensitivity of diagnostic mammography given the physiologic increased breast density in these patients that may compromise mammography. Therefore, although diagnostic mammography is not recommended as the initial examination in patients with a palpable mass, there is a role for diagnostic mammography as an adjunct to US. If US does not show an etiology for the palpable mass, diagnostic mammography should be done to look for malignant calcifications or architectural distortion.