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]. There is no role for MRI as the initial imaging evaluation in nipple discharge during pregnancy. Sestamibi MBI There is no role for MBI as the initial imaging evaluation in nipple discharge during pregnancy. Variant 7: Locoregional staging of newly diagnosed breast cancer during pregnancy. Initial imaging. Chemotherapy may be used to treat breast cancer after the first trimester of pregnancy [21,48]. Accurate staging is therefore important in order to determine optimal therapy while limiting harm to the fetus. The risk-to-benefit ratio will vary from patient to patient depending on many factors, including gestational age at the time of diagnosis and personal perspectives regarding pregnancy interruption. Locoregional staging is obtained to identify primary tumor size, regional node status, extent of disease, and additional foci of malignancy in the ipsilateral or contralateral breast. This information optimizes definitive local treatment and is used to determine the need for systemic staging to evaluate for distant metastases. Locoregional staging in pregnant patients is discussed below. However, decisions regarding systemic breast cancer staging in pregnant women are best addressed via patient- centered multidisciplinary tumor boards in order to provide specialized care in this complex clinical scenario [11,49]. Mammography and DBT Mammography is not contraindicated during pregnancy, and the dose to the fetus is negligible.
Breast Imaging of Pregnant and Lactating Women. 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]. There is no role for MRI as the initial imaging evaluation in nipple discharge during pregnancy. Sestamibi MBI There is no role for MBI as the initial imaging evaluation in nipple discharge during pregnancy. Variant 7: Locoregional staging of newly diagnosed breast cancer during pregnancy. Initial imaging. Chemotherapy may be used to treat breast cancer after the first trimester of pregnancy [21,48]. Accurate staging is therefore important in order to determine optimal therapy while limiting harm to the fetus. The risk-to-benefit ratio will vary from patient to patient depending on many factors, including gestational age at the time of diagnosis and personal perspectives regarding pregnancy interruption. Locoregional staging is obtained to identify primary tumor size, regional node status, extent of disease, and additional foci of malignancy in the ipsilateral or contralateral breast. This information optimizes definitive local treatment and is used to determine the need for systemic staging to evaluate for distant metastases. Locoregional staging in pregnant patients is discussed below. However, decisions regarding systemic breast cancer staging in pregnant women are best addressed via patient- centered multidisciplinary tumor boards in order to provide specialized care in this complex clinical scenario [11,49]. Mammography and DBT Mammography is not contraindicated during pregnancy, and the dose to the fetus is negligible.