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 gravid pregnant women [7,24-28]. With current digital techniques and increased Breast Imaging of Pregnant and Lactating Women 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. Despite the physiologic changes that alter the sonographic appearance of the breasts during pregnancy, screening whole- breast US may be used as a supplemental screening modality in pregnant women younger than 30 at high risk for breast cancer. It is, however, important to keep in mind that screening US may increase the false-positive rate and prompt additional biopsies. 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. 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 gravid pregnant women [7,24-28]. With current digital techniques and increased Breast Imaging of Pregnant and Lactating Women 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. Despite the physiologic changes that alter the sonographic appearance of the breasts during pregnancy, screening whole- breast US may be used as a supplemental screening modality in pregnant women younger than 30 at high risk for breast cancer. It is, however, important to keep in mind that screening US may increase the false-positive rate and prompt additional biopsies. 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].