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 between 30 and 39 years of age with a high risk of 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 Breast Imaging of Pregnant and Lactating Women 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]. 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.
Breast Imaging of Pregnant and Lactating Women. 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 between 30 and 39 years of age with a high risk of 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 Breast Imaging of Pregnant and Lactating Women 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]. 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.