Pregnancy- and Lactation-Associated Breast Cancer

Abstract

Although a mass could not be discernible by mammography because of increased radiodensity during pregnancy or lactation, calcification, asymmetric density, axillary lymphadenopathy, and skin and trabecular thickening were helpful for diagnosis of pregnancy-associated breast cancer. Sonographic findings of a solid mass with posterior acoustic enhancement and a marked cystic component were somewhat different from the appearance of breast cancer in nonpregnant women, possibly because of the physiologic changes of pregnancy and lactation.

Pregnancy-Associated Breast Cancer: A Literature Review

“…The same study by Yahg and colleagues noted ultrasound to be 100% sensitive in detecting a breast mass correlating with a palpable abnormality, supporting previously published data [33,35,36]. Additionally, ultrasound detected additional tumors in the breast in 20% of patients in this same series, and detected axillary metastases in 83% of those imaged (supported by US-guided fine needle aspiration [FNA]) [33].…”

“…As breast size and parenchymal density increase during pregnancy and lactation secondary to hyperestrogenic proliferative changes, the corresponding efficacy of mammography historically has been questioned [7]. More recently, both the safety and efficacy of mammography during pregnancy have been supported, and mammographic sensitivity rates of 78% to 90% have been documented [33][34][35][36]. A retrospective review by Yang and colleagues [33] of 20 pregnant patients imaged during pregnancy preoperatively found mammography to be 90% sensitive in detecting suspicious features of malignancy.…”

Pregnancy-associated breast cancer: spectrum of imaging appearances

“…Parallel orientation (Figure 1b) has been reported in 58% of PABC [5]. Posterior acoustic enhancement (Figures 2a and 3a) commonly seen in benign breast lesions has been reported in 63% of PABC cases [5].…”

“…Breast sonography helps to determine whether the palpable area represents a true mass or normal parenchyma. The reported sensitivity of sonography in the diagnosis of PABC is 100% [5,6]. Sonographic appearance can be useful in differentiating benign from malignant breast masses.…”

Treatment of the Pregnant Patient with Breast Cancer

“…Radiation exposure to a conceptus from a properly performed screening mammogram is inconsequential [11]. However, pregnancy may limit the sensitivity of mammography due to increased breast density [12]. Thus decisions as to whether to proceed with the examination should be based on clinical circumstances.…”