Radiological evaluation of palpable breast masses during pregnancy and lactation

• Published in: Egyptian journal of radiology and nuclear medicine 2011-06, Vol.42 (2), p.267-273
• Main Authors: Hosny, Iman Abbas, Eldin, Lamia Adel Salah, Elghawabi, Hamed Samir
• Format: Article
• Language: English
• Subjects: Pregnancy associated breast cancer; Pregnancy associated breast masses; US pregnancy associated breast masses
• ISSN: 0378-603X
• DOI: 10.1016/j.ejrnm.2011.04.003

To evaluate the role of different imaging modalities in the diagnosis of palpable breast masses during pregnancy and lactation. Forty eight patients with palpable breast masses during pregnancy and lactation were evaluated by Ultrasound. When Ultrasound revealed a benign lesion as cyst no further diagnostic evaluation was necessary. On the other hand, when Ultrasound demonstrated a suspicious lesion, mammography, MRI and or biopsy was performed. Ultrasound showed a well defined lesion with the criteria of benignity categorized as BI-RADS 2 in 25 cases, 20 cases as BI-RADS 3, 2 cases as BI-RADS 4 and one as BI-RADS 5. One of the 2 cases classified as BI-RADS 4 was completely obscured on mammography. According to Goettinger score, MRI categorized 4 lesions in lactating patients as 1 intermediate and 3 suspicious. Tru-cut biopsy and US guided aspiration established the pathological diagnosis in 23 cases. The majority of pregnancy-associated breast masses are benign; still, a thorough evaluation of any lesion is required, in order to rule out malignancy. US constitutes the most appropriate radiologic method for evaluating breast disorders in women during pregnancy and lactation. US has a greater sensitivity than mammography in this issue. MRI is not recommended during pregnancy and shows limitation in the lactating period. MRI breast should be used for undetermined cases and for staging malignancy. When the imaging results are suspicious and for grading malignancy, biopsy should be performed to obtain a pathologic diagnosis.