March 2024

Navigating mammograms during pregnancy: what you need to know

Pregnancy is a time of profound change and heightened awareness of one’s health. Amidst the joy and anticipation, concerns about health matters – including breast health – can arise. For women who may have a history of breast issues or those over 35, discussions about mammograms may come up during pregnancy.

Understanding the Need:

Mammograms are an essential tool in breast cancer screening for women over 40 and in younger women at high lifetime risk of breast cancer. In pregnancy, the decision to undergo a mammogram becomes more complex, as historically medical radiation of any kind – regardless of the dose or amount – was avoided during pregnancy.  However, the American College of Obstetricians and Gynecologists and the American College of Radiology both support the use of clinically appropriate mammography in pregnant women, as it’s a low-dose exam and is safe for pregnant women.

Pregnant patients who warrant breast imaging can rest assured that either screening or diagnostic mammography can be performed safely at any time during pregnancy. Imaging is particularly important for symptomatic pregnant patients, as pregnancy-associated breast cancer (PABC) is often detected late due to difficulty of physical exam and physiologic breast changes.  With often-delayed diagnosis and aggressive tumor subtypes, PABC has a poorer prognosis than breast cancer not associated with pregnancy.

When Might It Be Recommended?

Here are a few scenarios in which mammography might be recommended in a pregnant patient:

Suspicious Findings: If a woman discovers a lump or has other breast symptoms, a mammogram may be suggested to investigate further.

High Risk: Women with a strong family history of breast cancer or other risk factors may warrant screening mammography.

Previous Breast Issues:  Women with a history of breast cancer or indeterminate breast findings may require ongoing surveillance, even during pregnancy.

The Decision-Making Process:

If there’s a clinical need for breast imaging during pregnancy, it’s important to discuss with your healthcare provider and your radiologist.  They can provide guidance and ensure the correct imaging is obtained to give you peace of mind, even more important during pregnancy.

Navigating Emotions:

Undergoing medical procedures, especially during pregnancy, can evoke a range of emotions. It’s entirely natural to feel anxious, worried or even frightened about the possibility of breast cancer while carrying a child. Seeking support from loved ones, joining support groups or speaking with a counselor can help manage these emotions and provide reassurance.

What if I’m lactacting?

For women who need breast imaging and are lactating, it helps to pump or nurse

prior to the exam. The exam will still be less sensitive than the patient’s non-lactating state, but is still useful.

When it comes to breast health – pregnant or not pregnant – early detection saves lives. Schedule your routine screening mammogram today and reach out to your healthcare provider with any questions you might have.