Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2020 Nov-Dec;53(6):405-412.
doi: 10.1590/0100-3984.2019.0071.

Pregnancy-lactation cycle: how to use imaging methods for breast evaluation

Carlos Henrique de Sousa Rosas  1 , Ana Carolina de Ataíde Góes  1 , Laís Martinho Saltão  1 , Adriana Michiko da Silva Tanaka  2 , Elvira Ferreira Marques  1 , Almir Galvão Vieira Bitencourt  1
Affiliations
Review

Pregnancy-lactation cycle: how to use imaging methods for breast evaluation

Carlos Henrique de Sousa Rosas et al. Radiol Bras. 2020 Nov-Dec.

Abstract
in English, Portuguese

Pregnancy and lactation constitute states of intense hormonal variation with secretory and structural changes in the breast parenchyma. These changes translate into important features on breast imaging, as well as the emergence of specific benign and malignant lesions. This literature review aims to discuss the safety of the use of breast imaging methods (mammography, ultrasound, and magnetic resonance imaging) during the pregnancy-lactation cycle, and to present the expected physiological changes and imaging appearance of the main breast diseases that may occur in this period, such as galactocele, lactating adenoma, fibroadenoma, puerperal mastitis, and pregnancy-associated breast cancer.

A gravidez e a lactação são estados de intensa variação hormonal e mudanças estruturais e secretórias no parênquima mamário. Essas alterações se traduzem em características importantes nos aspectos de imagem da mama, bem como propiciam o surgimento de lesões benignas e malignas específicas. A presente revisão de literatura tem por objetivo discutir a segurança da utilização dos métodos imagem da mama (mamografia, ultrassonografia e ressonância magnética) durante o ciclo gravídico-lactacional e apresentar as alterações fisiológicas esperadas e os aspectos de imagem das principais doenças mamárias que podem ocorrer nesse período, como galactocele, adenoma lactacional, fibroadenoma, mastites puerperais e câncer de mama relacionado à gestação.

Keywords: Breast; Imaging diagnosis; Lactation; Pregnancy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Bilateral mammography on craniocaudal and mediolateraloblique views in a lactating patient who was breastfeeding only with the left breast. Global asymmetry is observed between the breasts with an increase in volume and density in the left breast compared to the contralateral.
Figure 2
Figure 2
A 29-year-old lactating patient complained of a palpable mass in the right breast. Ultrasound (A) showed a complex cyst with hypoechoic content and thickened walls, with no significant flow on the Doppler study. Mammography (B) showed a nodule with peripheral calcifications and areas of fat density within it. FNAB confirmed the diagnosis of galactocele.
Figure 3
Figure 3
T1 (A) and T2 (B) weighted MRI images showing cyst with thin septa, heterogeneous content, and fat-fluid level, which is compatible with fat content/galactocele.
Figure 4
Figure 4
Ultrasound of the right breast showing an oval, hypoechoic, circumscribed mass, with no posterior acoustic features and with orientation parallel to the skin. Core needle biopsy confirmed the diagnosis of lactating adenoma.
Figure 5
Figure 5
A 34-year-old lactating patient complained of a rapidly growing mass in the left breast. T2 (A) and post-contrast T1 (B) weighted MRI images showed a complex solid and cystic mass in the upper quadrants of the left breast, in the same topography of a previous biopsy compatible with fibroadenoma. A new percutaneous biopsy confirmed the diagnosis of fibroadenoma with lactational changes.
Figure 6
Figure 6
A 33-year-old patient at 27 weeks of pregnancy presented with a palpable mass in the left breast. Ultrasound showed a hypoechoic mass with irregular shape and non-circumscribed margins. A percutaneous biopsy confirmed the diagnosis of invasive ductal carcinoma.
Figure 7
Figure 7
A 38-year-old patient in the sixth month of puerperium. Ultrasound (A) showed an irregular, hypoechoic mass with microlobulated margins. Postcontrast T1 (B) and T2 (C) weighted MRI images showed a non-mass enhancement in the upper outer quadrant of the right breast, with low signal in T2, unlike the rest of the breast parenchyma, which shows intermediate to high signal due to the lactation state.
See this image and copyright information in PMC

References

    1. Sabate JM, Clotet M, Torrubia S, et al. Radiologic evaluation of breast disorders related to pregnancy and lactation. Radiographics. 2007;27(Suppl 1):S101–S124. - PubMed
    1. Vashi R, Hooley R, Butler R, et al. Breast imaging of the pregnant and lactating patient: physiologic changes and common benign entities. AJR Am J Roentgenol. 2013;200:329–336. - PubMed
    1. Holanda AAR, Gonçalves AKS, Medeiros RD, et al. Ultrasound findings of the physiological changes and most common breast diseases during pregnancy and lactation. Radiol Bras. 2016;49:389–396. - PMC - PubMed
    1. Joshi S, Dialani V, Marotti J, et al. Breast disease in the pregnant and lactating patient: radiological-pathological correlation. Insights Imaging. 2013;4:527–538. - PMC - PubMed
    1. Parker S, Saettele M, Morgan M, et al. Spectrum of pregnancy- and lactation-related benign breast findings. Curr Probl Diagn Radiol. 2017;46:432–440. - PubMed