Reducing delay in the diagnosis of pregnancy-associated XXXX : how imaging can help us.

@entity1 @entity3821 @entity0 @entity66 @entity5 @entity513
INTRODUCTION: The evaluation of breast symptoms during pregnancy or lactation can be challenging but prompt, appropriate assessment of symptoms may lead to earlier @entity5 detection. METHODS: A review of breast imaging from 22 @entity1 with @entity0 during or within 1 year of pregnancy was undertaken as part of a large population-based study of gestational @entity0 . Consensus findings of three reads using the Breast Imaging Reporting and Data System lexicon were recorded. RESULTS: The commonest presenting symptom was a lump. Diagnosis by percutaneous biopsy was made correctly in 21 of 23 lesions. Lesions were @entity513 (91%). One third had extensive associated @entity3821 ( @entity3821 ). Ultrasound (US) was abnormal in all symptomatic @entity1 . The most common sonographic finding was a solitary hypoechoic mass with irregular margins. 'Expanded stroma' with prominent ducts and architectural distortion was noted in three cases; all had extensive high-grade @entity3821 . In three @entity1 , bilateral breast US detected @entity5 in the asymptomatic breast. Mammography (performed in 86% of @entity1 ) was abnormal in 74%, despite the presence of dense breast tissue in 47%. Widespread calcifications were visible in 26%, with detection of asymptomatic @entity66 in one @entity1 . MRI was performed in six @entity1 . Background parenchymal enhancement did not impair lesion detection; however, overestimation of lesion size can occur. CONCLUSIONS: Ultrasonography is recommended for the initial diagnosis of breast symptoms during pregnancy and lactation. A negative study should not delay direct fine needle aspiration of a palpable lesion. Mammography is indicated where initial assessment suggests malignancy. MRI may have a role in selected cases.
