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DOI: 10.1148/rg.27si075505
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RadioGraphics 2007;27:S101-S124
© RSNA, 2007

Radiologic Evaluation of Breast Disorders Related to Pregnancy and Lactation1

Josep M. Sabate, MD, Montse Clotet, MD, Sofia Torrubia, MD, Antonio Gomez, MD, Ruben Guerrero, MD, Pilar de Las Heras, MD, and Enrique Lerma, MD

1 From the Unit of Breast Imaging, Department of Diagnostic Radiology (J.M.S., M.C., S.T., R.G.), and the Department of Pathology (E.L.), Hospital de la Santa Creu i Sant Pau, Avda Sant Antoni Maria Claret 167, 08025 Barcelona, Spain; and the Departments of Breast Imaging (J.M.S., A.G.) and Breast Pathology (P.L.), CEDIMMA, Barcelona, Spain. Recipient of a Certificate of Merit award for an education exhibit at the 2006 RSNA Annual Meeting. Received February 21, 2007; revision requested April 5 and received May 22; accepted May 30. All authors have no financial relationships to disclose. Address correspondence to J.M.S. (e-mail: Jsabate{at}santpau.es).

During pregnancy and lactation, the breast can be affected by a variety of specific and unique disorders, including benign disorders closely related to physiologic changes, inflammatory and infectious diseases, juvenile papillomatosis, and benign and malignant tumors. Patients with pregnancy-associated breast carcinoma tend to have more advanced neoplasms at diagnosis and a poorer prognosis due to delayed diagnosis and a more aggressive biologic pattern. Pregnancy-related Burkitt lymphoma characteristically manifests with bilateral and diffuse involvement of the breasts. Fibroadenoma may manifest with growth, infarction, large cysts, prominent ducts, and secretory hyperplasia during pregnancy and lactation. Galactocele is the breast lesion most commonly found during lactation and manifests as either pseudolipoma, a cystic mass with a fat-fluid level, or pseudohamartoma. Tumors and diseases affecting the breasts during pregnancy and lactation are basically the same as those observed in nonpregnant women but may have a different appearance. The sensitivity of mammography in pregnant and lactating women is decreased due to increased parenchymal density. Instead, ultrasonography is the most appropriate radiologic method for evaluating breast masses in this setting and is particularly useful in the diagnosis and treatment of abscesses. Knowledge of the unique entities that are specifically related to pregnancy and lactation and of their radiologic-pathologic appearances can help the radiologist make the correct diagnosis.

© RSNA, 2007






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