The average patient is between 32 to 38 years of age and, with many women choosing to delay childbearing, it is likely that the incidence of breast cancer during pregnancy will increase. The natural tenderness and engorgement of the breasts of pregnant and lactating women may hinder detection of discrete masses, and therefore, early diagnosis of breast cancer. To detect breast cancer, pregnant and lactating women should practice self-examination and undergo a breast examination as part of the routine prenatal examination by a doctor. If an abnormality is found, diagnostic approaches such as ultrasound and mammography may be used. Diagnosis may be safely accomplished with a fine-needle aspiration or excisional biopsy under local anesthesia.
Nuclear scans cause fetal radiation exposure.
If such scans are essential for evaluation, hydration and Foley catheter drainage of the bladder can be used to prevent retention of radioactivity. Radiation exposure during the first trimester can lead to congenital malformations, especially microcephaly. Doses of 10 rad may result in fewer defects. For the diagnosis of bone metastases, a bone scan is preferable to a skeletal series because the bone scan delivers a smaller amount of radiation and is more sensitive. However, no data evaluating the safety of MRI during pregnancy are available.