If an abnormality is found, diagnostic approaches such as ultrasound and mammography may be used. With proper shielding, mammography poses little risk of radiation exposure to the fetus. However, mammograms should only be used to evaluate dominant masses and to locate occult carcinomas in the presence of other suspicious physical findings. Diagnosis may be safely accomplished with a fine-needle aspiration or excisional biopsy under local anesthesia. Staging Procedures used for staging of breast cancer should be modified to avoid radiation exposure to the fetus in pregnant women.
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. Timing of the exposure to radiation relative to the gestational age of the fetus may be more critical than the actual dose of radiation delivered. 3 Radiation exposure during the first trimester can lead to congenital malformations, especially microcephaly. Doses of 10 rad may result in fewer defects. 1 Chest x-rays with abdominal shielding are considered safe, but as with all radiologic procedures, they should be used only when essential for making treatment decisions.