Silvia Obenauer1, Stephan Dammert. 1. Department of Radiology, Georg-August-University of Goettingen, 37 075 Göttingen, Germany. obenauerheuser@yahoo.de
Abstract
OBJECTIVES: Diagnosis of breast cancer is more difficult in pregnant and lactating women. In the present study, the value of different radiological methods has been evaluated. MATERIAL AND METHODS: Twenty-seven patients with palpable breast masses during the lactation period were evaluated. All masses were investigated in the clinical course as well as in ultrasound. If ultrasound demonstrated a suspicious lesion a mammogram was done. If clinical course, ultrasound, and mammography could not rule out breast cancer, MR mammography was done. RESULTS: Eighteen ultrasound-guided biopsies were done, revealing three cysts, seven hyperplasias/mastopathia, three cases of papilloma, and two carcinomas. The 18 mammograms were classified as BI-RADS 1 and 2 in nine cases, as BI-RADS 3 in seven case, as BI-RADS 4 in one cases, and as BI-RADS 5 in also one case. MR mammography was done in 9 cases revealing three BI-RADS 4 categories and one BI-RADS 5 category, all of them showed a malignant histology. CONCLUSIONS: The density of the lactating breast compromises breast cancer diagnosis. Ultrasound should be the method of choice. If possible mammography and MR mammography should be done after lactating period.
OBJECTIVES: Diagnosis of breast cancer is more difficult in pregnant and lactating women. In the present study, the value of different radiological methods has been evaluated. MATERIAL AND METHODS: Twenty-seven patients with palpable breast masses during the lactation period were evaluated. All masses were investigated in the clinical course as well as in ultrasound. If ultrasound demonstrated a suspicious lesion a mammogram was done. If clinical course, ultrasound, and mammography could not rule out breast cancer, MR mammography was done. RESULTS: Eighteen ultrasound-guided biopsies were done, revealing three cysts, seven hyperplasias/mastopathia, three cases of papilloma, and two carcinomas. The 18 mammograms were classified as BI-RADS 1 and 2 in nine cases, as BI-RADS 3 in seven case, as BI-RADS 4 in one cases, and as BI-RADS 5 in also one case. MR mammography was done in 9 cases revealing three BI-RADS 4 categories and one BI-RADS 5 category, all of them showed a malignant histology. CONCLUSIONS: The density of the lactating breast compromises breast cancer diagnosis. Ultrasound should be the method of choice. If possible mammography and MR mammography should be done after lactating period.