Type:
Educational Exhibit
Keywords:
Breast, Obstetrics (Pregnancy / birth / postnatal period), Ultrasound
Authors:
R. Scandiffio, C. Giaconi, A. Cilotti, C. Marini, D. Mazzotta, M. Moretti, D. Caramella; pisa/IT
DOI:
10.1594/ecr2011/C-1557
Background
Breast parenchyma undergoes important physiologic changes during pregnancy and lactation.
Hormonal modification leads to a change into parenchymal architecture from the 1st trimester of pregnancy; arising values of estrogen,
progesterone and prolactin lead to ductular thickenig,
lobular growth,
increasing in vascularity and involution of fibrofatty composition.
In the 2nd and 3rd trimester,
lobular growth is particularly marked,
cytological changes become clear and alveolar cells differentiate into a more specialized colostrum-cell epithelium.
Hormonal changes,
milk production and traumatic damage to nipple during lactation explain inflammatory,
infectious and also tumoral pathologies that can occur in breast in these periods.
US is the most indicated technique to evaluate breast during pregnancy and lactation; infact,
mammography sensitivity decreases because of glandular density,
due to young age and increase of parenchyma,
and its use is limited because of prenatal exposure during pregnancy and secretion of breast milk in lactation[1,2].
The routine use of MR during pregnancy is not indicated.
Interpretation of MR findings in lactation can be difficult because lactational parenchyma shows a rapid contrast enhancement and an early plateau [3].
From January 2008 to December 2009 we studied 20 symptomatic patients (11 pregnant and 9 in lactation women).
We performed US in all patients; 1 patient underwent MR; 5 patients underwent biopsy.
Disorders include gestational/secretional hyperplasia (8 cases), galactoceles (2 cases), abscess/puerperal mastitis (2 cases),
granulomatous mastitis (1 case),
lactating adenoma (1 case),
fibroadenomas (4 cases),
pregnancy- associated breast carcinomas (2 cases).