Brigham and Women's Hospital, Department of Radiology, Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
J Breast Imaging. 2023 Sep 22;5(5):508-519. doi: 10.1093/jbi/wbad059.
Women who are at high risk of developing breast cancer warrant screening that is often initiated at younger ages than in average-risk women; this is usually with a combination of annual mammography and breast MRI. Compared to average-risk women, those at high risk are more frequently recommended to undergo screening during childbearing age and thus potentially during pregnancy and lactation. Understanding the appropriate use of screening breast imaging during pregnancy and lactation can be challenging due to limited data defining the evidence-based roles of the different imaging modalities, including mammography, US, and MRI. There have also been assumptions about the diagnostic accuracy of these modalities secondary to physiological changes. This scientific review discusses the current state of evidence- and expert-based guidelines and data for breast imaging screening of high-risk pregnant and/or lactating women, and the clinical and imaging presentations of breast cancer for these women.
对于罹患乳腺癌风险较高的女性,通常需要比一般风险女性更早开始筛查,这通常包括每年进行乳房 X 线摄影和乳房 MRI 检查。与一般风险女性相比,高风险女性更频繁地被建议在生育年龄进行筛查,因此可能会在怀孕期间和哺乳期进行筛查。由于定义不同成像方式(包括乳房 X 线摄影、超声和 MRI)的循证作用的相关数据有限,因此在怀孕期间和哺乳期进行筛查时,正确使用乳房影像学检查可能具有挑战性。由于生理变化,人们对这些方式的诊断准确性也存在一些假设。本科学综述讨论了目前针对高风险妊娠和/或哺乳期女性乳房影像学筛查的循证和专家指南和数据,以及这些女性的乳腺癌临床表现和影像学表现。