Zafrakas Menelaos, Papasozomenou Panayiota, Gerede Angeliki, Mikos Themistoklis, Athanasiadis Apostolos, Grimbizis Grigoris
1st Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Obstetrics and Gynecology, School of Health Sciences, International Hellenic University, Thessaloniki, GRC.
Cureus. 2024 Aug 8;16(8):e66465. doi: 10.7759/cureus.66465. eCollection 2024 Aug.
In recent years, the age of childbearing has been increasing in Western countries, and consequently the need to conduct mammography during pregnancy and lactation is also increasing. The aim of the present study was to systematically review the existing evidence regarding the overall use of mammography during pregnancy and lactation. A systematic review of the literature was conducted in PubMed, Epistemonikos, and clinicaltrials.gov, by using the search terms "pregnancy" AND "mammography", and "lactation" AND "mammography". The review protocol was prospectively registered in PROSPERO (CRD42024543971). Initially, 1,038 articles were identified; the titles and abstracts of 441 studies were screened; 40 studies were retrieved; after assessment of full texts, 20 studies were included for data extraction and further analysis. All 20 studies were retrospective; 14 studies included women with pregnancy-associated breast cancer, five studies included women with breast symptoms during pregnancy and/or lactation and one study included young breast cancer patients under age 40. Overall, 420 diagnostic and one incidental screening mammography examinations were performed during pregnancy and/or lactation with a 78.6% cumulative detection rate of breast cancer. The role of mammography was confounded by the use of breast ultrasound in most studies. In conclusion, the use of mammography during pregnancy and lactation is based on empirical data from retrospective studies, not directly addressing this issue. Hence, well-designed, focused, prospective clinical studies are needed in order to improve existing evidence regarding the use of diagnostic and screening mammography during pregnancy and lactation.
近年来，西方国家的生育年龄一直在上升，因此在孕期和哺乳期进行乳房X线摄影检查的需求也在增加。本研究的目的是系统回顾关于孕期和哺乳期乳房X线摄影检查总体应用的现有证据。通过在PubMed、Epistemonikos和ClinicalTrials.gov中检索“妊娠”和“乳房X线摄影”以及“哺乳”和“乳房X线摄影”等检索词，对文献进行了系统回顾。该综述方案已在PROSPERO（CRD42024543971）中进行了前瞻性注册。最初，共识别出1038篇文章；筛选了441项研究的标题和摘要；检索到40项研究；在对全文进行评估后，纳入20项研究进行数据提取和进一步分析。所有20项研究均为回顾性研究；14项研究纳入了妊娠相关乳腺癌患者，5项研究纳入了孕期和/或哺乳期有乳房症状的女性，1项研究纳入了40岁以下的年轻乳腺癌患者。总体而言，在孕期和/或哺乳期共进行了420次诊断性乳房X线摄影检查和1次偶然的筛查性乳房X线摄影检查，乳腺癌的累积检出率为78.6%。在大多数研究中，乳房超声的使用混淆了乳房X线摄影的作用。总之，孕期和哺乳期乳房X线摄影检查的应用基于回顾性研究的经验数据，并未直接针对这一问题。因此，需要设计良好、针对性强的前瞻性临床研究，以完善关于孕期和哺乳期诊断性和筛查性乳房X线摄影检查应用的现有证据。
