Pregnancy associated breast cancer: mammographic and sonographic findings

Abstract

Introduction: Delay in diagnosis of PABC (pregnancy associated breast cancer) is common and the lack of awareness of PABC may preclude timely imaging investigation or biopsy. This study was performed with aim to evaluate the mammographic and sonographic findings in women with PABC. Methods: This retrospective cross-sectional study was conducted on 24 women with PABC during pregnancy and lactation in radiology ward of Imam Reza hospital, Mashhad university of Medical sciences in 2006-2018. The mammographic and sonographic features were assessed in 24 women with PABC. The diagnosis of PABC was performed after histological examination in all patients. Data were analyzed by SPSS software (version 22). p < 0.05 was considered statistically significant. Results:PABC was diagnosed in six patients (25%) during pregnancy and in 18 patients (75%) after delivery. The most common cause of admission was breast mass (83%). The most common finding in mammography examination was breast mass with microcalcification (40%). The most common finding in sonography was breast mass (83.3%). The most common manifestation in sonography was hypoechoic mass with non-uniform echogenesity with irregular margin and vertical orientation. Pathology finding showed ductal invasive carcinoma in 22 patients (91.66%), non-invasive carcinoma in one patient (4.16%) and inflammatory carcinoma in one patient (4.16%) Conclusion: Ultrasound appearance of PABC may be different from that of breast cancer in non-pregnant women and ultrasound findings such as prominent cystic component, posterior enhancement, and parallel orientation are not uncommon findings in PABC. So, ultrasound findings may mimic benign breast lesion during pregnancy and lactation. Mammography and ultrasound are two complementary imaging methods in women with palpable mass during pregnancy and lactation.

Keywords

• breast cancer
• lactation
• mammography
• pregnancy
• sonography