Pregnancy- and lactation-associated breast cancer - Mammographic and sonographic findings

Objective. To evaluate the mammographic and sonographic findings of pregnancy-associated breast cancer Methods. A total of 22 consecutive patients with breast cancer pathologically diagnosed during pregnancy(n=10) or lactation (n=12)were included in this study. The ages of the patients ranged from 26 to 49 years. Both mammography and sonography were performed on 12 patients; sonography only was performed on 7 patients; and mammography only was performed on 3 patients. Mammographic and sonographic findings were evaluated retrospectively. Results. Mammography revealed positive findings in 13 (86.7%) of 15 patients, even though all 15 patients had dense breasts. Mammographic findings included masses (n=5), masses with calcifications (n=2), calcifications with axillary lymphadenopathy (n=2), a mass with axillary lymphadenopathy (n=1), calcifications alone (n=1), asymmetric density alone (n=1), and diffuse skin and trabecular thickening alone (n=1). Sonographic findings were positive and showed masses for all 19 patients (100%). The common sonographic findings of masses were irregular shapes (n=15), irregular margins (n=16), parallel orientation (n=11), complex echo patterns (n=14, including marked cystic [anechoic] components [n=4]), and posterior acoustic enhancement (n=12). Surrounding tissue effects could be seen in 5 patients, including ductal changes (n=2), Cooper ligament thickening (n=1), edema (n=3), and skin thickening (n=3). Calcifications within or outside a mass (n=7) and axillary lymphadenopathy (n=8) were also detected. Conclusions. Although a mass could not be discernible by mammography because of increased radiodensity during pregnancy or lactation, calcification, asymmetric density, axillary lymphadenopathy, and skin and trabecular thickening were helpful for diagnosis of-pregnancy-associated breast cancer Sonographic findings of a solid mass with posterior acoustic enhancement and a marked cystic component were somewhat different from the appearance of breast cancer in nonpregnant women, possibly because of the physiologic changes of pregnancy and lactation.