Breast MRI during Pregnancy and Lactation: A Comprehensive Review

Abstract

Breast magnetic resonance imaging (MRI) has become an essential diagnostic tool in the evaluation of breast pathology, particularly in cases where conventional imaging methods, such as mammography and ultrasound, may be limited. This comprehensive review examines the role of breast MRI during pregnancy and lactation, highlighting its indications, safety considerations, technical aspects, and clinical implications. The physiological changes that occur in breast tissue during these periods can complicate imaging interpretation, necessitating a nuanced understanding of normal variations to differentiate between benign and malignant lesions effectively. The review discusses the high sensitivity of breast MRI in detecting malignancies, particularly in women with dense breast tissue or those at elevated risk for breast cancer. It emphasizes the importance of MRI in evaluating palpable masses, assessing known breast cancer, and investigating suspicious findings from other imaging modalities. Safety concerns regarding the use of gadolinium-based contrast agents during pregnancy and lactation are addressed, with current guidelines suggesting that MRI can be performed when clinically indicated, particularly when the benefits outweigh potential risks. Technical considerations, including optimal timing for imaging and the use of dedicated breast coils, are explored to enhance diagnostic accuracy. The review also highlights the challenges in interpreting MRI findings in pregnant and lactating women, where increased glandular tissue and vascularity can lead to false-positive results. Furthermore, the clinical implications of breast MRI are significant, as accurate diagnosis and timely intervention can greatly influence patient outcomes. The review underscores the necessity of a multidisciplinary approach to care, involving radiologists, obstetricians, and oncologists, to ensure comprehensive management of breast conditions in these populations. In conclusion, this review provides a thorough overview of the current understanding of breast MRI during pregnancy and lactation, emphasizing its critical role in improving diagnostic accuracy and patient outcomes while addressing the unique challenges presented by these physiological states.