Breast MRI during pregnancy and lactation: clinical challenges and technical advances

The breast experiences substantial changes in morphology and function during pregnancy and lactation which affects its imaging properties and may reduce the visibility of a concurrent pathological process. The high incidence of benign gestational-related entities may further add complexity to the clinical and radiological evaluation of the breast during the period. Consequently, pregnancy-associated breast cancer (PABC) is often a delayed diagnosis and carries a poor prognosis. This state-of-the-art pictorial review illustrates how despite currently being underutilized, technical advances and new clinical evidence support the use of unenhanced breast MRI during pregnancy and both unenhanced and dynamic-contrast enhanced (DCE) during lactation, to serve as effective supplementary modalities in the diagnostic work-up of PABC.

Automated summary

The breast undergoes significant changes in structure and function during pregnancy and lactation, affecting its imaging characteristics and potentially reducing the visibility of concurrent pathological processes. The high occurrence of benign gestational-related diseases further complicates the clinical and radiological evaluation of the breast during this period. This pictorial review highlights that, despite being currently underutilized, technical advancements and new clinical evidence support the use of unenhanced breast MRI during pregnancy and both unenhanced and dynamic-contrast enhanced imaging during lactation as effective supplementary modalities in the diagnosis of pregnancy-associated breast cancer (PABC).