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by the American Institute of Ultrasound in Medicine J Ultrasound Med 22:491-497 • 0278-4297 Pregnancy- and Lactation-Associated Breast CancerMammographic and Sonographic FindingsDepartment of Radiology, The Catholic University of Korea, Seoul, South Korea (B.Y.A., H.H.K., H.S.K., E.S.C., S.H.P.); Department of Radiology, Seoul National University, Seoul, South Korea (W.K.M.); Depart-ment of Radiology, University of North Carolina, Chapel Hill, North Carolina USA (E.D.P.); Departmentof Radiology, Pochon University, Kyungki-Do, South Korea (J.S.K.); and Department of Radiology, Yonsei University, Seoul, South Korea (K.K.O.). Dr Ahn is now with the Center for Health Promotion and Sports Medicine, Samsung Medical Center, Seoul, South Korea. Address correspondence and reprint requests to Hak Hee Kim, MD, Department of Radiology, Kangnam St Mary’s Hospital, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Ku, 137-040 Seoul, South Korea; e-mail: hhkim{at}catholic.ac.kr or radhhkim{at}medimail.co.kr.
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.
Key Words: breast • breast neoplasms, diagnosis • breast neoplasms, sonographic diagnosis • breast radiography • pregnancy-associated breast cancer Abbreviations: ACR, American College of Radiology • BI-RADS, Breast Imaging Reporting and Data System • PABC, pregnancy-associated breast cancer This article has been cited by other articles:
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