Can you get a mammogram while breastfeeding?

From the Guidelines

Yes, you can get a mammogram while breastfeeding, as it is indicated with minor modifications to address increased mammographic density, increased breast vascularity, and duration of lactation. When considering a mammogram during breastfeeding, it's essential to keep in mind that the density of milk-filled breasts can make mammogram images more difficult to interpret, potentially reducing the test's sensitivity in detecting abnormalities 1. To minimize breast fullness and discomfort during the procedure, it's generally recommended to schedule your mammogram for right after you've nursed or expressed milk. Informing the technologist and radiologist that you're breastfeeding is crucial so they can properly interpret the results. Some women may experience temporary discomfort during the compression of milk-filled breasts, but the procedure won't harm your milk supply or affect your ability to continue breastfeeding. If possible, bringing a breast pump to your appointment to express milk before the mammogram if needed can be helpful. For routine screening without symptoms, some healthcare providers might recommend waiting until three months after weaning when breast tissue returns to its non-lactating state for optimal imaging, but this should be discussed with your doctor based on your specific risk factors and concerns 1. Key considerations include:

• Scheduling the mammogram after nursing or expressing milk
• Informing the technologist and radiologist about breastfeeding
• Potential temporary discomfort during compression
• No harm to milk supply or breastfeeding ability
• Possible recommendation to wait until after weaning for routine screening without symptoms.

From the Research

Breast Cancer Screening During Lactation

• Breast cancer screening during lactation is a topic of interest, and several studies have investigated the feasibility and effectiveness of mammography in breastfeeding women 2, 3.
• According to a study published in the Journal of breast imaging, women at high risk of developing breast cancer may undergo screening during pregnancy and lactation, including mammography, ultrasound, and MRI 2.
• Another study published in Obstetrics and gynecology suggests that healthcare providers should consider routine age-related or high-risk screening for breastfeeding women, and discuss alternate surveillance strategies, including deferment until cessation of breastfeeding 3.

Mammography During Lactation

• A study published in Diagnostic and interventional imaging found that breast MRI is possible and indicated in case of suspicion of breast cancer during lactation, despite physiological changes in the breast during this period 4.
• However, the same study recommends a suspension of lactation for 24 hours after the injection of gadolinium chelate, as a precautionary measure 4.
• Another study published in Obstetrics and gynecology notes that lactation-related radiographic changes may make examination interpretation more challenging, and preprocedure milk expression and use of particular supplemental imaging modalities can improve examination sensitivity 3.

Limitations and Considerations

• The literature on breast cancer screening during lactation is limited, and more research is needed to establish evidence-based guidelines 2, 3.
• Breastfeeding women may have higher rates of false-positive findings and undergo more biopsies, despite the benefits of routine breast cancer screening 3.
• The choice of imaging modality and screening strategy should be individualized and based on shared decision-making between the healthcare provider and the patient 3.