Screening for Breast Cancer During Pregnancy or Breastfeeding: Risks vs. Benefits
24 Jan 2017
I’m forty-one years old, my toddler is almost weaned, and I’m newly pregnant. A mammogram is the last thing on my mind. However, I keep getting email reminders that I’m overdue for one. And I’m going to take action because I know that in my case, screening for breast cancer during pregnancy could save my life.
I’m not taking action only because of what I know from working at I’m Taking Charge.
I’m taking action because two months ago, breast cancer struck a friend of mine who also has young children. She’s my same age and like me, has zero risk factors for breast cancer other than age. She’s undergoing chemo right now.
Women like me are choosing to have children at older ages. Thanks to misunderstandings or just plain busy lives and exhaustion however, we might put off attempts to detect it. We owe it to ourselves and our families to place a higher priority on the importance of screening for breast cancer.
Who Should Get Checked for Breast Cancer During Pregnancy or Breastfeeding?
Carrie, our CNS advisor, reminds us in her guest post earlier this month that breast cancer affects 1 in 3000 pregnant women. Carrie says it wasn’t as much of an issue years ago because most women chose to have children before age 40. She believes that the number of pregnant women diagnosed will increase due to women choosing parenthood later in life. Carrie also reminds us that most cancer loves estrogen. Finally, she explains that it’s the most common type of cancer found during pregnancy, while breastfeeding, or within the first year of delivery.
So if you’re over 40, or if you’re younger but have a family history of breast cancer, or other risk factors, and/or your doctor recommends it, you should get a mammogram. You should do it even if you’re pregnant or breastfeeding, because waiting a year may be one year too many.
Risks Associated with Mammograms During Pregnancy or Breastfeeding
As with any mammogram, you could end up with a false negative or a false positive result. Some women are also concerned about risks of exposure to radiation.
Reducing Your Chances of a False Result
Overall, radiologists correctly identify about 84 percent of breast cancer cases via mammogram. The accuracy depends in part on the technique used and on the skills and experience of the radiologist. It also depends on your breast tissue. Here are some steps you can take now to reduce your chances of a false result:
- Seek out a certified mammography facility. You can do so here at the FDA certified mammography facility search site. Be sure to read through their recommendations, which include the suggestion to check that the facility is current on its MQSA (Mammography Quality Standards Act) certification.
- Consider a 3D mammogram. They allow for more accuracy for women with dense breast tissue. Younger women and African American women are more likely to have dense breast tissue (vs. fatty tissue).
- Make sure your radiologist has access to your previous mammograms and biopsy records, for comparison with your mammogram.
- If you’re breastfeeding, breastfeed or pump the milk out before the procedure. Full milk ducts can interfere with accuracy.
- Shower, and don’t put deodorant, powder, lotions, or any other substance on your skin the day of the mammogram.
Concerns About Radiation
Ashley Roman, ObGyn, explains over at TheBump.com why mammograms are perfectly safe during pregnancy. She says, “the risk of childhood leukemia seems to increase after 1-2 rad of exposure, and a mammogram is associated with only 0.02 rad of exposure.” Additionally, research from Berkeley’s School of Public Health and elsewhere show a correlation between the number of x-rays during childhood and childhood leukemia, but found no correlation with exposure to prenatal x-rays or to maternal x-rays prior to pregnancy.
If you’re worried about increasing your baby’s risk of childhood leukemia, a little perspective might help. A single mammogram is less risky than drinking a few cups of coffee each day (shown to increase the chances of childhood leukemia by over 60 percent), and definitely less risky than drinking alcohol during pregnancy.
I’ve Scheduled My Mammogram, Now What?
Make sure to tell your doctor that you’re pregnant or may be pregnant (if you’re not sure yet), so that they can take extra precautions if needed. For example, the 3D mammograms emit more radiation than a regular mammogram. Regardless of the type of mammogram, they’ll protect your belly with a lead shield, which will decrease exposure to the already low radiation by 50 percent. Also make sure to tell your physician if you’re breastfeeding so that they can take that into account when interpreting the image and give you any extra time you need to pump or breastfeed before the procedure.
Want to know more about mammograms and mammogram alternatives? Check out our article from last week on the topic.
Still not convinced about the importance of early breast cancer screening? Here’s some more information.
18 Oct 2017 - I'm Taking Charge - Life After Breast Cancer