By Robert M. Marks, MD
So, you were told by somebody that you shouldn’t get your mammogram while breastfeeding. Well, there are a ton of opinions, blogs, and quite frankly, medical professional societies and hospitals, which have their own opinions on the subject. But there is only one consensus opinion by the American College of Radiology (ACR), the professional society of doctors who perform all imaging, including breast imaging.
The ACR Appropriateness Criteria are evidence-based guidelines to assist health care providers in making the most appropriate imaging or treatment decision for a specific clinical condition. In 2018, the ACR published its Appropriateness Criteria for breast cancer screening during lactation. The ACR gave mammography and digital breast tomosynthesis (3D breast imaging) during lactation its highest grade of “usually appropriate”. In their statement, they recommend routine screening of women during lactation and recommend breast feeding or pumping just before mammography to decrease the density of the breasts. There is no need to change feeding plans after imaging.
This is important as pregnancy-associated breast cancer (PABC) is on the rise as more and more women are having children later in life. PABC is the most common invasive cancer diagnosed during pregnancy and occurs in as many as 1 in 3,000 pregnancies. Screening for this cancer during your annual mammogram time period is important to detect it at an earlier, curable stage, even while lactating.
So, the bottom line is this: It is absolutely okay and appropriate to get your mammogram while lactating.
DiFlorio-Alexander RM, Slanetz PJ, Moy L, et al. ACR Appropriateness Criteria® Breast Imaging of Pregnant and Lactating Women. American College of Radiology Available at https://acsearch.acr.org/docs/3102382/Narrative/ Accessed 1/18/2020.
Romero C, Vincoff NS. Patient Friendly Summary of the ACR Appropriateness Criteria: Breast Imaging of Pregnant and Lactating Women. J Am Coll Radiol. 2019 Apr;16(4 Pt A):e17. doi: 10.1016/j.jacr.2018.12.005.
Johnson HM, Lewis TC, Mitchell KB. Breast Cancer Screening During Lactation: Ensuring Optimal Surveillance for Breastfeeding Women. Obstet Gynecol. 2020 Jan;135(1):194-198. doi: 10.1097/AOG.0000000000003600.
IABLE (Institute for the Advancement of Breastfeeding and Lactation Education)