Breast Imaging Considerations in Symptomatic Young, Pregnant, and Lactating Women

Purpose of Review: Benign and malignant breast diseases in young, pregnant and lactating women including pregnancy associated breast cancers will be reviewed. Recent Findings: Compared to breast cancer in older women, poor prognostic indicators such as high nuclear grade, high Ki67 proliferation, estrogen receptor (ER) negativity, and overexpression of human epidermal growth factor 2 (HER2) may be present in young women. Even among ER + /HER2 cancers, young patients have a poorer prognosis. For pregnant women, the timing of care may be personalized based on gestational age, tumor subtype, clinical stage, and family planning considerations, including induction of labor and preservation of fertility for future pregnancies. Neoadjuvant chemotherapy can be safely administered during the second and third trimesters, and if necessary, radiation therapy can be given after birth. Summary: Symptomatic concerns warrant prompt imaging evaluation with biopsy to distinguish benign from malignant causes of breast disease in young, pregnant, and lactating women.