Breast Cancer Screening in High-risk Women During Pregnancy and Lactation.

The article focuses on breast cancer screening strategies for women at high lifetime risk during pregnancy and lactation. It reviews current evidence and expert guidelines from the American College of Radiology (ACR) and the National Comprehensive Cancer Network (NCCN), highlighting that annual mammography is safe and recommended during these periods, while dynamic contrast-enhanced (DCE) MRI is contraindicated during pregnancy but may be used during lactation. Clinical breast examinations are advised every 6 to 12 months, and whole-breast ultrasound may be considered as an adjunct, though data on its efficacy are limited. The article also discusses the challenges posed by physiological breast changes in pregnancy and lactation, the clinical and imaging features of pregnancy-associated breast cancer, and emerging non-contrast MRI techniques that may improve future screening options.