title: Breast cancer screening of pregnant and breastfeeding women with BRCA mutations.
abstract: Screening recommendations for women with BRCA mutations include annual breast MRI starting at age 25, with annual mammogram added at age 30. The median age of childbearing in the US is age 28, therefore many BRCA mutation carriers will be pregnant or breastfeeding during the time when intensive screening is most important to manage their increased breast cancer risk. Despite this critical overlap, there is little evidence to guide clinicians on the appropriate screening for women with BRCA mutations during pregnancy or breastfeeding. Hormonal shifts that occur during pregnancy, the postpartum period, and breastfeeding result in changes to the breasts that may further complicate the sensitivity and specificity of screening modalities. We explore the safety and efficacy of available breast cancer screening modalities, including clinical breast exam, mammogram, breast MRI, and ultrasound among women with BRCA mutations who are pregnant or breastfeeding, providing recommendations from the most current published literature and expert opinion.
authors.affiliation: University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Harris
authors.identifier: 0000-0003-1430-7903
authors.initials: H
authors.lastname: Carmichael
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, USA.|University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Cindy
authors.initials: C
authors.lastname: Matsen
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, USA.|University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Phoebe
authors.initials: P
authors.lastname: Freer
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, USA.
authors.forename: Wendy
authors.initials: W
authors.lastname: Kohlmann
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, USA.|University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Stein
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, USA.|University of Utah School of Medicine, Salt Lake City, USA.
authors.forename: Saundra S
authors.initials: SS
authors.lastname: Buys
authors.affiliation: Huntsman Cancer Institute, Salt Lake City, USA.|University of Utah School of Medicine, Salt Lake City, USA.|George E Wahlen VA, Salt Lake City, USA.
authors.forename: Sarah
authors.initials: S
authors.lastname: Colonna
mesh_terms: D001942:Breast Feeding; D001943:Breast Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D055088:Early Detection of Cancer; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D005817:Genetic Counseling; D020022:Genetic Predisposition to Disease; D006801:Humans; D008279:Magnetic Resonance Imaging; D008327:Mammography; D008403:Mass Screening; D009154:Mutation; D011247:Pregnancy; D014463:Ultrasonography
keywords: BRCA; Breast MRI; Breast cancer screening; Breastfeeding; Clinical breast exam; Mammogram; PABC; Pregnant; Ultrasound