|
Stage Information
Procedures used for determining the stage of breast cancer should be modified for pregnant women to avoid
radiation exposure to the fetus. Nuclear scans cause fetal
radiation exposure.[1] If such scans are essential for evaluation, hydration and
Foley catheter drainage of the bladder can be used to prevent retention of
radioactivity. Timing of the exposure to radiation relative to the gestational
age of the fetus may be more critical than the actual dose of radiation
delivered.[2] Radiation exposure during the first trimester can lead to
congenital malformations, especially microcephaly. Doses >100 rad
may produce congenital abnormalities. Doses of 10 rad may
result in fewer defects. Chest x-rays with abdominal shielding are considered
safe, but as with all radiologic procedures, they should be used only when
essential for making treatment decisions.[1,3] A chest x-ray delivers 0.008 rad.[4]
For the diagnosis of bone
metastases, a bone scan is preferable to a skeletal series because the bone
scan delivers a smaller amount of radiation and is more sensitive. A bone scan
delivers 0.1 rad.[3] Evaluation
of the liver can be performed with ultrasound, and brain metastases can be
diagnosed with a magnetic resonance imaging (MRI) scan, both of which avoid
fetal radiation exposure. No data evaluating the safety of MRI during
pregnancy, however, are available. Carcinogenesis in the fetus exposed to radiation is
another consideration.
References
- Gwyn K, Theriault R: Breast cancer during pregnancy. Oncology (Huntingt) 15 (1): 39-46; discussion 46, 49-51, 2001.
[PUBMED Abstract]
- Barnavon Y, Wallack MK: Management of the pregnant patient with carcinoma of the breast. Surg Gynecol Obstet 171 (4): 347-52, 1990.
[PUBMED Abstract]
- Hoover HC Jr: Breast cancer during pregnancy and lactation. Surg Clin North Am 70 (5): 1151-63, 1990.
[PUBMED Abstract]
- Gallenberg MM, Loprinzi CL: Breast cancer and pregnancy. Semin Oncol 16 (5): 369-76, 1989.
[PUBMED Abstract]
 Back to Top
< Previous Section | Next Section > |
