1
|
Jin X, Lai CT, Perrella SL, McEachran JL, Gridneva Z, Geddes DT. Maternal Breast Growth and Body Mass Index Are Associated with Low Milk Production in Women. Nutrients 2024; 16:2854. [PMID: 39275171 PMCID: PMC11397153 DOI: 10.3390/nu16172854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2024] [Revised: 08/20/2024] [Accepted: 08/23/2024] [Indexed: 09/16/2024] Open
Abstract
BACKGROUND Maternal breast volume is determined by the quantity of glandular and adipose tissue, and it undergoes significant changes during pregnancy. These changes are intricately linked to the development of glandular tissue, which most likely reflects lactation capacity. Evidence indicates that women with overweight or obesity exhibit larger breast volume compared to those with a normal body mass index (BMI), emphasizing the close relationship between breast volume and maternal adiposity. Hence, we aim to investigate breast volume growth and maternal BMI as potential risk factors for low milk production. METHODS Lactating women (n = 609) from the Perth metropolitan area in Western Australia between 2011 and 2023 were included in the analysis. Twenty-four-hour milk production measurements were conducted using the test weighing method, and milk removal frequencies were recorded. Mothers completed questionnaires regarding demographic, obstetric and infant details. Linear and logistic regression models were used to determine maternal and infant factors associated with milk production. RESULTS Here we show that increasing maternal age and BMI are associated with low milk production. Moreover, larger pre-pregnancy breast volume and breast growth are associated with both higher BMI and milk production. CONCLUSIONS Women who are older, have an obese BMI and who have minimal pre-pregnancy breast volume and breast growth should be provided with antenatal screening and breastfeeding support as they are more likely to experience low milk production.
Collapse
Affiliation(s)
- Xuehua Jin
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
| | - Ching Tat Lai
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
| | - Sharon L Perrella
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
| | - Jacki L McEachran
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
| | - Zoya Gridneva
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
| | - Donna T Geddes
- School of Molecular Sciences, The University of Western Australia, Crawley, WA 6009, Australia
- UWA Centre for Human Lactation Research and Translation, Crawley, WA 6009, Australia
- ABREAST Network, Perth, WA 6000, Australia
| |
Collapse
|
2
|
Bothou Α, Margioula-Siarkou C, Petousis S, Margioula-Siarkou G, Zervoudis S, Sotiriadis A, Amant F, Dinas K. Sentinel lymph node biopsy for breast cancer during pregnancy: A comprehensive update. Eur J Clin Invest 2024; 54:e14134. [PMID: 38095225 DOI: 10.1111/eci.14134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/27/2023] [Accepted: 11/05/2023] [Indexed: 02/15/2024]
Abstract
BACKGROUND Pregnant patients diagnosed with breast cancer (PrBC) may receive substantially different treatments compared to general population, considering that certain treatment options cannot be applied during pregnancy due to their potential harmful effects to the foetus. Regarding the use of sentinel lymph node biopsy (SLNB) in pregnant patients, potential concerns include foetal harm from radiation exposure, possible teratogenic effects of blue dyes and maternal anaphylaxis to isosulfan. OBJECTIVE The main objective of the present systematic review is to summarize and present current knowledge and up-to-date evidence about the safety and efficacy of SLNB in PABC. METHODS MEDLINE, Google Scholar and UpToDate databases were searched up to 22 January 2023. Articles studying the safety and effectiveness of SLNB in patients for PrBC were eligible for inclusion in the present review. RESULTS In total, 63 articles that met the inclusion criteria were included in this study. Forty-seven articles were strongly in favour of performing SLNB in PABC, 4 articles were partially in favour, 10 articles were strongly against and 2 articles were partially against performing SLNB in PABC. Sub-categorization based on type of study showed that the majority of studies in favour were of higher level of evidence than those against. Furthermore, there were overall 12 studies reporting on outcomes. There were overall 382 women with PrBC that underwent SLNB. Full data were reported for 237 cases. Overall live birth rate was 95.8%, while overall neonatal complication rate was 3.4%. No case of maternal side effects or anaphylactic reaction, maternal death, stillbirth and neonatal death was reported (0%). CONCLUSIONS Sentinel lymph node biopsy seems to be safe and effective technique for breast cancer during pregnancy.
Collapse
Affiliation(s)
- Αnastasia Bothou
- Breast Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
- University of West Attica, Athens, Greece
- Breast Department of Alexandra General Hospital, Athens, Greece
| | - Chrysoula Margioula-Siarkou
- Breast Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
- Gynaecologic Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
| | - Stamatios Petousis
- Breast Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
- Gynaecologic Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
| | - Georgia Margioula-Siarkou
- Breast Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
- Gynaecologic Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
| | - Stefanos Zervoudis
- University of West Attica, Athens, Greece
- Breast Department of REA Hospital, Athens, Greece
- Medical School, University of Montpellier-Nimes, Nimes, France
| | - Alexandros Sotiriadis
- Maternal-Fetal Medicine Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
| | - Fréderic Amant
- Division Gynecologic Oncology, UZ Leuven, Leuven, Belgium
- Department of Gynecologic Oncology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Konstantinos Dinas
- Breast Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
- Gynaecologic Oncology Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
- Maternal-Fetal Medicine Unit, 2nd Department of Obstetrics and Gynecology, Aristotle University School of Thessaloniki, Thessaloniki, Greece
| |
Collapse
|
3
|
Pyle C, Hill M, Sharafi S, Forton C, Sohaey R. Pregnancy-associated Breast Cancer: Why Breast Imaging During Pregnancy and Lactation Matters. JOURNAL OF BREAST IMAGING 2023; 5:732-743. [PMID: 38141239 DOI: 10.1093/jbi/wbad074] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Indexed: 12/25/2023]
Abstract
Pregnancy-associated breast cancer is characterized as breast cancer diagnosed during pregnancy, within the first postpartum year, or during lactation. It usually presents as a palpable mass, although the large majority of palpable masses during pregnancy are benign. Breast cancer is the most common invasive malignancy diagnosed during pregnancy and lactation, and its incidence is increasing as more women delay childbearing. Understanding the appropriate methods for screening and diagnostic workup of breast findings in this population is imperative for radiologists to promptly diagnose pregnancy-associated breast cancer. Use of available imaging modalities should be tailored to patient-specific factors, with US typically the first-line modality due to patient age and decreased sensitivity of mammography in the setting of lactational changes. This article illustrates the spectrum of imaging appearances of pregnancy-associated breast cancer, the appropriate diagnostic imaging workup, and the unique challenges encountered in evaluation of this patient population.
Collapse
Affiliation(s)
- Chelsea Pyle
- Oregon Health & Science University, Diagnostic Radiology/Women's Imaging, Portland, OR, USA
| | - Molly Hill
- University of Kansas Medical Center, Department of Radiology/Breast Imaging, Kansas City, KS, USA
| | - Shahrzad Sharafi
- Oregon Health & Science University, Diagnostic Radiology/Women's Imaging, Portland, OR, USA
| | - Camelia Forton
- Oregon Health & Science University, Diagnostic Radiology/Women's Imaging, Portland, OR, USA
| | - Roya Sohaey
- Oregon Health & Science University, Diagnostic Radiology/Women's Imaging, Portland, OR, USA
| |
Collapse
|
4
|
Fazeli S, Sakala M, Rakow-Penner R, Ojeda-Fournier H. Cancer in pregnancy: breast cancer. Abdom Radiol (NY) 2023; 48:1645-1662. [PMID: 36750478 DOI: 10.1007/s00261-023-03824-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 02/09/2023]
Abstract
Breast cancer is the most common malignancy in women, and for women under 40, it is the leading cause of cancer-related deaths. A specific type of breast cancer is pregnancy-associated breast cancer, which is diagnosed during pregnancy, the first-year postpartum, or during lactation. Pregnancy-associated breast cancer is seen in 3/1000 pregnancies and is increasing in incidence as women delay pregnancy. This type of breast cancer is more aggressive, and not infrequently, there is a delay in diagnosis attributed to physiologic changes that occur during pregnancy and a lack of awareness among physicians. In this review, we discuss the demographics of pregnancy-associated breast cancer, provide differential considerations, and illustrate the multimodality imaging features to bring attention to the radiologist about this aggressive form of breast cancer.
Collapse
Affiliation(s)
- Soudabeh Fazeli
- Department of Radiology, Division of Breast Imaging, UC San Diego Health, 9400 Campus Point Dr., La Jolla, CA, 92037, USA
| | | | - Rebecca Rakow-Penner
- Department of Radiology, Division of Breast Imaging and Body Imaging, UC San Diego Health, 9400 Campus Point Dr., La Jolla, CA, USA
| | - Haydee Ojeda-Fournier
- Department of Radiology, Division of Breast Imaging, UC San Diego Health, 9400 Campus Point Dr., La Jolla, CA, 92037, USA.
| |
Collapse
|
5
|
Olinger K, Maheshwari E, Shenoy-Bhangle AS, Adejolu M, McGettigan M, Mathew H, Lee KS, Nicola R. Mimics of cancer in pregnancy. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 48:1752-1773. [PMID: 36577923 DOI: 10.1007/s00261-022-03783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
Pregnancy is a remarkable time of pronounced growth and development of the fetus. Benign pathologies outside of the uterus, including those containing hormonally responsive tissue which undergo physiologic changes and other incidentally identified lesions, may mimic malignancy on clinical evaluation and imaging. A detailed history and physical exam, ultrasound and non-contrast magnetic resonance imaging features and comparison with prior imaging if available may help to narrow the list of potential differential diagnoses. Follow-up imaging in the postpartum period is often vital to confirm benignity and, in some cases, sampling to confirm the diagnosis is necessary. This review will cover the clinical, pathological and multimodality imaging features of numerous potential mimickers of cancer in the setting of pregnancy organized by organ systems. The goal is to better equip abdominal radiologists to accurately identify benign disease and help guide further imaging or follow-up recommendations to avoid unnecessarily aggressive intervention and improve patient care.
Collapse
Affiliation(s)
- Kristen Olinger
- Division of Abdominal Radiology, Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Building, Chapel Hill, NC, 27599, USA.
| | - Ekta Maheshwari
- Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15143, USA
| | - Anuradha S Shenoy-Bhangle
- Division of Abdominal Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02214, USA
| | - Margaret Adejolu
- Department of Radiology, The Royal Marsden Hospital, London, England, UK
| | | | | | - Karen S Lee
- Division of Abdominal Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Refky Nicola
- Division of Abdominal Imaging, Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
| |
Collapse
|
6
|
Chung M, Ruiz-Cordero R, Lee AY, Joe BN, Kelil T. MRI Evaluation of the Lactating Breast. CURRENT RADIOLOGY REPORTS 2022. [DOI: 10.1007/s40134-022-00395-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Abstract
Purpose of Review
To review the MRI appearance of physiologic lactational changes, common benign pathologies, and malignancies in the lactating breast.
Recent Findings
The prevalence of pregnancy-associated breast cancer has increased as more women delay childbirth and lactation. There is a transient increase in breast cancer risk after delivery when women may be lactating. MRI is more sensitive than mammography and ultrasound for the evaluation of the extent of disease in lactating women.
Summary
Understanding the key MRI findings of benign and malignant pathologies in the lactating breast is critical for accurate diagnosis and prompt evaluation of pregnancy-associated breast cancer.
Collapse
|
7
|
Inoue D, Yamamoto M, Arima H, Tamura K, Yoshida Y. A nationwide web-based survey of oncologic surgeons to clarify the current status of preoperative assessment for elderly cancer surgery patients in Japan. Sci Rep 2021; 11:22789. [PMID: 34815510 PMCID: PMC8611021 DOI: 10.1038/s41598-021-02319-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022] Open
Abstract
Elderly cancer patients requiring surgical treatment are increasing, and the deterioration of quality of life and shortening of healthy life expectancy due to postoperative complications represent major problems. This study investigated the current status of medical treatment, including perioperative evaluations, for elderly cancer patients requiring surgical treatment at cancer treatment facilities nationwide. A total of 436 cancer care facilities around Japan were invited to participate in this web-based survey regarding management of cancer patients ≥ 65 years old who had undergone surgical treatment in 2018. A total of 919 department heads from 245 facilities agreed to participate. Although most respondents answered that performance status, preoperative examinations, and comorbidities were important when deciding on a treatment plan, age, Geriatric Assessment (GA), and guidelines were "not important" for > 10% of all respondents. GA was familiar to 195 department heads (21%), and awareness of GA was significantly lower among respondents from medical education institutions than the other types of hospitals (18.5% vs 26.3%; P = 0.006). This large survey revealed that the use of GA is not widespread, and its awareness in medical education institutions remains low. We believe that accumulating evidence of geriatric oncology surgery is an urgent issue in Japan.
Collapse
Affiliation(s)
- Daisuke Inoue
- Department of Obstetrics and Gynecology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Makoto Yamamoto
- Department of Obstetrics and Gynecology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Fukuoka University, 7-45-1 Nanakuma, Jhonan-ku, Fukuoka, Fukuoka, Japan
| | - Kazuo Tamura
- Emeritus Professor, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jhonan-ku, Fukuoka, Fukuoka, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| |
Collapse
|
8
|
Pollack EB, O’Keefe MC. Breast Imaging in Special Populations: Indications and Findings in Pregnant and Lactating, Male, and Transgender Patients. CURRENT BREAST CANCER REPORTS 2021. [DOI: 10.1007/s12609-021-00428-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|