Performance of Diagnostic Breast Imaging in Symptomatic Pregnant and Lactating Patients: Systematic Review and Meta-Analysis.

Abstract

Purpose To perform a systematic review of the literature and meta-analysis to summarize the diagnostic performance of breast imaging modalities for cancer detection in pregnant and lactating patients. Materials and Methods A systematic review of the literature in PubMed, Scopus, Web of Science, and Cochrane Library databases published up until March 3, 2023, was conducted. Included studies evaluated patients of any age who underwent breast imaging during pregnancy or lactation. The primary outcome of this review was sensitivity and specificity of each imaging modality. Meta-analysis was performed using a bivariate modeling approach, and summary receiver operating characteristic (ROC) analysis was used to generate a summary area under the ROC curve (AUC). Results Twenty-five studies met the eligibility criteria and included 1681 female patients (mean age, 33 years; range, 18-49 years). For US, seven of 24 studies had complete data yielding an AUC of 0.90 (95% CI: 0.85, 0.93), a sensitivity of 81% (95% CI: 56, 94), and a specificity of 85% (95% CI: 71, 92). For mammography, three of 21 studies had complete data yielding an AUC of 0.93 (95% CI: 0.75, 0.97), a sensitivity of 72% (95% CI: 47, 88), and a specificity of 93% (95% CI: 86, 97). For MRI, two of eight studies had complete data yielding an AUC of 95% (95% CI: 59, 96), a sensitivity of 91% (95% CI: 56, 99), and a specificity of 88% (95% CI: 48, 98). Conclusion US, mammography, and breast MRI showed high diagnostic performance for detection of pregnancy-associated breast cancer in symptomatic pregnant or lactating patients. Keywords: Meta-Analysis, Breast, Oncology, Pregnancy, Mammography, MR-Dynamic Contrast Enhanced, Ultrasound Supplemental material is available for this article. © RSNA, 2025.