Pregnancy is accompanied by a lengthy list of do's and don'ts—take prenatal vitamins, no alcohol, exercise carefully, and eat well. But what about when an unplanned health issue presents itself, such as the necessity for a mammogram? For most women, this might not even be something they think about until they are in a position where breast cancer screening is an option.

Perhaps you're over 40 and in need of your yearly mammogram, or perhaps you have a history of breast cancer in your family and you want to keep your screenings current. More emergently, you've found a lump in your breast. So, can you have a mammogram when pregnant? The answer is yes, but there are several things to consider.

Pregnancy creates substantial hormonal changes that affect the body, as well as breast tissue. Estrogen and progesterone's rise causes the breasts to expand and condition to produce milk, which results in denser tissue. This increased density is more challenging to detect any abnormalities with using mammograms. Even post-delivery, should the woman be breastfeeding, milk-filled glands can also make the breasts denser and, as a result, make mammogram readings less clear.

While 3D mammograms have improved imaging technology to help navigate dense breast tissue, doctors often suggest postponing routine screening mammograms until after pregnancy if there are no symptoms or high-risk factors. However, if a lump or abnormality is found, your doctor may recommend immediate diagnostic imaging.

When Is a Mammogram Necessary During Pregnancy?

Mammograms are not done routinely if a woman becomes pregnant, yet there are specific situations where one might be unavoidable. Breast cancer in pregnancy does occur—1 in 3,000 times—but it's not common. If a lump is detected by a woman, she has constant breast pain and no explanation, or she is at high risk (e.g., strong history of breast cancer in her family or genetic defect such as BRCA1 or BRCA2), a physician will order a mammogram.

The process itself takes very little radiation exposure. The radiation employed by a mammogram is concentrated on the breast, and there is little to no radiation that reaches other areas of the body. A lead apron is also placed over the belly to shield the unborn child.

Alternative Breast Imaging Options During Pregnancy

For pregnant women requiring breast imaging, physicians may initially suggest an ultrasound. In contrast to a mammogram, an ultrasound is not done with the use of radiation and is deemed safe for pregnant women.

An ultrasound of the breast can establish whether a lump is a fluid-filled cyst or a solid tumor that needs further investigation. Yet ultrasounds are not always diagnostic, and in certain instances, a mammogram or biopsy is needed to determine or rule out cancer.

Magnetic Resonance Imaging (MRI) is also an imaging choice but has some drawbacks. The majority of breast MRIs employ a contrast material called gadolinium, which is able to pass through the placenta and to the fetus. Although risks are not entirely clear, physicians usually do not use MRI with contrast unless necessary. Some practitioners may offer an MRI without contrast as an option.

What If You Find a Lump In Your Breast During Pregnancy?

Breast changes throughout pregnancy are normal, but finding a lump should never be taken lightly. If you notice a lump, alert your medical provider right away. They will conduct a clinical breast exam and potentially have you get an imaging study such as an ultrasound or mammogram to see whether anything needs to be done.

If imaging indicates a suspicious mass, a biopsy can be suggested. Core needle biopsy is the most frequently used and is safe during pregnancy. It consists of numbing the skin with local anesthetic and inserting a hollow needle into the area to obtain a small sample of tissue to be tested.

Breast Cancer Treatment During Pregnancy

In the extremely uncommon event of a diagnosis of breast cancer while pregnant, therapy will be determined by the nature and extent of cancer and by how far along in pregnancy one is. The most frequent form of treatment is surgery—either mastectomy (surgical removal of the entire breast) or lumpectomy (surgical removal of the lump)—which is usually safe while pregnant.

Chemotherapy is also possible but usually only attempted after the first trimester, when it can damage developing fetal tissue. Radiation therapy is not used during pregnancy and is typically deferred until after giving birth. Hormonal therapy and targeted therapies are also omitted until after giving birth.

Can I Get a Mammogram While Breastfeeding?

Yes, you can have a mammogram while you are breastfeeding. The radiation in a mammogram does not impact breast milk or hurt the baby. But breast density is still high during lactation, and this might complicate detection of abnormalities. To enhance image quality, physicians usually advise breastfeeding or pumping 30 minutes prior to the mammogram.

Routine screening mammograms are usually delayed in pregnancy unless there is a high-level concern.

If a lump is detected, an ultrasound is typically the initial imaging study done, with a mammogram being a consideration if additional assessment is necessary.

• Pregnancy mammograms utilize minimal radiation and are safe when required.
• Breast MRI with contrast is usually avoided in pregnancy.
• Breast biopsy, when necessary, is safe during pregnancy.

If breast cancer does develop during pregnancy, there are available treatment options that can be adjusted to keep the mother and infant safe.

Pregnancy is a period of significant change, and health issues particularly those involving breast health, are anxiety-provoking. Routine mammograms are typically postponed until after giving birth, but diagnostic testing can be done if necessary. The best you can do is discuss changes you notice in your breasts with your healthcare provider in an open manner. Early detection and prompt treatment can make a very big difference in the health of both mother and fetus.

Delhi's Air Quality Index today recorded 'severe' in several location. The Central Pollution Control Board (CPCB) data from 40 monitoring stations from across the city showed AQI above 401 at 7.05 am on Wednesday morning. City's average AQI stood at 376.

While it has only been three days into December, the AQI levels have undergone severe changes. On November 30, Delhi's AQI was recorded at 279, on December 1, it was recorded at 304, while on December 2, the AQI went up to 372.

Amid all this, Dr Ritu Singh, Director Professor and HOD, Department of Biochemistry at Lady Hardinge Medical College posted on her Instagram, what she calls the 'only steps to save your lungs in Delhi".

What Does the Doctor Say?

"If you’re living in Delhi right now, the first line of protection is simple: avoid breathing unfiltered air. If you can’t leave the city, wear an N95 mask every time you step outside or move away from a HEPA-filtered space," says Dr Ritu Singh.

The doctor points out that keeping a high quality HEPA filter at home and at your workplace is essential. She points out that though it may be expensive, but one should know that their "lungs are not replaceable". She says, "Yes, spend all your hard earned money on HEPA filters because the lung is not replaceable."

What Is HEPA Filter? How Does It Help?

As per the US Environmental Protection Agency (EPA), HEPA or also known as the high efficiency particulate air is a type of filter that can theoretically remove at least 99.97% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns (µm). The diameter specification of 0.3 microns corresponds to the worst case; the most penetrating particle size (MPPS). Particles that are larger or smaller are trapped with even higher efficiency. Using the worst case particle size results in the worst case efficiency rating (i.e. 99.97% or better for all particle sizes).

What Else Can Be Done To Stay Safe From Air Pollution?

Dr Singh suggests that indoor plants could be added, though it could only offer a "small but meaningful improvement in air quality".

One famous NASA experiment, published in 1989, found that indoor plants can scrub the air of cancer-causing volatile organic compounds like formaldehyde and benzene.

These plants are:

• Spider Plant
• Snake Plant
• Peace Lilly
• Aloe Vera
• Boston Fern
• English Ivy
• Rubber Plant
• Golden Photos
• Bamboo Palm
• Dracaena

The doctor also recommends that one should increase their intakes of antioxidant foods. "Increase your antioxidant intake—turmeric, amla, oranges—these won’t fix pollution, but they help your body cope with oxidative stress.”

Antioxidants strengthen the immune system by fighting oxidative stress, which is caused by unstable molecules called reactive oxygen species (ROS). The body's normal processes, like breathing and metabolism, create free radicals (ROS). Antioxidants donate electrons to these unstable molecules, which neutralizes them and stops them from damaging healthy cells.

"Right now, the goal is extremely clear: prevent inhalation of polluted air. Delhi’s current levels are dangerous for the lungs, the heart, and the entire respiratory system," the doctor says.

India is only second in the world to have people with chronic kidney diseases in 2023, said The Lancet study. In 2023, China recorded 152 million patients with chronic kidney disease (CKD), while India was at 138 million.

The study, led by researchers from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, along with collaborators in the U.S. and the U.K., found that CKD was the ninth-leading cause of death worldwide, claiming nearly 15 lakh lives in 2023.

Regionally, the highest prevalence was reported in North Africa and the Middle East (18% each), followed by South Asia (nearly 16%), and more than 15% in Sub-Saharan Africa, Latin America, and the Caribbean.

In fact, senior director and HOD Nephrology at Medanta Kidney and Urology Institute, Dr Shyam Bansal says, "Chronic kidney disease is one of the fastest-growing chronic illnesses in India, mainly because diabetes and hypertension are becoming more common. Diabetes now affects about 10% of the population and hypertension nearly 25%, and together they remain the leading causes of kidney disease."

The report also highlighted CKD’s strong link to heart disease. It contributed to almost 12% of global cardiovascular deaths in 2023 and ranked as the seventh-leading cause of heart-related mortality, ahead of diabetes and obesity.

The researchers outlined 14 key risk factors for CKD, with diabetes, hypertension, and obesity contributing the most to the loss of healthy life. Dietary habits—such as low intake of fruits and vegetables and high sodium consumption, also played a significant role in raising CKD risk.

“Chronic kidney disease is both a major risk factor for other leading causes of health loss and a significant disease burden in its own right. Yet, it continues to receive far less policy attention than other non-communicable diseases, even as its impact grows fastest in regions already facing the greatest health inequities,” said senior author Theo Vos, professor emeritus at IHME.

The findings draw on data from the Global Burden of Disease (GBD) 2023 study, which tracked trends in diseases, injuries, and health risk factors across 204 countries and territories from 1990 to 2023.

Importance of Early Detection Of Chronic Kidney Disease

Importantly, the authors noted that most people with CKD in 2023 were in the early stages, highlighting the urgent need for strong screening programmes and strategies to reduce risk before the disease advances.

This is why its early diagnosis is utmost important. Dr Bansal on the need for early detection says, "“The biggest challenge is identifying people at risk as early as possible. Early diagnosis and timely control of risk factors are essential if we want to slow the progression of chronic kidney disease."

Early detection could also reduce heart-related deaths due to kidney disease and delay one's requirement for replacement therapies, which is usually sought in advanced stages of the disease.

Dr Bansal also points out that early detection could help one live a better life and also in many ways reduce the burden on the Indian healthcare system, and save cost. "We are dealing with a large population at risk, and kidney disease is complex and costly to treat. While infrastructure and specialist availability are improving, managing this growing burden remains a significant challenge," he says.

A GP has raised concern about a key sign that may show you have Covid rather than a cold or flu. Winter illnesses often look alike, which makes it hard to tell them apart, and getting the right diagnosis is important for proper care. Dr Rupa Parmar, GP and medical director at Midland Health, explained that there are certain clues that can help people understand what they are dealing with. She advised that anyone unsure should check with their doctor, as it is safer to ask than ignore a concern.

Why Breathlessness Matters

Dr Parmar noted that shortness of breath stands out as a sign of Covid. It rarely appears in a cold or flu, but it is common with Covid because the infection tends to affect the lungs and cause inflammation. The NHS also lists breathlessness as a sign linked more strongly with Covid than with flu or a cold. This symptom is also seen in conditions such as respiratory syncytial virus. In some cases, people with the flu who do not recover and worsen may develop breathing trouble if they develop complications such as pneumonia.

How Cough Patterns Differ

She added that coughs appear in all three infections, but they do not sound the same. A cold usually causes a light cough, flu tends to bring a dry one, and Covid usually causes a dry, ongoing cough. Many people with Covid cough for more than an hour or have several episodes of coughing through the day.

Loss Of Taste Or Smell As A Warning Sign

Another clue is a change in taste or smell. Dr Parmar said this sign is more specific to Covid. A sudden loss of taste or smell, or even a noticeable change, is more likely linked to the coronavirus. She explained that the pattern of symptoms often helps point to the right illness. A mild cough and sore throat usually fit a cold, a fever and strong fatigue suggest flu, and a loss of smell or taste with a steady cough point to Covid.

How Symptoms Begin And Progress

She also noted that the start of symptoms can differ. A cold tends to appear slowly, flu symptoms usually show up quickly within a few hours, and Covid can begin with mild signs that grow stronger over time. A cold mainly affects the nose and throat, while flu and Covid can cause symptoms across the body.

What To Do If You Have Covid Symptoms

Even though there are no formal self-isolation rules anymore, the NHS advises people to stay home and limit contact with others if they or their children have symptoms and either have a high temperature or feel too unwell to manage daily activities at work, school, or home. The NHS states that people can return to their usual routine once they feel well again or no longer have a high temperature.