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.

COVID-19 is not only a name but a terrible memory for the world, which made people stuck in their homes for months and caused thousands of deaths. Although after the advent of vaccines, normal life regained its pace, the impact of that turbulent time persists in everyday life. One example of a negative after-effect is the rising number of hip replacement surgeries among young Indians, which is, without a doubt, a worrying post-pandemic orthopaedic trend.

This very trend of rising cases of hip replacement surgeries is so serious that it was a major issue of discussion in the 2nd DELHI HIP 360 Conference, held at Crowne Plaza New Delhi. Where doctors reported a significant rise in cases of hip arthritis and avascular necrosis (AVN), a painful condition caused by disruption of blood supply to the hip bone, particularly among younger and middle-aged adults. The conference was organised by the Delhi Orthopaedic Association in association with the Indian Arthroplasty Association.

In the second edition of this conference, Dr. L Tomar, Organising Chairman of DELHI HIP 360 and Director, Department of Orthopaedics and Joint Replacement at Max Hospital, New Delhi, said, “We are observing 40% rise in hip replacement surgeries in younger people. Steroids played a life-saving role during the COVID pandemic, but indiscriminate or prolonged use in some patients has been associated with a rise in osteonecrosis and early degenerative changes in the hip joint." He also added that they are now seeing relatively younger patients coming with severe hip damage, collapse of the femoral head, and advanced arthritis requiring early hip replacement surgeries.

Dr. L Tomar further added, “India is witnessing a silent rise in hip disability due to a combination of post-COVID complications, obesity, sedentary lifestyle, trauma, alcohol consumption, and increasing life expectancy. Early diagnosis is critical because if AVN is detected in the initial stages, joint-preserving procedures may still be possible before destruction of the hip occurs.”

Dr. Karun Jain, Organising Secretary of the conference, said, “One of the biggest challenges with AVN is that patients often ignore early symptoms such as groin pain or stiffness, assuming it to be muscular pain. By the time they seek medical advice, the hip joint may already have undergone irreversible collapse. Awareness, timely MRI evaluation, and early intervention can help reduce disability.”

The conference has brought together leading orthopaedic surgeons, arthroplasty specialists, fellows, and residents from across India to deliberate on the latest advances in Total Hip Arthroplasty (THA), complex hip reconstruction, robotic-assisted surgery, rehabilitation, and management of post-COVID hip complications.

The experts at the conference emphasize that the AVN, which was thought of as a disease of the elderly, is no longer limited to a certain age bracket. It can affect young people as well due to the modern sedentary lifestyle. Thus, doctors at the conference are also expecting even greater demand for hip replacement surgeries.

World Thyroid Day is observed on 25 May every year. This day aims to spread awareness about thyroid disorders, their symptoms, and management options that can help women. However, one concern that continues to linger with respect to thyroid disorders is why they occur more often in women. Hormonal changes, lifestyle factors, and a higher risk of autoimmune conditions can increase the risk of thyroid problems in women. Yes, that’s right! Hence, women should ensure they go for timely health check-ups. Here, an expert highlights vital tips for women. Read on to know more about this and seek timely help. Remember, thyroid problems should not be left untreated at all.

In an interview with Health and Me, Dr Shruti Kotangale, Consultant Gynaecologist, Obstetrician, and Infertility Expert at AIMS Hospital, Dombivli, explained why thyroid problems are more common among women. Read here to know how gender makes a difference.

Why do thyroid disorders occur more often in women?

Thyroid disorders are rising among many women. The thyroid is a small gland in the neck, but it plays a critical role in controlling metabolism, energy levels, and maintaining hormonal balance. Women can suffer from thyroid problems because of frequent hormonal changes during puberty, pregnancy, and menopause. These changes can impact thyroid health. Lifestyle factors such as stress, poor diet, and lack of sleep can also worsen thyroid imbalance. Hence, women are at a higher risk of suffering from autoimmune conditions, where the body’s immune system attacks the thyroid gland.

Hypothyroidism vs hyperthyroidism

Conditions such as hypothyroidism (underactive thyroid) and hyperthyroidism (overactive thyroid) are commonly seen in women. Hypothyroidism occurs when the thyroid gland is underactive. Symptoms can include tiredness, weight gain, dry skin, hair fall, constipation, feeling cold, a slow heartbeat, and low mood or depression. Hyperthyroidism occurs when the thyroid gland becomes overactive, and women may experience weight loss, a fast heartbeat, sweating, anxiety, tremors, irritability, frequent bowel movements, and even difficulty sleeping. Women are advised to seek immediate medical attention and manage these symptoms without any further delay.

How to manage thyroid disorders?

Thyroid disorders may be concerning, but they are manageable with appropriate care and management tips as recommended by experts. Both hypothyroidism and hyperthyroidism can be managed with timely diagnosis, regular screening, and taking medications as suggested by the doctor. It is also important to eat a balanced diet, exercise daily for at least 30 minutes, get sound sleep at night, and de-stress through yoga and meditation. This World Thyroid Day, the focus should be on awareness, regular check-ups, and taking small steps to stay healthy and manage thyroid problems. Moreover, follow the doctor’s advice and do not self-medicate, as doing so can be risky.

So ladies, this World Thyroid Day, make an effort to know more about this group of disorders that affects your gender more often than men. Be it fatigue, mood swings, or weight fluctuations, it is imperative to know the early warning signs of this condition in order to work towards a more preventive approach.

IBD or Inflammatory Bowel Disease is a growing health concern worldwide - particularly amongst young adults. The two main types of IBD are Ulcerative Colitis and Crohn’s disease. However, these can be confused because they share symptoms.

Some of these are abdominal pain, diarrhea, fatigue, and weight loss. They affect the digestive tract differently, thus also have different complications and treatment plans. It is important to understand these differences so that patients may seek out timely diagnosis and better disease management.

1. Different Parts of the Digestive Tract Are Affected

Ulcerative Colitis is limited to the colon and rectum. Inflammation begins in the rectum and spreads continuously upwards. In Crohn’s disease, any part of the digestive system can be impacted. Including the mouth, esophagus, stomach, small intestine, and colon. However, it is most commonly the small intestine that is involved in Crohn’s disease.

2. Inflammation Pattern is Different

In ulcerative colitis, inflammation is continuous. There are no healthy gaps in between the affected areas. Crohn’s disease causes patchy inflammation. Meaning, there are sections of healthy tissue known as “skip lesions”.

3. Crohn’s Disease causes more serious damage

Ulcerative colitis affects only the innermost lining of the bowel. Crohn’s disease, on the other hand, can involve all layers of the intestinal wall. This increases the risk of complications such as fistulas, bowel obstruction, and intestinal narrowing.

4. Symptoms May Look Similar, But Often Differ

Both conditions can cause diarrhea, abdominal cramps, fatigue, and unintended weight loss. However, bloody stools are more common in ulcerative colitis. Crohn’s disease may also cause mouth ulcers, severe nutritional deficiencies, and pain in the anal region.

5. Nutritional Problems Are More Common in Crohn’s Disease

Because Crohn’s disease frequently affects the small intestine, patients may struggle to absorb nutrients properly. This struggle results in anemia, a vitamin B12 deficiency, low iron levels, and weight loss.

6. Surgery Has Different Outcomes

Ulcerative colitis can be cured by removing the colon. In Crohn’s disease, surgery is used mainly to treat complications, but inflammation can affect another part of the digestive tract.

7. Smoking Affects the Diseases Differently

Smoking worsens Crohn’s disease. It increases the risk of flare-ups, complications, as well as repeat surgeries. However, Ulcerative Colitis does not show the same pattern. Some studies have found lower rates of ulcerative colitis among smokers. Although smoking is never recommended as a treatment because of its serious health risks.

8. Treatment Approaches

Both conditions are treated with anti-inflammatory medications, immunosuppressing drugs, and dietary changes. But in Crohn’s disease, often more aggressive and long-term treatment is required. This is because it can affect the deeper layers of the bowel and multiple parts of the digestive tract.