Image Credit: Health and me
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.
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.
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.
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.
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.
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.
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.
Credit: Canva
In today’s hyper-connected world, access to health information has never been easier. Yet, ironically, the ability to understand and apply that information remains one of the biggest barriers to better health outcomes.
This is where health literacy comes in, not just the ability to read a pamphlet or follow a doctor’s prescription, but the broader skill of accessing, comprehending, and using health information to make informed decisions for oneself, one’s family, and one’s community.
While definitions vary, there is consensus that health literacy is multi-dimensional. It involves confidence, critical thinking, and practical skills, knowing when to seek care, how to evaluate health claims, and how to follow treatment correctly. In essence, health literacy is the foundation of preventive care and treatment adherence, and its absence can be devastating.
The scale of the problem in India is stark: nearly 90 percent of Indians have low health literacy. This gap directly affects patient outcomes, from delayed diagnoses and poor compliance with treatment to preventable complications and higher healthcare costs.
Several factors explain this reality:
Low health literacy doesn’t just harm individuals; it amplifies inequities and strains the entire healthcare ecosystem. It also worsens misinformation, as people turn to social media or word-of-mouth for guidance, often encountering unverified or unsafe advice.
Credit: Canva
Blockbuster drug Ozempic, known for treating type 2 diabetes and obesity, has a surprising side effect. A new study published in The Lancet Psychiatry showed that the GLP-1 receptor agonists might prevent worsening of depression and anxiety.
People with diabetes or obesity are generally more likely than the general population to suffer from depression and anxiety. It is because both diabetes and obesity increase the risk of mental ill-health, and vice versa.
The findings showed that people with diabetes using semaglutide had a substantial decrease in hospitalizations and sick leave due to mental illness, including less worsening of depression, anxiety, and self-harm.
“Our findings suggest that GLP-1 drugs, particularly semaglutide, might contribute to better mental health in people with diabetes and obesity, but since this was an observational study, controlled clinical trials are needed to confirm the results,” said Jari Tiihonen, specialist physician and professor at the Centre for Psychiatry Research, Karolinska Institutet.
The research, led by an international team from Griffith University, the Karolinska Institutet, and the University of Eastern Finland, tracked Swedish national registers between 2009 and 2022.
It included 95,490 people, of which GLP-1 receptor agonists were used by 22,480 individuals during the follow-up period.
Semaglutide was associated with a decreased risk of worsening
Patients using semaglutide experienced a 42 percent lower risk of hospitalization for mental health issues during periods of use, compared to periods when they were not taking the drug.
More specifically, the risk reduction was 44 per cent for sickness absence or hospital care due to depression, 38 per cent for anxiety disorders, and 47 per cent for substance use.
Also read: Can Weight Loss Jabs Surge Divorce Rates? What Experts Are Saying
The team also found some benefits with Liraglutide. The drug was associated with an 18 per cent lower risk of sickness absence and hospital care due to psychiatric reasons.
Semaglutide works as a GLP-1 receptor agonist that mimics the GLP-1 hormone to regulate appetite and blood sugar. It slows gastric emptying and makes you feel fuller longer. It also signals the brain to reduce hunger and cravings, and triggers the pancreas to release insulin when blood sugar is high.
They work by increasing insulin release in a glucose-dependent manner, decreasing the liver's production of glucagon, and slowing down the emptying of the stomach, which helps lower blood sugar levels after a meal. They also act on the brain to suppress appetite and increase feelings of fullness, leading to reduced calorie intake.
Read More: Can Semaglutide Help Fight Cancer In The Brain?
In people with type 2 diabetes, notes Harvard Health, the body's cells are resistant to the effects of insulin and the body does not produce enough insulin, or both. This is when GLP-1 agonists stimulate the pancreas to release insulin and suppress the release of another hormone called glucagon.
These drugs also act in the brain to reduce hunger and act on the stomach to delay emptying, so you feel full for a longer time. These effects can lead to weight loss, which can be an important part of managing diabetes.
Credit: iStock
In the wake of a young doctor from Chandigarh accusing a well-known private hospital of unnecessarily admitting patients to Intensive Care Units (ICUs), it is imperative to understand who truly requires critical care.
In a widely shared video posted on the social media platform Instagram, Dr Prabhleen Kaur alleged that the hospital is making the patients remain admitted in the ICU for as long as possible to mint money.
The doctor did not mention the name of the hospital. And HealthandMe could not independently verify the details and the authenticity of the post.
However, the incident reignited concerns over accountability, patient safety, and standards of care in the country.
Speaking to HealthandMe, Dr. Sachna Shetty, Consultant Emergency Medicine at Jaslok Hospital and Research Centre, said that: "ICU admissions are for patients with life-threatening conditions needing intensive support".
"This includes shock, respiratory failure, neurological emergencies, cardiac issues, and multi-organ dysfunction," the doctor added.
The NHS UK explains that intensive care units (ICUs) are specialist hospital wards that provide treatment and monitoring for people who are very ill.
They're staffed with specially trained healthcare professionals and contain sophisticated monitoring equipment.
Also called critical care units (CCUs) or intensive therapy units (ITUs), it is required in cases where a person is seriously ill and requires intensive treatment and close monitoring.
Most people in an ICU have problems with one or more organs. For example, they may be unable to breathe on their own. Some common reasons include:
"ICU beds are limited, reserved for those who'll benefit most. Decisions are time-sensitive, based on triage and clinical scoring. It's about who needs advanced life support, not just who looks critical. Fair use of resources is key," the doctor added.
India’s ICU admission guidelines—issued by the Ministry of Health and Family Welfare in January 2024 — clearly defines who should and should not be admitted to an ICU. According to the guidelines:
The guidelines stress the importance of physiological parameters returning to near-normal or baseline status.
Furthermore, reasonable resolution and stability of the acute illness that led to ICU admission are essential factors.
Patient and family agreement for ICU discharge, particularly in cases where a treatment-limiting decision or palliative care is opted for, is also highlighted.
© 2024 Bennett, Coleman & Company Limited