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.

Insulin resistance is a condition in which the body cannot effectively use insulin. Shockingly, this condition is now being linked to first-trimester miscarriages, especially in women with PCOS, with lab markers such as HbA1c and fasting insulin offering early clues. Therefore, it is essential for women to take charge of their health and maintain their blood sugar levels within the recommended range, as per Dr Sushruta Mokadam, Senior Consultant Obstetrician & Gynaecologist, Motherhood Hospital, Kharadi, Pune. The expert went on to talk about other aspects of the same, detailing just how first trimester miscarriages could be a consequence of ignoring high blood sugar or insulin resistance.

Why are miscarriages in the first trimester rising?

Currently, there is a surge in cases of miscarriages during the first trimester, which is raising concern among experts. This may be due to undiagnosed insulin resistance. Yes, that’s right—miscarriage is not only caused by infections, hormonal imbalance, or blood clotting disorders, but also by insulin resistance. Many women fail to pay attention to insulin resistance, which affects how the body processes sugar and plays a major role in causing hormonal imbalance. Women with Polycystic Ovary Syndrome (PCOS) are at a higher risk, as metabolic dysfunction can lead to miscarriage. Many women are experiencing repeated early pregnancy loss but are not screened for insulin resistance, leading to missed opportunities for early intervention.

How are miscarriages and insulin resistance linked?

Miscarriage and insulin resistance link: Insulin resistance occurs when the body’s cells do not respond properly to insulin, leading to higher blood sugar and insulin levels. This imbalance can impact ovulation and egg quality and interfere with the implantation of the embryo. In early pregnancy, it may affect placental development, increasing the risk of miscarriage in the first trimester. In women with PCOS, insulin resistance is commonly present, even in those who are not overweight.

The impact of insulin resistance on reproductive health

High insulin levels can lead to increased androgen (male hormone) production, further affecting reproductive health. This hormonal imbalance can make it difficult for a pregnancy to be sustained, especially in the early weeks, which may result in miscarriage. Lab tests such as HbA1c (which reflects average blood sugar levels over time) and fasting insulin levels can help identify at-risk women. Even subtle elevations in these markers, including those within the upper-normal range, can indicate underlying metabolic dysfunction that may increase the chances of miscarriage.

What to do?

Pregnant women should opt for regular screening, manage blood sugar levels, eat a balanced diet, and exercise daily before planning pregnancy. Even during pregnancy, they should stay in touch with an expert who can guide them throughout the process.

The relationship between chronic stress and liver health is a complex physiological loop driven largely by cortisol, the body’s primary stress hormone. While the liver is often viewed as a detox organ, it is highly responsive to hormonal signals, especially during prolonged stress. But at a time when competition is at its all-time peak in every aspect of life, be it work or school, it is a no-brainer that stress levels are peaking across age groups. That being said, Dr. Tushar Madake, Consultant, Department of Transplant Hepatology at Ruby Hall Clinic, Pune, spoke about the impact of high cortisol on the liver.

What is cortisol?

When stress becomes chronic, the adrenal glands continuously release cortisol. The liver, rich in glucocorticoid receptors, responds by shifting into a survival mode. In short-term situations, this helps by releasing glucose into the bloodstream for quick energy. However, when stress persists without physical activity, this constant signal disrupts normal metabolism.

The impact of high cortisol levels

One major effect is increased glucose production, where the liver generates sugar from non-carbohydrate sources. Over time, this leads to consistently high blood sugar and forces the pancreas to produce more insulin, eventually contributing to insulin resistance. At the same time, cortisol promotes the release of fatty acids into the bloodstream. The liver absorbs these fats but struggles to process and export them efficiently, leading to elevated triglycerides and unhealthy cholesterol levels.

How does stress affect the liver?

Stress also drives fat storage in the abdominal region and within the liver itself. This can result in fatty liver disease, even in individuals without poor dietary habits. As fat accumulates, inflammation follows. Liver immune cells release inflammatory substances, creating oxidative stress that damages liver cells. Additionally, when the liver is overloaded with managing excess glucose and fat, its ability to detoxify the body declines. Hormone balance, toxin clearance, and medication metabolism are all affected.

Stress can also impair bile flow, which is essential for fat digestion and toxin removal. Reduced bile movement further worsens internal imbalance. Ultimately, chronic stress keeps the liver in a constant state of overdrive, leading to long-term metabolic strain, inflammation, and gradual liver dysfunction.

Fatty liver disease, as a term, has been used for several years to describe a state of excess fat accumulation in the liver. However, the perception is changing—once known as non-alcoholic fatty liver disease (NAFLD), the condition is now referred to as metabolic dysfunction-associated steatotic liver disease (MASLD). The new term, according to leading diabetologist Dr V Mohan, offers more clarity because fatty liver is often associated with alcohol intake. However, even people who do not drink alcohol can develop this condition, and it has a metabolic angle to it. Despite the new name, the concern around fatty liver disease remains the same—can it be reversed?

Can MASLD be reversed?

In an interview with Health and Me, Dr Tushar Madake, consultant in the Department of Transplant Hepatology at Ruby Hall Clinic in Pune, spoke about the new name for fatty liver disease and why the metabolic angle is important.

Fatty liver disease may have a new name, but the concern around it has not changed. The current medical nomenclature identifies this as steatotic liver disease (SLD), with the previously identified NAFLD referred to as metabolic dysfunction–associated steatotic liver disease (MASLD). This classification places emphasis on the true source of the disease—metabolic health—and not necessarily alcohol intake.

Symptoms and diagnosis of MASLD

One of the reasons why fatty liver disease is challenging to diagnose is the fact that it does not exhibit noticeable symptoms in its early stages. The organ functions without issues, and individuals might not suspect a problem. Unlike common assumptions, this condition affects people who are not necessarily overweight or who consume alcohol.

Some of the early symptoms include constant fatigue, an increase in abdominal fat storage, and a feeling of heaviness in the upper right quadrant of the abdomen. Changes in the skin, such as discolouration around the neck and armpits and skin tag development, can also be among the symptoms of the condition. Individually, these signs do not necessarily indicate any cause for concern. However, when present together with metabolic issues such as type 2 diabetes, obesity, high levels of cholesterol, and high blood pressure, they might signify liver impairment in the early stages.

Therefore, early diagnosis and monitoring are crucial. If you have these risk factors or experience these symptoms, it is recommended that you undergo tests for liver dysfunction and ultrasonography. In some cases, you may also need to undergo a scan, for instance, a FibroScan, for early detection of liver fibrosis.

Reversing MASLD is possible

Dr V Mohan, one of India’s leading diabetologists, said, “The encouraging news is that early-stage fatty liver is not a permanent condition. With consistent lifestyle changes, reversal is possible. Weight loss, regular physical activity, reduced intake of refined carbohydrates and fats, and higher protein consumption can all contribute to improved liver health.”