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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.
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Once widely known as non-alcoholic fatty liver disease (NAFLD), the common and dangerous fatty liver condition was rephrased as Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) due to its strong link to metabolic health issues like obesity and diabetes.
MASLD now includes patients with fatty liver disease linked to metabolic risk factors such as obesity, diabetes, and hypertension.
Globally, it was observed that all patients who have non-alcoholic fatty liver disease also have some associated form of metabolic dysfunction. The patients reported having either obesity, diabetes, metabolic syndrome, hypertension, or cholesterol problems.
And all these problems eventually lead to significant comorbidities later, like some people developed heart disease, while others developed complications of diabetes.
In view of these, a global consensus process in 2023 involving hundreds of experts from different countries adopted MASLD as it better reflected these underlying causes of the condition.
Also read: Lancet Study Shows Metabolic Liver Disease To Rise Over 38% By 2050: What’s Behind The Surge
MASLD is an umbrella term for liver conditions that develop in the presence of 1 or more cardiometabolic risk factors—including high blood sugar, elevated body mass index (BMI), and hypertension—but in the absence of other causes of liver fat accumulation.
The condition can be defined by excess liver fat accumulation (more than 5 per cent of liver weight) in the presence of metabolic dysfunction, independent of alcohol intake.
It encompasses a spectrum from simple steatosis to steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma.
“Initially, it was thought that having fatty liver disease without alcohol was a benign condition, but now it is recognized that, since it is associated with lots of metabolic comorbidities, it's no longer benign,” Dr. Ashish Kumar, Professor of gastroenterology and hepatology at Sir Ganga Ram Hospital in New Delhi, told HealthandMe.
He stated that whenever a diagnosis of fatty liver is present, "we should actually include other comorbidities, like obesity, dyslipidemia, which means cholesterol problem, diabetes, sugar problem, pre-diabetes, and hypertension. At least 50–70–80 percent of these patients will have one or more of these comorbidities".
Although alcohol has remained the number one risk for liver disease, MASLD seems to be rising globally, including among people who do not drink. Why?
The reasons include:
a sedentary lifestyle,
increased consumption of fast and processed food,
lack of exercise,
lack of sleep,
stressful life.
Also read: Why Regular Scans Are Crucial for Liver Cancer Patients: Doctors Explain
The experts noted that food, especially the increasingly accessible junk food or processed food, is a major culprit.
“So even if the person is not drinking alcohol, people are developing addiction to processed food, and this is causing an epidemic level of obesity and diabetes. Consequently, MASLD is also increasing, and now it is becoming the number one cause of liver disease,” Dr Kumar said.
According to Dr. Sanjay Goja, Director, Liver Transplant & HPB Surgery, Narayana Hospital, Gurugram, prevention must focus on following a healthy lifestyle like maintaining a healthy BMI, engaging in regular physical activity, and eating a balanced diet.
Controlling diabetes, cholesterol, and blood pressure is also important to prevent the risk of MASLD.
Dr Siddharth Badola, Manipal Hospital, Ghaziabad, suggested sustainable lifestyle changes such as:
Maintaining an adequate body weight: Even slight weight loss (5–10 percent) has been shown to significantly reduce liver fat and inflammation.
Follow a balanced and nutrient-rich diet: People should focus on consuming whole grains, fresh fruits and vegetables, lean proteins, and healthy fats, while limiting refined carbohydrates and processed foods.
Avoid foods with added sugar: Excess consumption of fructose, commonly found in packaged foods and sugary beverages, is a key contributor to fat accumulation in the liver.
Engage in regular physical activity: At least 150 minutes of moderate-intensity exercise per week is recommended to improve insulin sensitivity and liver health.
Manage associated metabolic conditions: Effective control of diabetes, hypertension, and dyslipidemia is essential in reducing the risk of MASLD progression.
Ensure adequate sleep and stress management: Poor sleep quality and chronic stress can negatively impact metabolic balance and liver function.
Keep your body hydrated with ample water intake and follow structured meal timings.
Heart attacks are now affecting younger people. (Photo credit: iStock)
Although a heart attack is generally considered a disease of the elderly, its incidence in young individuals is unfortunately on the rise. The reasons behind this are multifactorial. A heart attack is a condition where one of the arteries (blood vessels) suddenly becomes partially or completely occluded by a thrombus. Although the thrombus generally occurs suddenly, the underlying reason is a chronic process of lipid deposition in the vessel walls called atherosclerosis. Atherosclerosis can begin even in the first decade of life, but events like heart attacks conventionally occurred beyond 45 years in men and 55 years in women. On average, heart attacks occur in Indians about 10 years earlier than in their Western counterparts.
Dr Shyam Sasidharan, Consultant, Department of Cardiology, KIMSHEALTH Thiruvananthapuram, spoke about the early onset of heart attacks. From a population perspective, the rising number of heart diseases due to coronary artery disease (CAD) is significant not only because of its overall negative impact on the healthy population but also due to the potential for preventive interventions.
Acute coronary syndromes, or heart attacks, are on the rise among younger individuals, particularly in our country. Studies of the Asian-Indian migrant population have revealed a probable racial predisposition for premature CAD. However, the majority of the risk can still be attributed to the increased incidence of conventional CAD risk factors in young people, such as obesity, inactivity, diabetes, hypertension, and dyslipidaemia.
Smoking and substance abuse are resulting in more heart disease among the young. Lesser-discussed, unconventional risk factors, such as mental stress, lack of healthy employment practices, environmental pollution, and lack of proper food safety regulations, are in fact contributing significantly to this silent epidemic. COVID-19 infection as well as vaccination were widely attributed as causes of heart attacks in young people, but without adequate scientific evidence.
Credit: Canva/WHO
Women can play a major role in preventing as well as eliminating Chagas Disease, a potentially life-threatening neglected tropical disease that affects 8 million people globally and causes 10,000 deaths every year, according to UN agencies.
World Chagas Disease Day is observed every year on April 14 to raise awareness around the disease, and the impact it has on lives.
In a statement, the Pan American Health Organization (PAHO) and the Global Chagas Coalition urged health authorities to make women central to the fight against the disease and to empower them to make early detection, prevention, and care.
“Eliminating Chagas disease as a public health problem requires placing women at the center of diagnosis, treatment, and care strategies,” said Dr. Jarbas Barbosa, PAHO Director.
“Ensuring timely access to quality health services, particularly for women of reproductive age, is essential to prevent new infections and advance toward the elimination of congenital Chagas disease in the Region of the Americas,” he added.
Chagas disease, also known as American trypanosomiasis, is a illness caused by the parasite Trypanosoma cruzi, and is primarily transmitted by triatomine insect vectors.
It gets spread through
If left untreated, one third of infected people—including women and the children they carry—will develop life-altering heart, digestive, and even neurological conditions, and may even become fatal.
Once endemic to 21 countries in Latin America, the disease has now spread globally due to migration. It is now a global health concern with cases found in 44 countries including the US, Canada, Europe, Australia, and Japan.
World Chagas Disease Day was celebrated for the first time in 2020.
The theme this year is “Women at the heart of care, protecting the next generation” and underscores the key role women play in family and community caregiving, as well as their greater interaction with health services, particularly during pregnancy.
Chagas Disease: Role Of Women
According to the World Health Organization (WHO), about 2 million women aged 15-44 years are living with Trypanosoma cruzi infection worldwide.
Congenital transmission or mother-to-child transmission remains a major challenge, occurring in about 3–5 percent of pregnancies. However, it also provides a key opportunity for effective intervention.
The transmission cycle of the disease can be effectively broken by
“On the contrary, it represents a strategic opportunity to strengthen more equitable, accessible, and responsive health systems that recognize and respect women’s needs.”
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