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.
Pancreatic cancer, which is notoriously difficult to catch early, can now be detected early with a simple blood test, but powered by artificial intelligence (AI).
The AI-based test analyzes metabolic fingerprints in a blood sample and spots pancreatic cancer at its earliest stages with up to 94 percent accuracy.
The study published in the journal Nature Communications showed that the diagnostic tool called PanMETAI can be a non-invasive and cost-effective screening tool to save lives lost due to pancreatic cancer -- one of the deadliest forms of cancer worldwide, with only a 13 percent five-year survival rate.
The tool combines with nuclear magnetic resonance (NMR) metabolomics to identify pancreatic cancer with remarkable accuracy. NMR is a method that captures the unique chemical fingerprint of hundreds of metabolites in a patient's blood.
"By combining the power of AI with the rich metabolic information captured by NMR spectroscopy, we have created a tool that can detect pancreatic cancer at its earliest and most treatable stages. Our goal is to bring this technology to clinical practice so that more patients can benefit from timely diagnosis and treatment," said Yu-Ting Chang, Professor of internal medicine (gastroenterology and hepatology) at National Taiwan University, Taiwan.
The researchers noted that the PanMETAI platform enables high-precision pancreatic cancer prediction, facilitating early detection, which will enhance treatment outcomes.
Pancreatic cancer is hard to treat as the symptoms are rarely seen in the initial stages, and most patients receive their diagnosis at an advanced stage, when treatment options are limited.
The PanMETAI platform tapped the current screening methods -- blood marker CA19-9 -- for early detection.
Using 500 microliters of blood serum, the platform was able to extract over 260,000 metabolic signals in the study. It then analyzed the datasets using an AI model.
By integrating these metabolic profiles with age, the cancer marker CA19-9, and a protein biomarker called Activin A, PanMETAI correctly distinguished cancer patients from high-risk controls in nearly every case, said the team.
The researchers then validated the model in an independent Lithuanian cohort of 322 participants. The results proved that the tool works reliably across diverse populations.
Further, the team found that NMR metabolomic data were essential to boost early-stage detection sensitivity.
These capture subtle metabolic shifts -- such as decreased HDL cholesterol (bad cholesterol) and glutamine (an essential protein), and elevated lactic acid, glucose, and glutamic acid -- that occur before the cancer becomes clinically apparent.
Pancreatic cancer is the 12th most common cancer worldwide.
Data from the Globocan reveal there were 510,992 new cases of pancreatic cancer in 2022, with China, the US, and Japan reporting the highest number of cases.
The pancreas is a 15cm long gland found behind the stomach and in front of the spine. The organ is key to digesting food and curbing blood sugar levels in the body.
Cancer develops in the pancreas when a change in the cells of the organ causes them to grow uncontrollably. Most pancreatic cancers start in exocrine cells, which produce digestive enzymes to help digest food and are secreted into the small intestine.
While there are hardly any early symptoms, the ones appear can include:
Credits: Canva
Rates of binge drinking have raised among gen Z since their teenage years. As per a recent research by the UCL Centre for Longitudinal Studies (CLS), data from nearly 10,000 people born across the UK in 2000-02 who are taking part in the Millennium Cohort Study was analyzed. The research found that the gen Z is challenging their reputation as the "generation sensible".
The study found that 7 in 10, which is 63 per cent of 23-year-olds report binge drinking in the past year.
Nearly a third or around 29 per cent also said they did so at least monthly, which is up from 10 per cent at age 17.
The study also found that while drug use is relatively limited in the teenage years, by 20, almost half of them, or 49 per cent have used cannabis and a third, around 32 per cent have tried harder drugs like cocaine, ketamine and ecstasy.
Researchers compared substance use in the same group at ages 17 and 23. By 23, the share reporting binge drinking at least once in the past year rose by 15 percentage points, from 53% at 17 to 68%. Binge drinking refers to consuming six or more alcoholic drinks in one sitting.
Drug use among Gen Z has increased substantially as they move from their teenage years into their early 20s. The share of young people who said they had tried cannabis rose by 18 percentage points between ages 17 and 23, climbing from 31 per cent to 49 per cent.
Use of harder drugs showed an even steeper rise. The proportion of young people who said they had experimented with harder substances more than tripled, increasing from 10 per cent at 17 to 32 per cent by the age of 23. Meanwhile, the number who reported using these drugs at least 10 times in the past year went up from 3 percent to 8 percent.
The study also examined other potentially addictive behaviors. Nearly a third of the group, about 32 per cent, reported gambling by the age of 23. However, only 4 percent described their gambling as problematic.
Vaping saw one of the most noticeable increases. Daily vaping rose sharply from 3 percent at age 17 to 19 per cent by age 23. In comparison, cigarette smoking remained relatively stable, increasing slightly from 8 per cent to 9 percent.
Lead author Dr Aase Villadsen said the findings challenge the common belief that younger generations are moving away from alcohol.
She explained that while recent reports have suggested Gen Z drinks less than earlier generations, the new study indicates that this may not hold true once some members of this generation reach their early 20s.
Although late adolescence and early adulthood are often periods of experimentation, Villadsen said the rise in binge drinking and drug use during the early 20s is concerning, especially if these behaviors begin to become long-term habits.
She noted that the sharp increase in these behaviors between adolescence and early adulthood highlights how risks can intensify during this stage of life.
Villadsen also stressed that prevention strategies should focus on groups that appear to be more vulnerable. For instance, young men were found to be about seven times more likely than women to report gambling problems and were also more likely to use harder drugs.
Dr Katherine Severi, chief executive of the Institute of Alcohol Studies, as reported by The Guardian, said young people are particularly vulnerable to alcohol’s effects because the brain continues to develop until the mid-20s.
She said it is worrying that despite frequent claims that younger generations drink less, the findings suggest that Gen Z drinkers in their early 20s may be consuming alcohol at similar or even higher levels than millennials did at the same age.
Severi also pointed to higher rates of heavy drinking among university students as a major concern. According to her, this reflects the influence of the broader alcohol environment rather than individual choices alone.
She explained that affordability, easy availability and heavy promotion of alcohol are major drivers of alcohol-related harm, and students are often exposed to all three.
Severi added that universities have a responsibility to ensure students can study and live in a safe environment. She also said commercial ties with alcohol companies, such as sponsorships of sports clubs or campus events, should not take priority over student health and wellbeing.
The findings come from Substance Use and Addictive Behaviours: Initial Findings From the Millennium Cohort Study at age 23, a briefing paper by Aase Villadsen and Emla Fitzsimons that will be published on the CLS website.
Credits: Wikimedia Commons
The United States has signed 24 bilateral health Memoranda of Understanding or MoUs with Latin America and African countries under the Trump administration's America First Global Health Strategy.
The first agreement with Panama is described as “strengthening Western hemisphere health security”, which it added is “a priority”. Thereafter, four Latin American agreements too involve smaller grants and focus on disease surveillance. Other 20 agreements all with African countries who have been previous recipients of health grants via the now disbanded US agency for International Development or USAID and decimated US President's Emergency Funds for AIDS Relief (PEPFAR).
The five-year MoUs aim to quickly shift financial responsibility for key health services to national governments. In several countries, including Kenya, Uganda and the Democratic Republic of Congo (DRC), more than half of HIV programme funding has traditionally come from donors, particularly the United States. In the DRC, for instance, at least half of the antiretroviral medicines used have been financed by the US.
The transitional Memorandums of Understanding (MoUs) signed between the United States and several countries come with a major condition. They require strong investment in infectious disease surveillance systems.
The goal is to ensure that pathogen information from outbreaks is shared with the US within a week. Officials say this helps detect global threats early and protect public health.
At the same time, it gives US pharmaceutical companies early access to pathogen data, allowing them to develop vaccines, medicines and diagnostics more quickly.
The United States and the Democratic Republic of Congo (DRC) signed their health MoU on 26 February. According to the US State Department, the agreement focuses on strengthening the country’s ability to detect and contain infectious disease outbreaks before they spread internationally.
Under the agreement:
Most of the funding will support a national integrated surveillance and outbreak response system.
The MoU also aims to modernize health data systems through electronic medical records, interoperable platforms, better trained community health workers and expanded services for HIV, tuberculosis, malaria, polio and maternal and child health.
In several cases, health agreements were preceded by deals related to natural resources.
The United States and the DRC first signed a strategic partnership on critical minerals. The deal aims to secure supplies of minerals needed for commercial and defense industries.
The DRC is one of the world’s largest sources of rare earth minerals, including cobalt and copper. China has historically dominated the purchasing and processing of these resources.
Recently, the DRC has begun opening its mineral sector to US investors. According to Reuters, the government sent Washington a shortlist of state owned assets involving:
Guinea followed a similar path. It signed a minerals MoU with the US on 5 February, followed by a health MoU on 27 February. The health agreement prioritizes strengthening laboratory networks and improving biosafety standards by 2027.
Not all countries are comfortable linking health support to access to resources or data.
In the DRC, a group of lawyers has challenged the minerals agreement in the Constitutional Court. They argue that the deal violates the constitution and undermines national sovereignty over natural resources.
Zimbabwe also withdrew from negotiations with the US over a similar agreement.
Officials said the country was asked to share biological resources and outbreak data for years without any guarantee that vaccines, treatments or diagnostics developed from that data would be available to Zimbabwe if a future crisis occurred. They also said the US did not offer reciprocal sharing of its own epidemiological data.
Kenya’s agreement with the United States has also faced legal hurdles. The country’s High Court halted the MoU after two court challenges questioned provisions that could allow the US access to patient data and pathogen information.
Zambia has also expressed reservations about its proposed health deal with Washington. The agreement stalled after the US linked the billion dollar package to cooperation in the country’s mining sector, particularly copper and cobalt.
Zambia has since asked for revisions, saying parts of the deal do not align with its national interests.
Some experts argue that these agreements reflect a broader shift in US global health policy.
Sophie Harman, professor of international politics at Queen Mary University of London, wrote in the BMJ that extraction appears to be central to the approach.
According to her analysis, the policy focuses less on improving global health outcomes and more on strengthening US economic and geopolitical interests, including competition with China.
She warns that countries entering such agreements could risk giving up resources or scientific data while gaining relatively limited health benefits.
© 2024 Bennett, Coleman & Company Limited