Are mammograms safe while breastfeeding?

What does the evidence say about mammograms while breastfeeding?

1. Mammograms use ionizing radiation on the breast tissue being imaged only, and that radiation has no effect on breast milk, so clinical guidance holds that breastfeeding does not need to be interrupted after a mammogram. 1
2. A breast MRI performed with contrast is a different procedure from a mammogram because it introduces a gadolinium-based contrast agent into the body. Guideline bodies including the Academy of Breastfeeding Medicine and the American College of Radiology state breastfeeding does not need to be interrupted after contrast-enhanced MRI either, since the amount reaching an infant through milk is estimated at under 0.0004 percent of the maternal dose. 1
3. Emptying the breast by nursing or pumping shortly before a mammogram is commonly advised for comfort and to reduce the chance of milk letdown during breast compression between the imaging plates, though researchers note no data confirm whether this practice changes diagnostic accuracy. 2
4. Diagnostic X-ray imaging leaves no radiation or radioactivity in the body or in breast milk and does not affect milk production, so breastfeeding can resume right away afterward. 3
5. Lactation increases breast density substantially: one longitudinal imaging study measured a 53 percent increase in volumetric breast density compared with prepregnancy levels, and greater density can make mammogram images more challenging to interpret. 4

How mammograms changes by nursing stage

• Early weeks. In the early postpartum period, a routine screening mammogram is uncommon since screening intervals are based on age, not on how recently you gave birth. If a mammogram is needed sooner for a specific concern such as a new lump, it does not require pausing breastfeeding: the radiation stays in the breast tissue and does not enter milk. Nursing or pumping shortly before the appointment can ease compression.
• Established nursing. Once breastfeeding is established, breast tissue holds more milk and is measurably denser, which can make the images more challenging to interpret. Emptying the breast by nursing or pumping shortly before the appointment can reduce density and ease discomfort during compression. Let the imaging center know you are breastfeeding so they can account for it, but breastfeeding itself does not need to stop before or after a standard mammogram.
• Weaning. Later in the postpartum period, if follow-up imaging beyond a standard mammogram is recommended, know that a breast MRI performed with contrast is a different procedure: it involves a gadolinium-based agent that briefly enters the body, unlike mammography, which uses radiation only on the breast being imaged. National guideline bodies state breastfeeding does not need to be interrupted after contrast-enhanced MRI either, but ask the ordering provider directly if that specific type of imaging comes up.