A suspicious breast mass is found in a pregnant patient. What is the imaging modality of choice to avoid fetal radiation exposure?

• A. Breast MRI
• B. FNA + biopsy
• C. Mammogram
• D. Breast ultrasound

Answer: (A)

Minimize fetal exposure to ionizing radiation. Breast MRI fits this goal because it uses magnetic fields and radiofrequency energy, with no ionizing radiation reaching the fetus. Mammography relies on X-ray radiation, even if shielding is used, so it poses some fetal exposure. Ultrasound also avoids radiation and is safe in pregnancy, but MRI offers superior soft-tissue detail for characterizing a suspicious breast mass when radiation risk is a primary concern. If MRI is used, non-contrast imaging is preferred during pregnancy to avoid gadolinium unless absolutely necessary.