Thinking About Ob/Gyn

Episode 10.5 The Dense Breast Dilemma


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Howard and Antonia explore the safety of medications during pregnancy and the controversial reporting requirements for breast density on mammograms, examining how science is being overshadowed by fear-mongering in healthcare decision-making.

• Examining the evidence behind avoiding fluconazole (Diflucan) in first trimester, finding that short courses likely pose minimal risk
• Discussing the important distinction between possibility and probability when evaluating medication safety in pregnancy
• Analyzing the wide variation in cesarean delivery rates across US counties, from 5.4% to over 53% for low-risk patients
• Critiquing politically-motivated FDA actions on SSRIs, food dyes, and other health policies not supported by scientific evidence
• Explaining why the FDA's requirement to notify women of dense breasts on mammograms may cause more harm than good
• Demonstrating how supplemental testing for women with dense breasts leads to false positives and unnecessary procedures
• Reviewing the historical development of prenatal diagnosis from early ultrasound to cell-free DNA testing

00:00:33 Evidence for Diflucan in Pregnancy

00:12:12 Cesarean Delivery Rates Across US Counties

00:16:39 FDA's Position on SSRIs and Food Dyes

00:28:46 Managing Dense Breasts in Mammography

00:44:46 History of Prenatal Abnormality Diagnosis



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Thinking About Ob/GynBy Antonia Roberts and Howard Herrell

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