Breast lump while breastfeeding: Should you wait to evaluate?
I had been breastfeeding my baby for seven months when I discovered a large lump had developed in my breast. Two months later I went to my doctor. He referred me to a breast specialist who examined my breast, told me it was probably a benign tumor and to come back when I was finished nursing. I have no idea when I'm going to be done breastfeeding -- it might be a year from now. I just found another lump in my breast. Though I'm only 25 and my family has no history of breast cancer, shouldn't he have evaluated the lump?Question:
I can really understand your concern about the lump(s) you discovered in your breast.
Most lumps in the breasts of nursing mothers are due to galactoceles (milk-filled cysts) and may be caused by the blockage of a milk duct. Though a lactating mom's breasts may have the tendency to feel lumpy, it is still extremely important to properly evaluate a mass that remains unchanged to rule out the possibility of malignancy.
In the article, "Diagnosing and Managing Breast Disease During Pregnancy and Lactation", published in the May 1997 issue of Medscape Women's Health, Carol Scott-Conner, MD, PhD, reminds us that when a breast mass is discovered, "watchful waiting" is no more appropriate during lactation than at any other time. A thorough workup is warranted, including breast biopsy if indicated.
In lactating women who have been found to have a palpable breast mass, ultrasound can be used as a diagnostic tool. Ultrasound will show the location of the mass and whether it is fluid filled (usually cystic or benign) or solid (possibly malignant.) Mammograms can be used in the breastfeeding mother, though they are more difficult to read due to the density of the breast tissue. If a mammogram is used, it is important to find a radiologist accustomed to reading mammograms of lactating women. Fine-needle aspiration of a cystic mass or biopsy are other diagnostic tools that can be safely used while breastfeeding. It would be wise to nurse your baby immediately prior to any breast exam or diagnostic procedure to help reduce the amount of milk within your breast.
It is rare to be diagnosed with breast cancer during lactation. This may be the reason your Doctor told you to come back when you were no longer nursing. He probably also was not aware of just how long that might be. I would advise speaking with him again, letting him know that you are still quite concerned. If the lump in your breast has remained constant in size, or has grown, and your Doctor is not interested in pursuing diagnostic tests at this time, I would advise you promptly seek a second opinion. Very best wishes!Answer: