On the Coast – Families Issue 101 I August/September 2019 | Page 6

Lactation Lumps
with Dr Mary Ling, Central Coast Breast and General Surgeon
MEDICAL
TESTS DURING
BREASTFEEDING
Persistent breast lumps may
need further investigations, which
are usually compatible
with breastfeeding.
Imaging
Mammogram and ultrasound are
safe to use during breastfeeding. It
is recommended that breasts are as
empty as possible prior to the test to
maximize the quality of the images.
Biopsy
Breast lumps are a concern at
any time and can be very common
during breastfeeding
Here are five causes of “lactation lumps”.
Blocked Milk Duct
A blocked milk duct leads to trapped
milk in the breast tissue, which may form
a painful lump. Anything that prevents
good breast drainage can cause a blocked
duct, such as poor positioning, a tight bra
or scarring from previous breast surgery.
Frequent breastfeeding, gentle breast
massage and warm compresses can help.
A blocked milk duct usually resolves
within 24 to 48 hours, however, it may
progress to mastitis.
Mastitis & Abscess
Mastitis is inflammation of the breast
and affects 10 percent of breastfeeding
mums. In addition to a lump, mastitis can
cause redness on the breast, fever and
chills. Untreated mastitis can result in an
abscess, which is a walled-off area of pus
and bacteria in the breast. An abscess
requires urgent medical attention.
Diagnosis is made by ultrasound and
1
2
treatment involves antibiotics and
drainage.
Galactocele
A galactocele is a benign milk-filled
cyst. Typically the lump is smooth and
painless. Massaging the lump may cause
milk to be expressed from the nipple.
Diagnosis is made by ultrasound and
sometimes by sampling the cyst content.
Galactocele usually
disappear when
breastfeeding ends.
3
A breast biopsy has a small risk
of infection and bleeding. In
breastfeeding women, there is an
additional risk of milk fistula –
where there is a constant leakage
of milk through a ‘hole’ on the
skin of the breast. It is important
to continue breastfeeding after a
biopsy to avoid a fistula, otherwise,
the milk will find the path of least
resistance to flow which may be the
opening at the biopsy site.
5
Breast Cancer
Breast cancer is uncommon in women
of childbearing age. Breastfeeding
women account for only 3 percent
of breast cancer cases. However any
persistent breast lumps (or changes) after
treatment for blocked duct, mastitis or
abscess always require investigations.
4
Benign Breast
Lumps
Benign breast lumps
unrelated to
breastfeeding, such
as cysts (fluid filled
lumps) and
fibroadenomas (solid
lumps), can also
occur.
Dr Mary Ling is a Breast and General Surgeon who consults at Gosford, Woy Woy and Kanwal.
& 02 4321 0302
6
www.drmaryling.com.au
ON TH E C OA S T – FA MILIES
@drmaryling
*This advice is general only.
All surgical procedures have
risks. Speak to your doctor
about your symptoms