A mass that develops in the breast is called a breast lump. It may vary in size, shape, and texture, depending on the underlying cause. Although it may cause concern, most breast lumps are benign and harmless.
Clogged ducts or mastitis can be a common cause of breast lump in breastfeeding mothers. However, it is essential to seek an early evaluation for an exact diagnosis. Diagnostic tests, such as mammograms and breast ultrasounds, do not reduce milk production, and you can safely continue to breastfeed.
Read this post to learn more about the types, diagnostic methods, treatment, homecare, and alarming signs and symptoms of breast lumps in breastfeeding mothers.
Types Of Breast Lumps In Breastfeeding Women
Various medical conditions can cause breast lumps. The following are the common types of breast lumps that may occur in breastfeeding women (1).
- A clogged or blocked milk duct causes insufficient drainage of the milk. A lump or local discomfort may develop when milk builds up behind the blocked duct. Stasis of milk flow can result in breast infection in many mothers.
- Mastitis is the inflammation of breast tissue. It may cause pain, swelling, redness, and warmness over the lump. Mastitis can often involve infection of breast tissue accompanied by fever. Antibiotic treatment is often needed to cure this condition.
- Fibrocystic breast disease, also called fibrocystic changes or fibrocystic breasts, is a benign (non-cancerous) type of breast lump. It can feel tender during a breast examination, and you may also feel multiple nodules in the breast. Fibrocystic changes do not affect breastfeeding.
- Breast cysts are harmless, usually oval-shaped collections of fluid. It can often be moved around and may feel hard and smooth during self-examination. Although many cysts may resolve without any treatment, some may require drainage.
- Hematoma is a collection of blood under the skin due to surgery or trauma. Breast hematoma can be painful and may appear red and swollen externally. You may notice skin discoloration if the hematoma is close to the skin.
- Lipomas are benign fatty masses that usually grow slowly. This can be soft and does not cause pain. Although it is not cancerous, the breast’s abnormal shape due to lipoma can be the reason for many women to opt for surgical removal.
- Breast cancer can be the cause of breast lumps in some breastfeeding women. Hard, immobile, painful breast lumps with indefinite borders can be associated with breast cancer. You may require imaging tests and biopsies to confirm the diagnosis of breast cancer.
Breast lumps can be due to various reasons, ranging from self-resolving conditions to breast cancers that require complex treatments. In any case, self-diagnosis is not ideal since an expert examination and tests are vital to identify the exact cause.
When To Consult A Doctor?
You may consult a doctor if you notice any changes in your breasts. Breastfeeding mothers should also seek the advice of a lactation consultant to continue breastfeeding during the treatment.
Seek medical care if you notice any of the following signs and symptoms.
- Thickening of breast tissue in some area or breast lump on self-examination
- Baby refuses to feed on the breast with a lump
- Changes in shape and size (usually becomes larger) of the breasts
- Breast lump or cysts persisting more than two or three menstrual cycles
- Constant breast pain
- Skin changes, such as puckering or dimpling, on the breast
- Breast itchiness and redness
- An inverted nipple that was not present before
- Any nipple discharge except milk
Self-examination by observing and palpating the breasts may help you identify any of these changes in the breasts. You may also contact your healthcare provider if you notice these signs after the treatment of any previous breast condition.
Diagnosis Of Breast Lumps In Breastfeeding Mothers
The symptoms, health history, and physical examination could help the doctor identify a breast lump. The following imaging tests are ordered for the detailed evaluation of the breast lump (2).
- A mammogram is a breast X-ray to help visualize breast changes. X-ray is not known to affect the milk supply, and you may continue nursing after the procedure (3).
- Breast ultrasound may help identify the location of the lump and differentiate between solid and fluid-filled lumps.
- MRI scan of the breasts helps to look for the soft tissues of the breast. Healthcare providers may give contrast (dye) injection on the arm before the MRI exam to enhance blood vessels and tissues’ appearance.
Doctors may order breast biopsy for some women. The biopsy procedure includes a collection of tissue samples and its microscopic evaluation. Under local anesthesia, needles guided with ultrasound or mammography collect the tissue sample. Local anesthetics do not transfer to breast milk in detectable amounts, so mothers can nurse safely after the procedure.
There are various breast biopsy options, such as (2):
- Core needle biopsy with a large needle, which features a special tip to remove the tissue samples.
- Fine-needle aspiration biopsy uses a thin needle with a syringe that removes cells and fluid from the lump.
- Vacuum-assisted biopsy uses a probe with a vacuum device to collect the sample.
- Stereotactic biopsy uses mammographic images of the lump taken from various angles. Based on these images, the doctor collects the sample from the location with a needle.
- Surgical biopsy is a method of collecting tissue samples through a small incision. This may often be collected at the time of lump removal surgery.
If the doctor performs a fine-needle aspiration, the following outcomes may occur (2).
- Fluid-filled breast cyst may disappear or reduce in size after the aspiration.
- Doctors may order further testing if the breast lump disappears and the fluid is not bloody and instead has a straw (pale yellow) color.
- If the lump does not disappear and bloody fluid is aspirated, the doctors may order lab analysis. They may also make a referral to a radiologist or breast surgeon for further testing and procedures.
- Imaging tests, such as ultrasound or mammogram, are done if no fluid is drawn from the lump. A tissue biopsy could be conducted to check for cancer.
Although breast cancers are rare in breastfeeding mothers, breast changes in nursing mothers are evaluated with the same concerns as in non-breastfeeding women.
Treatment For Breast Lumps While Breastfeeding
A simple fluid-filled breast cyst without any symptoms may not require treatment. Although some cysts may resolve without treatment, it is essential to confirm the diagnosis with fine-needle aspiration or ultrasound.
Treatment options may vary according to the underlying cause and may include the following (2) (4).
1. Fine-needle aspiration
Fluid-filled breast cysts can be treated with fine-needle aspiration, which is also a diagnostic procedure. Usually, the symptoms and lump disappear after aspirating the fluid. Some women may require draining more than one time to remove the fluid.
2. Hormone therapies
Doctors may prescribe birth control pills (oral contraceptives) in case of recurrent breast lumps. Hormonal therapy with tamoxifen is often given for severe cases if the mother is ending the nursing. This medication is not recommended for lactating mothers since its active metabolites could pass into breast milk.
3. Surgeries
If the breast lump reoccurs many times or becomes larger, surgical removal is considered. The surgical options may include:
- Lumpectomy: It is also called wide local excision or excision biopsy, a breast-conserving surgery that removes only the lump. Breast milk supply may not be affected by minor surgeries, which are common in cases of small lumps. Incisions near the areola, post-surgical radiation therapy, and procedures to remove larger lumps may affect the breast milk supply. However, in most cases, babies can feed on the other breast.
- Mastectomy: This is a surgical procedure involving partial or complete removal of one or both breasts in case of breast cancer. This may also be done as a preventive measure in high-risk groups. Nursing mothers can continue to breastfeed safely from the unaffected breast. Doctors may plan post or pre-surgical radiation or chemotherapy, according to the type and stage of cancer. They may also consider the possible ways to retain the breast milk supply from the unaffected breast.
Delaying breast cancer treatment to breastfeed may not be ideal since cancer may metastasize (spread to other parts of the body) or invade the nearby tissues within a few months. You may discuss with the oncologist to know the best possible treatment based on your condition.
4. Antibiotics
Taking a complete course of antibiotics is required to treat breast infections. Clogged or blocked ducts or mastitis can often end in breast infections in women who stop breastfeeding from the affected breast.
Your doctor will prescribe safe lactation antibiotics to treat the infection. It is recommended to complete the prescribed course of antibiotics to avoid recurrent infections even though the symptoms get better within a couple of days of treatment.
5. Chemotherapy
Some nursing mothers may require chemotherapy to treat cancerous breast lump. Breastfeeding is not recommended during chemotherapy since most of these drugs are highly toxic and can easily pass into breast milk.
Breastfeeding might be possible after completing chemotherapy. However, this may depend on the chemotherapeutic drug. Discuss with your healthcare provider to know the best possible drug and relactation after the treatment.
6. Radiation therapy
Radiation therapy could damage the lactation tissues, resulting in reduction or cessation of the milk supply. You may safely breastfeed from the unaffected breast since radiation does not damage the other breast tissue.
Choose the best possible treatment option with a better outcome and seek advice from a board-certified lactation consultant to plan your baby’s diet during the treatment. Abrupt weaning of the baby is not recommended if the mother is undergoing diagnosis or treatment for breast lumps.
Home Remedies For Breast Lumps
You may seek medical care if you find any breast lumps. Home remedies and lifestyle changes may help to manage breast cysts in some women; however, a few types of lumps require advanced medical treatment.
You may try the following methods to reduce the discomfort due to breast cysts and benign clogged milk ducts (5).
- Apply a cold or warm compress to reduce the pain.
- Wear a supportive bra to relieve discomfort.
- Gently massage the affected area if you have a clogged duct since this may improve draining.
- Contact your doctor and try over-the-counter pain medications, such as acetaminophen or NSAIDs, if recommended.
- Avoid caffeine.
Taking vitamins, herbal remedies, and dietary supplements are not scientifically proven to help breast cysts or other types of breast lumps. You may discuss with your physician to know the side effects of alternative medicines if you want to try them.
Breast lumps are often harmless, but some conditions may require immediate treatment that may result in breastfeeding cessation. If you have the choice, you may pick the treatment option that lets you breastfeed simultaneously. In most cases, it is safe to breastfeed from the unaffected breast while undergoing treatment. If nursing is not possible, the pediatrician may recommend suitable high-quality formula to meet your baby’s nutritional needs.