Benign disorders of the breast in pregnancy and lactation

• Main Authors: Taib, Nur Aishah, Rahmat, Kartini
• Format: Book Section
• Published: Springer International Publishing AG 2020
• Subjects: RC Internal medicine; RD Surgery
• Online Access: http://eprints.um.edu.my/37187/

Benign cystic or solid lumps frequently occur in the breasts of young women, and consequently can also be seen during pregnancy and lactation. Simple cysts do not increase the risk of malignancy. The current management is routine follow-up. Complex cysts are thick walled or contain a mass, and should be followed by a US-guided biopsy and then treated similar to any non-gravid, non-lactating patient. Galactoceles can be detected during the last trimester of pregnancy and during or after stopping lactation. Aspiration can be done to confirm the content. Co-existence of galactocele and malignancy is extremely rare, and the key is to follow up until it resolves. Fibroadenoma is the most frequent lesion found during pregnancy and lactation. Management is usually conservative after triple assessment. Surgery is usually not recommended in pregnant and lactating women unless rapid increase in size occurs or there is discordance in the triple assessment. Lactating adenomas are sometimes interpreted as a variant of fibroadenoma. They can naturally disappear at the end of pregnancy or lactation. Management is usually conservative, and an excisional biopsy is only mandated if it is rapidly enlarging or if there is discordance in the triple assessment. Gestational gigantomastia is a rare condition consisting of diffuse severe hypertrophy of both breasts during pregnancy. Mastectomy and reconstruction may rarely be required in such cases.