Lumps and Other Breast Changes During Pregnancy and Breastfeeding
While you’re pregnant or breastfeeding, your breasts go through a lot of changes and may look and feel different than they normally do. That can sometimes make it harder to tell if a change is due to a condition that needs to be treated. It’s best to be cautious and tell your doctor about any unusual symptoms, such as a lump or irritation.
Most of these breast changes don’t turn out to be cancer, but it’s important to know that breast cancer can develop in people who are pregnant, recently gave birth, or are breastfeeding. It’s also possible to safely get treatment for breast cancer during pregnancy.
If you have a lump, swelling or other symptoms, your doctor will do a physical exam of the breast. And they may order one or more imaging tests, such as an ultrasound — which uses sound waves rather than X-rays like a mammogram. Ultrasound is considered safe to use during pregnancy or breastfeeding and can help your doctor tell the difference between a cyst, which is filled with fluid, and a solid mass that may or may not be cancer.
There are several types of non-cancerous lumps, and some other benign (non-cancerous) breast conditions, that may develop when you’re pregnant or breastfeeding. They’re not linked with a higher risk of developing breast cancer, but some may need treatment. These are some of the most common ones.
Benign lumps
Non-cancerous lumps in the breast may be caused by hormonal changes, a blocked milk duct, or other factors. Your doctor may order an ultrasound to help determine which type of lump it is.
Lactating adenoma
Lactating adenoma is the most common type of breast mass in pregnant or breastfeeding people. An adenoma is a benign tumor made up of mostly glandular tissue. It can be brought on by the hormones associated with pregnancy and breastfeeding. You may have one lactating adenoma or many. They are easy to move under the skin, have clear borders, and typically contain multiple lobules (small glands that make milk). Lactating adenomas usually don’t need to be removed. They often dissolve on their own when hormone levels drop after you give birth or stop breastfeeding.
Fibroadenomas
There are other types of adenomas, known as fibroadenomas, that are responsive to hormones and may grow during pregnancy and breastfeeding. Fibroadenomas are round, movable lumps in the breast made up of glandular and fibrous tissue. They usually don’t require any treatment unless they are large and painful. Most don’t increase your risk of breast cancer, but a very rare type called a complex fibroadenoma can slightly increase your risk.
Galactoceles
Galactoceles are milk-filled cysts caused by the blockage of a milk duct. These round, movable lumps in the breast usually happen in someone who is breastfeeding or recently stopped breastfeeding. It’s possible to have one galactocele or several. Galactoceles may feel tender. Cool compresses or ice packs can help relieve the discomfort. In some cases, a galactocele may be drained to relieve symptoms. If it comes back, it can be drained again. In rare cases, a galactocele can become infected and will need to be treated with antibiotics.
Other benign breast conditions
The other most common non-cancerous breast conditions that turn up during pregnancy and breastfeeding are mastitis and bloody nipple discharge.
Mastitis
Mastitis is inflammation or an infection in the breast caused by bacteria. During breastfeeding, the nipples may become sore and cracked, allowing bacteria to enter the breast. Also, engorged or blocked milk ducts can cause inflammation that turns into an infection. Symptoms of mastitis can include:
swelling, tenderness, redness, and heat in the breast
breast lump(s)
pain or burning in the breast, which might be worse when you’re breastfeeding
skin redness
flu-like symptoms such as fever, headache, and generally feeling ill
Mastitis is treated with antibiotics. It usually gets better within about 10 days, but sometimes can take weeks to resolve. For pain relief, over-the-counter pain relievers such as acetaminophen (brand name: Tylenol) or ibuprofen (brand names: Advil, Motrin) can be helpful, along with warm compresses applied every few hours. If an abscess (a lump of pus) forms, it may need to be drained using a needle or during a minor surgical procedure.
The symptoms of mastitis can be similar to those of inflammatory breast cancer. If you have what appears to be an infection in your breast that isn’t responding to antibiotics, your doctor should order tests to check for inflammatory breast cancer. This is a rare but aggressive form of breast cancer that first appears as an area of redness and skin irritation.
Bloody nipple discharge
If you have bloody nipple discharge when you’re pregnant or breastfeeding, it could be due to an injury or another underlying issue that needs to be checked out. Your doctor may take a sample of the nipple discharge and look at it under a microscope to check for abnormal cells. If there are abnormal cells in the sample or there is a mass in the breast, imaging tests and/or a biopsy might be needed.
Which doctor should I see for breast changes?
You may want to start by seeing your OB-GYN or primary care doctor if you notice a breast change. If further assessment is needed, it’s often worth asking for a referral to a breast care specialist (such as a breast surgeon).
