Localised swelling or mass that develops in the breast and may cause pain.
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What to do when you find breast lumps during pregnancy?
Breast lumps during pregnancy Breast lumps detected during pregnancy are generally benign and reflect fibroadenoma, lactating adenoma, cysts, infarction of the breast or galactocele. Although rare, the possibility of breast cancer must also be considered to avoid any delays in diagnosis. After patient questioning and clinical examination, the first imaging modality to use is ultrasound. No further assessment is called for If the clinical signs are unclear then mammography and often biopsy should be performed. The changes to the secretion pathway do not occur evenly within the breast during pregnancy. Hyperplasic lactating adenoma, can cause one or more palpable lumps. Clinical changes Clinical examination reveals a darkening of the nipple and areola, a more prominent nipple and dilated superficial skin veins as from the end of the first trimester. During the final stages of pregnancy, breast adipose tissue nearly completely disappears and is replaced by hard, tight lobes; the skin becomes thinner. A little colostrum may be released by breast massage. Clinical examination can be challenging due to the increased size of the breasts, their sensitivity and especially their harder, more nodular consistency. A previously palpable lump can be concealed during pregnancy by hypertrophic breast tissue, or may increase in size, hence the importance of examining the patient's breasts at the beginning of pregnancy and then at regular intervals during its course. Duct ectasia is frequently observed using ultrasound. The breast is more hypoechoic due to lobular hyperplasia and duct dilation; its echogenicityis more or less homogeneous. Mammograms of pregnant women generally show a higher tissue density because of the young age of the women but also due to glandular development and adipose tissue atrophy, which decreases the sensitivity of mammography. Even so, mammography remains a very helpful modality for diagnosing breast cancer and should therefore be performed if there is the slightest doubt.Pre-pregnancy assessment is important to monitor changes such as increased size or heterogeneity of existing lesions (particularly fibroadenoma, hamartoma and cysts) during pregnancy. Clinical examination When a patient consults for a palpable lump that she has detected, she should be questioned and thoroughly examined in order to confirm the presence of a mass, describe it and prescribe the appropriate complementary investigations.Questioning should be aimed at determining the date of appearance of the lump, as well as individual patient history (possible known fibroadenoma) and familial history. Clinical examination is based on careful breast inspection and palpationand comparison with the contralateral side to: • confirm the presence of the mass; • identify its location and size; • describe its consistency and mobility; • detect related signs: skin retraction, nipple changes, discharge, lymph nodes, signs of inflammation, pyrexia. Finding a breast lump in a young pregnant woman in majority cases (80%) the lump is benign and the patient can be reassured and continue her pregnancy relieved. And when it is cancer, the delay in diagnosis (still very frequent) due to postponing investigations until after delivery, may have serious consequences. Ultrasound is used as the first-line imaging technique. It enables accurate diagnosis of simple cystic lesions and sometimes helps to confirm that there is actually no lump but just normal fibroglandular tissue. It allows accurate investigation of solid lesions. Mammography When 4-view mammography is performed, the mother receives a dose of radiation of about 3 mGy and the dose received by the uterus is lower than 0.03 μGy . The fetus is therefore exposed to a negligible amount of radiation . Doses of up to 1 mGy are considered to be acceptable for the fetus. The threshold value above which there exists a risk for the fetus. Mammography may be performed with a lead screen or apron that approximately halves the dose to the fetus and reassures the patient. Mammography should be prescribed on even the slightest doubt after clinical and/or ultrasound examination, because it can be particularly useful for diagnosis in cases of breast cancer. Moreover, if a lesion contains fatty density, its benignity can be affirmed and biopsy avoided. MRI On the basis of current knowledge, the injection of gadolinum, as is required for breast MRI, is contraindicated during pregnancy. Breast samples It is essential that pathologists be aware that the patient is pregnant before assessing breast samples. Cytological assessment can lead to false negative, as well as false positive results. If atypical findings are observed, taking a biopsy is mandatory in these cases. Biopsy Taking biopsies is the most reliable method for diagnosing solid masses. Biopsies are generally performed using ultrasound guidance but are sometimes also carried out using stereotactic guidance (microcalcifications). In the latter case, there is a slightly higher rate of complications (milk fistula, infection or bleeding), and post-biopsy compression should be applied for a longer time. Pregnancy-associated breast cancer (PABC) PABC is defined as breast cancer that occurs during pregnancy or within the year following childbirth. It is a rare disease that accounts for only 6–10% of all breast cancers in women aged under 40 years.. The average age of onset is 34 years. Patient questioning on familial history is essential and women with a significant risk should be examined carefully. In majority of cases, breast cancer occurs in young women with no noteworthy history, so the possibility of cancer should not be excluded in a 25-year-old woman just because she has no family history of the disease. Patients may be treated surgically at any time during pregnancy and chemotherapy may be initiated from the 2nd trimester on. The main risk for the fetus is prematurity. Radiotherapy is generally contraindicated during pregnancy, as is hormone therapy. Numerous different oncological, obstetrical, psychological and personal parameters (choice, mother's age, other children, risk factors) need to be taken into account. . Conclusion Breast masses discovered during pregnancy should be investigated immediately either to reassure the patient (most lesions are benign), or if necessary, rapidly implement treatment when breast cancer is diagnosed since any delay in diagnosis and therapy can jeopardize successful management. content source
How to avoid breast lumps during pregnancy?
Breast lumps definition and facts Breast lumps can be caused by infections, injuries, non-cancerous growths, and cancer. Breast cancer usually causes no pain in the breast. The symptoms of breast cancer include painless breast lumps, nipple discharge, and inflammation of the skin of the breast. The chances that a particular breast lump could be cancerous depends on many factors, including past medical history, physical examination, as well as genetic and other risk factors. The only way to be certain that a lump is not cancerous is to have a tissue sampling (biopsy). There are several ways to do the biopsy. The treatment of a breast lump depends on its cause. Breast self-examination Continuing with self-breast exams during pregnancy is important. Unfortunately, during pregnancy it is more difficult to accomplish because of all the changes your breasts are going through. Your breasts are growing in size, are tender, and sometimes may even be lumpy. It is still important for you to examine your breasts during pregnancy every 4-5 weeks. Very common lumps found among women during pregnancy are clogged milk ducts. These are red, tender-to-the-touch, hard lumps in your breasts. Warm compresses (running warm water over your breasts in the shower or applying a warm wash cloth) and massages will probably clear the duct in a few days. If you are unsure of any new lump, tell your doctor on your next visit. Keep in mind breast cancer is rare among women younger than 35. If you are planning on having a baby and are over the age of 35, you may want to consider asking your doctor about a mammogram before you get pregnant. content source
Home remedies for breast lumps during pregnancy
What are Breast Lumps? A breast lump is a mass that develops in the breast. Breast lumps vary in size and texture and may cause pain. Some are not found until a physical or imaging exam. Most breast lumps are benign (non-cancerous). Your doctor will likely perform a physical exam to evaluate a breast lump. To determine whether that lump is benign, your doctor will likely order a mammogram and breast ultrasound. In addition, breast MRI, PET/CT or scintimammography may be obtained. If the lump is confirmed to be benign, no further action may be needed, but your doctor may want to monitor it to see if it changes, grows or disappears over time. If the tests are inconclusive, a biopsy using ultrasound, x-ray or magnetic resonance imaging guidance may be performed. If the lump is confirmed to be cancer, surgery is usually performed. Additional treatment may include radiation therapy, chemotherapy, or hormone therapy. Home remedies to treat breast lumps To minimize the discomfort associated with breast cysts, you might try these measures: Wear a well-fitted, supportive bra. If your breast cysts are painful, supporting your breasts may help relieve some discomfort. Apply a compress. If cysts are painful, either a warm or cool compress can offer relief. Applying an ice pack can also relieve pain. Avoid caffeine. There's no evidence linking caffeine and breast cysts. However, some women find symptom relief after eliminating caffeine from their diets. Consider reducing or eliminating caffeine — in beverages, as well as in foods such as chocolate — to see if your symptoms improve. Consider trying over-the-counter pain medications if your doctor recommends them. Some types of breast pain may be eased by the use of acetaminophen (Tylenol, others) or nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, Naprosyn, others). Content source Featured Image Source