Palpable masses in breast during lactation

Diagnosis of breast cancer is more difficult in pregnant and lactating women. In the present study, the value of different radiological methods has been evaluated.

Twenty-seven patients with palpable breast masses during the lactation period were evaluated. All masses were investigated in the clinical course as well as in ultrasound. If ultrasound demonstrated a suspicious lesion a mammogram was done. If clinical course, ultrasound, and mammography could not rule out breast cancer, MR mammography was done.

Eighteen ultrasound-guided biopsies were done, revealing three cysts, seven hyperplasias/mastopathia, three cases of papilloma, and two carcinomas. The 18 mammograms were classified as BI-RADS 1 and 2 in nine cases, as BI-RADS 3 in seven case, as BI-RADS 4 in one cases, and as BI-RADS 5 in also one case. MR mammography was done in 9 cases revealing three BI-RADS 4 categories and one BI-RADS 5 category, all of them showed a malignant histology.

The density of the lactating breast compromises breast cancer diagnosis. Ultrasound should be the method of choice. If possible mammography and MR mammography should be done after lactating period.