Every palpable lump in pregnancy or lactation gets a targeted ultrasound; a solid mass that is not a classic galactocele or lactating adenoma is biopsied — pregnancy-associated breast cancer is often diagnosed late.
Orient first
- Physiological changes make the breast dense and nodular; lesions are harder to feel and to see.
- Common benign: galactocele, lactating adenoma, fibroadenoma growth, abscess.
- Mammography with abdominal shielding is safe when cancer is suspected or proven.
Acquire the study
- Targeted high-frequency ultrasound of the lump and axilla; mammography when ultrasound is suspicious; ultrasound-guided core biopsy.
The manoeuvre
- Mass: size in mm in three planes, margin, orientation, posterior features — BI-RADS lexicon.
- Galactocele: fluid-fat level or milk content; lactating adenoma: oval, circumscribed, hypervascular.
- Colour Doppler vascularity and the axilla for abnormal nodes.
What confirms it
- Histology on core biopsy.
What licenses you to exclude it
- A classic galactocele or simple cyst at the palpable site; anything else solid needs tissue or short-interval follow-up.
The classic misread
- Attributing a solid mass to "pregnancy changes".
- Avoiding mammography out of misplaced fear of radiation when cancer is suspected.