Advertisement

Palpable masses in breast during lactation

Published:November 20, 2006DOI:https://doi.org/10.1016/j.clinimag.2006.10.005

      Abstract

      Objectives

      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.

      Material and Methods

      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.

      Results

      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 historlogy.

      Conclusions

      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.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Clinical Imaging
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Bottles K
        • Taylor R
        Diagnosis of breast masses in pregnant and lactating women by aspiration cytology.
        Obstet Gynecol. 1985; 66: 76-78
        • Kuerer M
        Breast carcinoma associated with pregnancy and lactation.
        Surg Oncol. 1997; 6: 93-98
        • Swinford AE
        • Adler DD
        • Graver KA
        Mammographic appearance of the breasts during pregnancy and lactation: false assumptions.
        Acad Radiol. 1998; 5: 467-472
        • Petrek JA
        Breast cancer and pregnancy.
        in: Harris JR Hellmann S Breast diseases. 2nd ed. Lippincott, Philadelphia1987: 809-816
        • Treves N
        • Holleb AI
        A report of 549 cases of breast cancer in women 35 years of age or younger.
        Surg Gynecol Obstet. 1958; 107: 271-283
        • Applewhite RR
        • Smith LR
        • DeVicenti F
        Carcinoma of the breast associated with pregnancy and lactation.
        Am Surg. 1973; 39: 101-104
        • Wallack MK
        • Wolf JA
        • Bedwinek J
        • et al.
        Gestational carcinoma of the female breast.
        Curr Probl Cancer. 1983; 7: 1-58
        • Horsley JS
        • Alrich EM
        • Wright CB
        Carcinoma of the breast in women 35 years of age and younger.
        Ann Surg. 1969; 169: 839-843
        • Fischer U
        • Kopka L
        • Grabbe E
        Breast carcinoma: effect of preoperative contrast-enhanced MR-imaging on the therapeutic approach.
        Radiology. 1999; 213: 881-888
        • Heywang SH
        • Wolf A
        • Pruss E
        • Hilbertz T
        • Eiermann W
        • Permanetter W
        MR imaging of the breast with Gd-DTPA: use and limitations.
        Radiology. 1989; 171: 95-103
        • Kuhl CK
        • Mielcareck P
        • Klaschik S
        • Leutner C
        • Wardelmann E
        • Gieseke J
        • Schild HH
        Dynamic breast MR imaging: are signal intensity time course data useful for differential diagnosis of enhancing lesions?.
        Radiology. 1999; 211: 101-110
        • Müller-Schimpfle M
        • Ohmenhäuser K
        • Stoll P
        • Dietz K
        • Claussen CD
        Menstrual cycle and age: influence on parenchymal contrast medium enhancement in MR imaging of the breast.
        Radiology. 1997; 203: 145-149
        • Kuhl CK
        • Bieling HB
        • Gieseke J
        • Kreft BP
        • Sommer T
        • Lutterbey G
        • Schild HH
        Healthy premenopausal breast parenchyma in dynamic contrast-enhanced MR imaging of the breast: normal contrast medium enhancement and cyclical-phase dependency.
        Radiology. 1997; 203: 137-144
        • Kaiser WA
        MR Mammography.
        Springer, Berlin1993
        • Kaiser WA
        False positive results in dynamic MR mammography. Causes, frequency and methods to avoid.
        MRI Clin N Am. 1994; 2: 539-554
        • Nunes LW
        • Schnall MD
        • Orel SG
        • et al.
        Breast MR imaging interpretation model.
        Radiology. 1997; 202: 833-841
        • American College of Radiology (ACR)
        Illustrated breast imaging reporting and data system (BI-RADS).
        3rd ed. American College of Radiology, Reston (Va)1998
        • Petrek JA
        • Dukoff R
        • Rogatko A
        Prognosis of pregnancy-associated breast cancer.
        Cancer. 1991; 67: 869-872
        • DiFronzo L
        • O'Connell T
        Breast cancer in pregnancy and lactation.
        Surg Clin North Am. 1996; 76: 267-278
        • Ribeiro G
        • Palmer MK
        Breast cancer associated with pregnancy. A clinician's dilemma.
        Br Med J. 1977; 2: 1524-1527
        • Stucker D
        • Ikeda D
        • Hartman A
        • Carlson R
        New bilateral microcalcification at mammography in a postlactational woman: case report.
        Radiology. 2000; 217: 247-250
        • Lethaby A
        • O'Neill M
        • Harvey V
        Overall survival from breast cancer in women pregnant or lactating at or after diagnosis.
        Int J Cancer. 1996; 67: 751-755
        • Liberman I
        • Giess C
        • Dershaw D
        • Petrek JA
        Imaging of pregnancy-associated breast cancer.
        Radiology. 1994; 191: 245-248
        • Schotte K
        • Cocquyt V
        • Dhondt M
        • VanBelle S
        Breast cancer during pregnancy.
        Acta Clin Belg. 2000; 55: 102-108