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Research Brief

Ultrasound Effective for Identifying Breast Lesions During Lactation

Ultrasound imaging is sensitive and effective for distinguishing malignant breast lesions from normal tissue changes associated with lactation.

Jill Sakai, Contributor
Wednesday, October 31, 2018


Breast tissue changes associated with pregnancy and lactation can complicate the identification and diagnosis of breast lesions in breastfeeding women. Lactating women with breast concerns are often referred for ultrasound imaging due to the difficulty of physical examinations.

A study published online Oct. 12 in Breast Care described the range of breast ultrasound outcomes seen in 77 lactating women who received radiologic exams to evaluate breast concerns such as palpable masses, swelling or pain. Examinations were categorized based on standardized Breast Imaging Reporting and Data System (BI-RADS) criteria and included normal lactation-associated tissue changes as well as cysts and solid lesions.

With ultrasound imaging, three of the 77 patients were diagnosed with invasive breast cancer. BI-RADS category 3 solid masses were identified in 12 patients (15.6 percent) and category 4 solid masses in one, which was downgraded to category 3 following biopsy. Of the remaining patients, 28 (36 percent) had only normal lactation-related changes and 33 (43 percent) showed benign features such as simple or complicated cysts, stable fibroadenomas or galactoceles (milk cysts).

Based on these findings, the authors conclude that ultrasound is a sensitive and effective first-line diagnostic tool to distinguish between normal lactation-related tissue changes and possible pregnancy-associated breast cancer. While the majority of breast masses detected in lactating women were benign, the identification of malignant lesions in three patients highlights the importance of evaluating breast symptoms in this patient population.