Areola Lumps: When to Consider Surgery and Breastfeeding Impact

Q: Areola Lumps: When to Consider Surgery and Breastfeeding Impact

Hello： Since it is unclear from your description whether the cyst was completely excised, I recommend that you consult a breast surgeon. <br>If it has been completely removed, then follow-up observation is sufficient. <br>Whether breastfeeding is affected is primarily determined

Nipple lump

Hello, I would like to ask about a lump I discovered on my areola, approximately 1.5 cm in size, which is painful when pressed.
I visited a dermatologist who diagnosed it as a sebaceous cyst and mentioned that if it grows larger, surgery may be necessary.
They only provided a topical ointment.
Later, I went to a breast surgeon at the hospital, who also confirmed it as a sebaceous cyst and noted that it was inflamed.
During the visit, they incised it to drain the pus and prescribed antibiotics to prevent infection.
After a week, during the follow-up, the doctor noted that pressing on it was painful and that there was a blood clot.
After treatment, they said no further follow-up was needed.
The wound has now healed, but I can still feel a small hard area about 1 cm in size (it has been nearly a month since I first noticed it).
I would like to know if I should consider surgical removal or if I should just observe it for now.
Additionally, if it is not removed, will it affect breastfeeding in the future when I become pregnant? Thank you.

Niming, 20~29 year old female. Ask Date: 2017/02/24

Dr. Wu Yuting reply Surgery

Hello: Since it is unclear from your description whether the cyst was completely excised, I recommend that you consult a breast surgeon.
If it has been completely removed, then follow-up observation is sufficient.
Whether breastfeeding is affected is primarily determined by whether the milk ducts have been impacted, so I still suggest you consult your attending physician.
* Breast Surgery Dr.
Wu Yu-Ting * Xinying Hospital

Reply Date: 2017/02/24

More Info

When it comes to lumps on the areola, particularly those diagnosed as sebaceous cysts (or "粉瘤" in Chinese), it's essential to understand both the nature of the lump and the implications for future breastfeeding and pregnancy.
From your description, it seems that you have already undergone an evaluation by both a dermatologist and a breast surgeon, who have confirmed the diagnosis of a sebaceous cyst that has become inflamed. The treatment you received, which included incision and drainage of the cyst, is a common approach to manage such conditions, especially when there is an infection or accumulation of pus or blood.

When to Consider Surgery
In general, surgery is recommended for sebaceous cysts if they are symptomatic (causing pain or discomfort), recurrent, or if there is concern about infection. Since you mentioned that the lump is still palpable and hard after a month, it may be worth considering surgical removal, especially if it continues to cause discomfort or if there are changes in size or characteristics.
However, if the lump is stable, not growing, and not causing significant pain, it may be reasonable to monitor it for now. Regular follow-up with your healthcare provider is crucial in this scenario. They can assess the lump's characteristics and decide if surgical intervention is necessary based on its behavior over time.

Impact on Breastfeeding
Regarding your concerns about breastfeeding in the future, the presence of a sebaceous cyst or even a small residual lump after drainage typically does not affect the ability to breastfeed. The breast tissue is quite resilient, and as long as there is no significant scarring or disruption to the milk ducts, breastfeeding should not be impacted. However, if surgery is performed, it is essential to discuss with your surgeon how the procedure might affect the surrounding tissue and milk production.

Recommendations
1. Observation: If the lump remains stable and asymptomatic, continue to monitor it. Regular check-ups with your healthcare provider can help ensure that any changes are promptly addressed.

2. Surgical Consultation: If you experience increased pain, swelling, or any changes in the lump, consult your healthcare provider about the possibility of surgical removal.

3. Breastfeeding Plans: If you plan to become pregnant and breastfeed in the future, discuss your concerns with your obstetrician or midwife. They can provide guidance on how to manage any potential issues related to the lump or surgery.

4. Healthy Practices: Maintain good breast hygiene and be aware of any changes in your breast tissue. If you notice new lumps or changes in existing ones, seek medical advice promptly.

In conclusion, while the presence of a sebaceous cyst can be concerning, it is often manageable with appropriate medical care. Monitoring the lump and maintaining open communication with your healthcare providers will help ensure the best outcomes for your breast health and future breastfeeding plans.

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