Breast Lump Concerns: Impact on Breastfeeding and Cancer Risks

Breast lump

Hello Dr.
Wu: Recently, while breastfeeding, I discovered a hard lump about three centimeters in one breast, which appears red and swollen, and is painful to touch.
During my pregnancy, I had it checked and it was diagnosed as a benign fibrocystic mass, which was two centimeters at that time.
The doctor recommended surgery, but I did not want to undergo surgery during pregnancy, so I did not seek further treatment.
If I pursue treatment now, will I be unable to continue breastfeeding? Is there a possibility that it could become malignant? Will the surgery be very painful?

Meimei, 30~39 year old female. Ask Date: 2004/10/05

Dr. Wu Jingtang reply Breast and Thyroid

Dear Miss,
Based on your description, it seems that you have recently given birth and are currently breastfeeding.
If you have discovered a hard lump about three centimeters in size that appears red and swollen, and is painful to the touch, it is more likely to be mastitis.
Generally, this condition requires antibiotic treatment, and if necessary, incision and drainage may be needed.
If this is the case, it is best to temporarily stop breastfeeding.
The incision and drainage procedure may cause some pain, but it is brief.
This is not necessarily related to the benign fibrocystic changes you found during your pregnancy check-up.
I recommend that you consult a breast surgeon.
In general, mastitis does not lead to malignant tumors.

Wishing you good health,
Dr.
Wu

Reply Date: 2004/10/05

More Info

When it comes to concerns about breast lumps, especially during breastfeeding, it’s essential to approach the situation with caution and a clear understanding of the potential implications for both breastfeeding and cancer risks. Based on your description of a three-centimeter hard lump that is red, swollen, and painful to touch, it is crucial to seek medical evaluation promptly.

First, it’s important to note that breast lumps can arise from various conditions, including benign (non-cancerous) and malignant (cancerous) causes. In your case, the previous diagnosis of a benign fibrocystic lump during pregnancy is reassuring, but the changes you are currently experiencing warrant further investigation. The fact that the lump has increased in size and is now causing discomfort and visible changes in the skin (redness and swelling) could indicate an infection, such as mastitis, or other complications that need to be addressed.

Regarding your concerns about breastfeeding, it is generally possible to continue breastfeeding even if surgery is required for a lump, but this depends on the specific circumstances. If the lump is determined to be benign and does not pose an immediate risk, your healthcare provider may recommend monitoring it rather than surgical intervention. However, if surgery is necessary, many procedures can be performed with techniques that minimize disruption to breastfeeding. It’s crucial to discuss your breastfeeding goals with your surgeon and pediatrician, as they can provide tailored advice based on your situation.

As for the risk of the lump becoming malignant, it’s essential to understand that while most breast lumps are benign, any changes in size, shape, or associated symptoms (like pain and redness) should be evaluated to rule out breast cancer. The likelihood of a benign lump transforming into cancer is generally low, but it is not impossible. Regular monitoring and follow-up imaging, such as ultrasounds or mammograms, are vital in managing breast health, especially with a family history of breast cancer.

In terms of pain associated with surgery, experiences can vary widely among individuals. Many factors, including the type of surgery, anesthesia used, and individual pain tolerance, will influence your experience. Surgeons often employ techniques to minimize pain and promote faster recovery, and they will provide you with pain management options post-operatively.

In summary, it is crucial to consult with a healthcare provider, preferably a breast specialist, to evaluate the lump further. They may recommend imaging studies or a biopsy to determine the nature of the lump. If surgery is indicated, discussing your concerns about breastfeeding and pain management with your healthcare team will help ensure that you receive the best care tailored to your needs. Remember, early intervention and clear communication with your healthcare providers are key to managing your breast health effectively.

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