Breast Cysts and Fibroadenomas: Pregnancy Concerns Explained

Q: Breast Cysts and Fibroadenomas: Pregnancy Concerns Explained

Hello, 1. For palpable breast tumors： the diagnostic rate can reach 90%. For non-palpable tumors, the diagnostic rate may be less than 50-60%. 2. A definitive diagnosis requires a pathological examination report; therefore, physicians cannot make a 100% di

Breast cysts, fibromas, pregnancy issues?

Hello Dr.
Zhou,
I am 32 years old and have recently been preparing for pregnancy and considering breastfeeding in the future.
However, I have been experiencing chest pain frequently over the past six months, which led me to undergo a breast ultrasound.
The report indicated that I have four cysts and one nodule that is "most likely" a fibroadenoma, and I was advised to return for another ultrasound in six months.
However, the doctor could not confirm whether it is indeed a fibroadenoma, as a surgical excision would be necessary for a definitive diagnosis.
This has caused me some concern regarding my pregnancy plans.
The report stated: "0.6 x 0.4 x 0.5 cm hypoechoic nodule is probably a fibroadenoma.
Otherwise, no other focal lesion.
No malignancy."
I would like to ask Dr.
Zhou the following questions:
1) What is the typical accuracy of breast ultrasound? Is there ever a situation where the identification of a fibroadenoma is 100% certain? Does "probably" indicate a 70%, 80%, or 90% chance?

2) Given my current breast condition, is it appropriate for me to become pregnant? Will pregnancy increase the risk of the tumor growing or becoming malignant?

3) If it turns out that I am not dealing with a fibroadenoma but rather a malignant tumor after becoming pregnant, could this affect the safety of both the fetus and myself?

4) If I undergo monthly breast ultrasounds during my pregnancy to monitor for growth, and if the growth rate remains slow, can we be confident that it is not malignant?

5) Am I classified as having "fibrocystic changes" or "fibroadenoma"?

6) Should I be concerned about the four cysts, or can they be left alone? Is it possible for them to resolve on their own?
Thank you very much! Wishing you all the best for your health and well-being!
Sara

Sara, 30~39 year old female. Ask Date: 2013/05/30

Dr. Zhou Jiazhen reply Breast and Thyroid

Hello,
1.
For palpable breast tumors: the diagnostic rate can reach 90%.
For non-palpable tumors, the diagnostic rate may be less than 50-60%.

2.
A definitive diagnosis requires a pathological examination report; therefore, physicians cannot make a 100% diagnosis based solely on imaging studies.

3.
There is no certainty; the smaller the tumor, the lower the detection rate.

Regarding pregnancy:
1.
It will not affect pregnancy.

2.
It should not be a concern as long as regular check-ups are maintained.

If malignancy is confirmed, early intervention is still recommended, and the decision will depend on the gestational age of the fetus to assess any potential impact.

4.
It is uncertain; the general principle for tumor management is that if the tumor is growing, surgical removal is advised, as the likelihood of malignancy increases.
Additionally, it is not necessary to have ultrasound examinations every month; follow-up every 3-6 months is sufficient.

5.
Both conditions are possible, and sometimes they may coexist.

6.
A cyst may increase, decrease, or remain unchanged; regular outpatient follow-up is sufficient.

Wishing you peace and health.

Director of Surgery, Taoyuan Hospital, Department of Health
Zhou Jiazhen

Reply Date: 2013/05/30

More Info

Hello Sara,
Thank you for reaching out with your concerns regarding breast cysts and fibroadenomas, especially as you prepare for pregnancy and breastfeeding. It's understandable to have questions about the implications of these findings on your health and future pregnancy. Let’s address your questions one by one.

1. Accuracy of Breast Ultrasound: Breast ultrasound is a valuable tool in evaluating breast lumps and cysts. While it is quite effective, it is not 100% accurate. The term "probably" in your report indicates that the radiologist believes there is a high likelihood (often around 70-90%) that the nodule is a fibroadenoma, but definitive diagnosis typically requires a biopsy. This means that while the ultrasound can provide useful information, it cannot guarantee the nature of the lump without further testing.

2. Suitability for Pregnancy: In general, having cysts or a probable fibroadenoma does not preclude you from becoming pregnant. These conditions are common and often benign. However, hormonal changes during pregnancy can cause breast tissue to become denser and may lead to changes in existing cysts or fibroadenomas. While the risk of these conditions becoming malignant is low, it is essential to maintain regular check-ups with your healthcare provider to monitor any changes.

3. Potential for Malignancy During Pregnancy: If a fibroadenoma were to turn out to be malignant, it could pose risks to both the mother and the fetus. However, this scenario is rare. If you have concerns about the possibility of malignancy, it is crucial to discuss them with your healthcare provider. They can help you weigh the risks and benefits of monitoring versus further diagnostic procedures.

4. Monitoring During Pregnancy: Monthly ultrasounds can be a way to monitor the size and characteristics of the lumps during pregnancy. If the growth rate is slow and the characteristics remain consistent, it is less likely to be malignant. However, any significant changes should be evaluated promptly.

5. Distinguishing Between Cysts and Fibroadenomas: You mentioned having four cysts and one nodule that is probably a fibroadenoma. Cysts are fluid-filled sacs, while fibroadenomas are solid tumors made up of glandular and connective tissue. Your report indicates that you have both conditions, which is not uncommon.

6. Management of Cysts: Many breast cysts are benign and can resolve on their own, especially if they are simple cysts. However, if they cause discomfort or if there are changes in size or characteristics, further evaluation may be warranted. Regular follow-ups are essential to ensure that they remain stable.

In summary, while your findings may raise concerns, they are common and often benign. It is crucial to maintain open communication with your healthcare provider, who can guide you on the best course of action as you navigate your pregnancy and breastfeeding journey. Regular monitoring and follow-up ultrasounds will help ensure that any changes are promptly addressed.
Wishing you all the best for your health and your upcoming journey into motherhood!
Best regards,
Doctor Q&A Teams

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