Common causes of breast lumps in lactating mothers

Breastfeeding is a mother’s gift to her child and herself – there are innumerable advantages of breastfeeding to both the mother & child but sometimes mothers can face some difficulties during breastfeeding. One of them is the development of breast lumps during breastfeeding.

Breast lumps during breastfeeding can not only lead to anxiety in the mother but can sometimes be a sign of something as ominous as cancer. The common causes are:

Milk collection (Galactocele) – this is probably the most common cause of breast lumps in breastfeeding mothers. It commonly occurs due to a blocked duct and the patient can feel a painful lump in the breast. It can sometimes also occur, if breast milk is not emptied at regular intervals.

Management of a galactocele/ milk collection can range from emptying of breast milk either by feeding or by using a breast pump. Hot fomentation/ gentle massage also works well in this condition. If the problem occurs frequently, then one should consult a lactation expert/ doctor for further evaluation

 Breast abscess/ mastitis – this is inflammation of the breast tissue which can progress to pus formation as well. It is secondary to a bacterial infection and you would be surprised to know that the source of the bacteria is the child’s mouth. These bacteria can enter through the nipple (more common in ladies with cracked/ sore nipples) and lead to infection.

Patient usually develops intense pain in the breast, which can be associated with redness and fever as well. If one notices any such symptoms, they should visit their breast surgeon immediately. In the initial stages, this condition is managed using antibiotics. In case, pus develops, then the surgeon is left with no option but to drain the pus out by performing a minor surgery.  If the abscess is very large, your doctor might also recommend stopping breastfeeding using a drug.

Breast cancer – can sometimes be detected during breastfeeding. These lumps can initially be mistaken for a milk collection but unlike milk collections, they don’t respond to simple measures and keep on increasing in size. Sometimes these lumps might even be painless.

Due to these two reasons, cancers can often increase in size before they are detected in breastfeeding mothers.

If a mother notices a lump in the breast during breastfeeding, which does not settle in a few days, she should immediately visit a breast cancer surgeon and get herself evaluated. If the surgeon is suspecting a cancer, they will order an ultrasound followed by a needle biopsy to confirm the diagnosis.

These are some of the common causes of breast lumps during lactation. It is good to be aware of these lumps and one should not delay meeting a doctor in case they notice such problems. Having said this, majority of the mothers have an uneventful lactation period.

Over the last few years it has been seen that mothers are reducing the duration of breastfeeding due to professional commitments. Given all the advantages of breastfeeding for the mother and the child, this world breastfeeding week all ladies should pledge to complete breastfeeding at least for 6-8 months.

 

This information has been provided by

Dr. Rohan Khandelwal

Principal Consultant, Breast Cancer Surgeon

The Breast Centre

CK Birla Hospital, Gurgaon

 

World Breastfeeding Week 2020

Breast Cancer Care During COVID19 – my experience at CK Birla Hospital, Gurgaon

The current COVID19 pandemic has affected the way all doctors practice and oncologists are no exception. Over the last 2-3 months, we have witnessed a lot of changes in treatment protocols, attitude of cancer patients towards their disease and the behavior of newly diagnosed breast cancer patients. Rather than going into technical details regarding the treatment protocols which we are following (which are an Indian modification of American/ European guidelines, most suited for our breast cancer patients at CK Birla Hospital), I will be discussing changes which we have made as doctors and how are our patients coping with the pandemic.

When the lock-down was announced in mid March, fear & panic is what prevailed amongst the patients and they were initially apprehensive in coming to the hospital for their surgery/ chemotherapy. But by early April, it was clear to patients that COVID will persist for a few months and although the world might be in lock-down but the cancer brewing inside their body would continue to grow and they would need to fight it out.

This change in patient attitude coupled with the proactive management at CK Birla Hospital (specially measures taken to improve patient and staff safety), we were able to carry out breast cancer treatment smoothly, even during the lock-down.

During the two months of lock-down, 94% of our breast cancer patients continued their chemotherapy. The ones who skipped some cycles were patients with metastatic disease, who wanted a ‘chemotherapy holiday’. In this period, my unit also operated 22 breast cancer patients. The number of benign (non cancerous) breast surgeries dipped dramatically during this period but we have seen a rebound increase in such cases since the lockdown norms have been eased.

After talking to a lot of friends & colleagues in UK/USA, I realised that I will only be able to take care of my patients if I stay healthy and disease free. To ensure that, in addition to the measures implemented by the hospital, I have also started using extra precaution in the form of a 3M 6200 mask with two p100 filters, which keeps the smoke plumes (thought to be a the leading case of infection in surgeons & anaesthetists) away. Of course, my OCD of hand washing has also served me well during this period 😊.

rk ppe

Our breast cancer patients have also adapted well over the course of the last 2 months. Our unit has a very active cancer support group known as ‘Vijay’ and all the members have devised new methods to keep in touch with each other during these tough times.

In the pre-covid times, old patients used to visit the new patients on the day of their surgery/ first chemotherapy. This is has been replaced by zoom group calls to support newly diagnosed patients. Even our treatment completion celebrations have undergone a lot of change. Earlier, these used to be elaborate affairs where the patient’s family & the treating team would participate actively, but now we have toned it down (but not stopped it, as it is a very important landmark in the patient’s life) to a simple cake cutting with everyone wearing masks.

pt celebration

To summarise, my biggest learnings during this period have been

  • Cancer care has to go on but we should be willing to adapt our treatment strategies after a thorough discussion with the patient
  • The safety of the treating team & patients is of paramount importance in order to deliver seamless breast cancer care during this outbreak

 

 

This article has been written by,

Dr. Rohan Khandelwal

Principal Consultant – Breast Cancer Surgery

CK Birla Hospital, Gurgaon

rohankhandelwal@gmail.com

Breast Cancer Treatment Completion

We don’t remember days, we remember moments

______________________________________________________
It’s always a delightful moment to see the smile on a patient’s face, when they conquer breast cancer.