In the haze of joy and sleeplessness during the months after childbirth, thoughts about breast cancer are the last thing on a new mother’s mind. Her body is undergoing so many changes that, of course, she and her doctors would naturally assume any breast changes are related to breastfeeding.
Probably, they are. However, there is a small but real incidence of women who develop breast cancer during and following pregnancy. Often, they end up having delays in seeking evaluation and getting a diagnosis, because they or their doctors may not appreciate that risk!
So, what things should prompt an evaluation?
- Lumps most often will be changes in the breast tissue as it revs up milk production. A distinct lump or “dominant mass” could be a clogged duct, galactocele, cyst or a common benign tumor called a fibroadenoma, but if it doesn’t resolve within a few weeks with treatment, it needs imaging.
- Redness most often will represent infections like mastitis or an abscess, but if it doesn’t resolve within a few weeks with treatment, it will also need imaging and possibly a biopsy. At the very least, that could determine if the right antibiotics are being used. An uncommon form of breast cancer called inflammatory breast cancer can present this way.
- Bloody milk or baby refusing one breast most often will be due to nipple trauma, latch issues, or positioning; if so, seeing a board-certified lactation consultant is appropriate. But rarely, this can represent a form of breast cancer within the milk ducts.
- “Something’s not right”. You are the most knowledgeable person about your own breasts. Even if it doesn’t neatly fit one of the categories above, if something really seems wrong to you, your doctors should take that seriously.
What evaluation should be done?