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Pregnancy and lactation are associated with significant changes to the breast tissue as a result of stimulation from high levels of estrogen and progesterone. The changes in breast tissue that occur during this time can make the diagnosis of new pathologies challenging. While the majority of the breast conditions that can arise during pregnancy and lactation are benign, it is important for the clinician to have a broad differential diagnosis to initiate the appropriate workup. The majority of issues that arise are new or enlarging breast masses, which are frequently benign fibroadenomas, lactating adenomas, or galactoceles. While mammography has been proven to be safe in pregnancy, ultrasound is the preferred imaging modality and a biopsy may be required to rule-out malignancy. Pregnant women can also present with bloody nipple discharge, but this is typically self-limited condition that just requires close follow-up. Many women who are lactating can also present with engorged breasts, and breast and nipple pain, which can complicate breast feeding. Lactating breasts are also at risk for developing to mastitis or abscesses. In addition, lactating women can develop viral and fungal skin infections of the areola and nipple. This review will discuss the diagnosis and safe management of these conditions.

Review of the diagnosis and management of benign breast issues during pregnancy and lactation