A strange looking breast mass. Diagnosis?

Ultrasound can throw up strange looking lesions, especially in the breasts. 

This lactating female patient had complex cystic lesion of the breast on ultrasound imaging. 

The key word here is lactating female. 

It looks cystic, poorly vascular on color Doppler, contains echogenic debris.

In a lactating patient, the only possibility is a galactocele or milk cyst of the breast. 

(Images courtesy of Dr Golam).

Differentiating points:

Differentiating a galactocele from other breast cystic lesions on sonographic imaging can be challenging, but there are some key features that can help. Here are some points to consider:

Galactoceles are typically located in the subareolar region of the breast.

They are often associated with lactation or recent breastfeeding.

They have a characteristic appearance on ultrasound, with a well-defined, round or oval shape and a homogeneous, anechoic,  sometimes complex, interior, as in our case above. 

Other cystic lesions, such as simple cysts or complex cysts, may have different imaging characteristics, such as internal echoes, septations, or thickened walls.

FNAC is diagnostic:

In cases of diagnostic uncertainty, ultrasound-guided aspiration can be used to confirm the cystic nature of the lesion and rule out other causes of breast masses. 

More on galactocele:

Galactocele is a milk containing cyst of the breast in lactating women. 

1. Galactoceles are usually harmless and can often be managed without surgery.
2. Symptoms may include a lump or swelling in the breast, pain, or nipple discharge.
3. Diagnosis is typically made through imaging tests, such as an ultrasound or mammogram.
4. Treatment options may include aspiration to drain the fluid, or surgery to remove the sac.
5. Breastfeeding can sometimes trigger the formation of a galactocele, but it's not a common occurrence.
6. Galactoceles are not related to breast cancer and do not increase a woman's risk of developing breast cancer.
7. In rare cases, a galactocele may become infected, which can cause more serious symptoms and require prompt medical attention.
8. Regular breast exams and mammograms are still important for women who have experienced a galactocele to ensure overall breast health.

For more visit:

Galactocele ultrasound imaging