Hi,

I recieved this email from a friend/co-worker who now lives in a small Idaho town with limited access to health care providers.  It rather stumped me and a couple other LC's I discussed the situation with so we would really appreciate and wider perspective!  I don't work much with medical issues and breastfeeding and so have limited experience on this end of things--however, I was really thinking galactocele. And that's all I have found in my resources that is sounds like.  

Obviously it's too late to cancel the surgery...but please share your collective wisdom!  I have copied her emails just as she sent them:

Thanks so much!

Michele Crockett, IBCLC, PCPA, LLL

I have a large breast lump that was biopsied last week.  The expectation was a lactating adenoma (benign tumor), but the final diagnosis given today was mastitis!  I have no fever, no pain, no illness.  The surgeon treating me agrees that this is entirely weird.  So, now I'm on antibiotics and hopefully that will take care of the lump, which is actually inflamed, infected tissue.  Another oddity is that this infection seems to be "compartmentalized" instead of affecting the whole breast.  The biggest immediate concern is that the biopsy site heal from the inside out so that it will stop leaking milk/fluid and not form a fistula.  The surgeon, who doesn't want me to wean, said that weaning is usually necessary to get a fistula to stop draining and heal.  He also said that in his experience, it hasn't been very effective to wean from just one breast but we could certainly try that option if a fistula develops.  I feel like the surgeon is sincere in his desire for us to continue breas
tfeeding.  I will have an ultrasound tomorrow to rule out an abscess. 

Her second email responding to my questions:

Thanks for your quick reply.  You can definitely post my story on Lactnet.  I'll try to tell more of my story from the beginning....I have a very large mass (now the size of an egg) and my OB dr thought it was a cyst and it does match the description of a cyst.  However, the surgeon did an initial ultrasound that revealed that the mass was not cystic in nature and seemed to be mostly solid.  With that knowledge, he thought it was an adenoma, hence the biopsy to rule out malignancy and confirm the diagnosis of an adenoma.  We were all surprised that the dx was mastitis. Today, my more thorough ultrasound showed a significant abscess the size of a golf ball and the radiologist thought is should be drained asap.  So now I have a surgery scheduled for Monday under general anesthesia.  Ugh!  Is there any possibility that it could still be a cyst and not an abscess???  

Yes, I did have some initial nipple damage the day Isaiah was born (only from us trying to force him to nurse; as long as he initiated the feed he latched great).  It has taken awhile to heal, but that's been the only damage. 

I still have no sign of infection and everyone is surprised that I have no pain and no fever.  I golf ball sized abscess should hurt.

There is no known damage from the biopsy.  This mass is quite aways from my nipple and more in the area of my pectoralis muscle.

If you think that it could all be a misdiagnosis and really be a cyst, I'll try to get a hold of my dr this weekend and let him know about the cell count numbers.  The biopsy was done in office but sent to a patholoy lab for testing and dx.  

I initially found this "lump" at about 3 weeks post partum (4 weeks ago) and assumed it was a plugged duct because what else could it possibly be.  At the time it was much larger that a "pea-sized" plugged duct should have been, but I just couldn't imagine what else it could realistically have been.  So, I used heat and massage and nothing happened.  After a week, the lump was now golf ball sized, I called my OB who said to keep using heat and massage and give it another week.  After that week, the lump was more like an egg sized and, upon examination, my OB immediately referred me to the surgeon, thinking it was a cyst. 

I hope that gives more useful details.  Please feel free to share this info with anyone (I'm really not concerned if it identifies me or not) who might be able to help.  I've been given nurses orders to keep my feet up and rest a lot this weekend. 

Thank you, thank you, thank you for all your help!

             ***********************************************

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