I have worked with one mother who had a galactocele (deep in the breast
superior to the areola rather than right under nipple-areola complex) who
was told by surgeon who I respect that the galactocele could be allowed to
just sit there.  If it didn't grow or cause problems it wouldn't hurt
anything.  This advice was given after careful visualization and some
aspiration to rule out malignancy.  This woman did have some problems with
repeat episodes of mastitis, but they were successfully managed (more or
less, given the hassle) with antibiotics and tx for inflammatory sx.
However, she struggled for 6 months with these repeated problems, and only
her dedication saved the lactation.

 The fact that there is caking of the one nipple duct suggests to me that
some blockage is happening which prevents that area of the breast from
draining well. One of the very most interesting pieces of information I have
seen recently on Lactnet discussed Susan Love's new work disecting breasts,
and her observations that the ductal system is tangled the way roots of a
plant are.  If a galactocele is present, it has the potential to influence
the drainage of more than one duct.  If we are still acting on the
supposition that the myriad ducts converge into larger sinuses which narrow
into a small number (22?) nipple ducts, then one plug up in the system could
affect the drainage of a whole lobe or channel to the surface.  I think Jack
Newman's discussion of ultra sound therapy to shatter such blockages is
interesting.  If kidney and gall stones can be treated this way, it makes
sense that a cystic blockage of the breast might respond well.  Unilateral
weaning is a non-invasive alternative, as is doing what my client did:  just
dealing with resultant hassles and carrying on.

 I have become interested in a new physical therapy called manual lymphatic
drainage.  Practicioners gently apply manual massage along the lyphatic
drainage pathways to encourage blocked areas to flow.  I don't know if it's
total hocus pocus or not, but I had it done on myself to see what it felt
like on an area in my face where I've had chronic sinus problems.  It was
pleasant, and when I sat up and bent over to put my shoes on, moisture
plopped out of my right tear duct, and I've felt better.  It wasn't crying
-- believe me, I've cried out of that eye!  Two of my daughters have had
mono and struggled to recover for months.  I had them massaged, and both
felt terribly worse for about a week, and now are feeling better than they
have in a long time.  I'm a suspicious person, but I have to say I was
rather impressed.  I'm going to try to see if I can get anyone coming to me
with chronic mastitis problems to see this woman.
Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html