Evaluation of breast lesion by ultrasonography during pregnancy and lactating women

Abstract

Introduction:Substantial physiological changes occur during pregnancy and lactation, making breast evaluation challenging in these patients. The aim of this study was to characterize the breast lesion seen in Indian women and to establish the correlation between clinical features of breast lesion and their pathological diagnosis. Materials and Methods:This is a prospective and observational study conducted at Subbiah institute of Medical sciences attended between April 2019 to March 2020. All female Patients irrespective of age who came for ultrasound breast examination with suspected breast lesions, complain of pain, palpable lump, breast complaints like nipple discharge, retraction, skin thickening were included in the study. Sixty pregnant or /and lactating females who came for ultrasound examination were done such as proper application of compression, transducer positioning, and image labelling.Results:In our present study 100 patients were examined amongst which 39 cases were benign 3 were malignant lesions and rest of the cases were normal. Of the remaining consecutive 39 cases (BIRADS 2 to 6) were evaluated clinically, by sonography and FNAB. In this study, the age range of patients presenting with breast lesions was 18–70 years with mean age 48.3 years. 19 patients were breast lesions occurred in the age group of 40-60 years, 6 were younger than 40 years and 14 were between 61-70 years. Most lesions were found in the upper outer quadrant and the right breast was affected more than the left. 15 lesions were assigned BIRADS 5 category. The second most common category was BI-RADS 2 in 11 lesions.  There were total of 39 benign cases, Fibroadenoma (13) being the commonest, followed by Fibrocystic disease (9), Cysts (7), Mastitis (4), Duct ectasia (3), least being Phylloides, Galactocele and Papilloma. Conclusion:Evaluation of the pregnant and lactating patients who present with a breast problem is challenging. Although ultrasound may characterise the finding in many cases, mammography and even MRI may have a role in the management of these patients.