Local Complications of Breast Surgery during Pregnancy and Lactation

Approach to the growing breast lump during lactation

Physiological changes during pregnancy and lactation result in increased lumpiness of the breast. This makes the evaluation of the breast challenging. Although most self-detected lumps, during this period, tend to be benign, the priority in these patients is to exclude tumours that may require prompt management. We present a case of phyllodes tumour that occurred during lactation and discussed the resultant pitfalls that may occur during the triple assessment of a breast lump in a lactating mother.

Breast pseudoaneurysm after core needle biopsy in a pregnant patient

Breast pseudoaneurysm is an extremely rare complication of interventional breast procedures. Pregnancy and lactation are associated with increased breast vascularization, which may act as a risk factor. We present the case of a 36-year-old woman in the third trimester of a spontaneous twin pregnancy, who presented with a newly-detected BI-RADS 4 mass in her right breast. The patient requested not to defer a biopsy until after the pregnancy, and an ultrasound-guided breast core biopsy was performed. The patient presented bleeding during the procedure, but no hematomas or other vascular lesions were immediately detected. During follow-up, a breast ultrasound revealed an anechoic circumscribed mass and high‐velocity blood flow. The color Doppler showed a spiral blood flow with the Yin-Yang sign, together with a communication channel between the sac and feeding artery. A diagnosis of breast pseudoaneurysm was made. The patient was managed conservatively, and breastfeeding continued normally. This case report highlights the importance of color Doppler in the detection of pseudoaneurysms, and the need to consider deferring invasive breast procedures in pregnant women when possible.