A clinico-radiological correlation of breast diseases during lactation and the significance of unilateral failure of lactation.

Over a period of three and a half years, 58 patients who for various reasons had both ultrasonography and mammography during lactation were analyzed to identify and correlate breast diseases, if any, with the clinical symptomatology. The clinical symptoms were breast pain, mass and/or unilateral failure of lactation. Twenty-one (21) out of 58 (36%) had abnormal findings. The commonest was galactocele (N = 9) which usually presented with breast pain and a mass. Unilateral failure of lactation and in particular refusal of the infant to suckle (infant rejection sign) was associated with breast lesions such as malignancy (N = 4), breast abscess (N = 2) and infected galactocele (N = 2). Mammographically, the affected breast showed a significantly reduced ductal pattern as well as significant pathology such as a mass. Symptomatic patient with bilateral successful lactation had benign breast lesions such as simple galactocele and fibroadenoma. Unilateral failure of lactation in a symptomatic breast may signal serious breast pathology during lactation and a thorough radiological evaluation including core biopsy of solid lesions and mammography is therefore suggested. Patients with breast pain and or mass but with bilateral normal lactation tend to have benign breast changes and ultrasound alone was adequate in evaluating these patients.