A galactocele is a benign breast cyst most commonly developing in people who are pregnant or lactating. This condition involves the formation of a retention cyst filled with milk or a milky substance within the breast tissue. Understanding the nature of this lump and its timeline for resolution is the primary concern for those who discover one.
Defining a Galactocele
A galactocele is a milk-filled cyst that forms inside the milk-carrying ducts of the breast. It occurs when a lactiferous duct becomes obstructed, causing milk components to accumulate behind the blockage.
The obstruction leads to the retention of milk, which distends the duct over time. This trapped fluid forms the palpable cyst. The underlying cause is related to the hormonal environment of pregnancy and lactation, which stimulates milk production. Galactoceles are the most commonly diagnosed benign breast mass during the lactation period.
Recognizing the Signs
A person typically notices a galactocele as a lump within the breast tissue. This mass usually presents as smooth, distinct, and mobile, meaning it can be easily moved under the skin. While often painless, some people may experience mild discomfort or a feeling of fullness in the affected area.
The size of the lump can fluctuate, sometimes increasing after a feeding session or pumping due to continued milk production and accumulation. Although the cyst itself is generally not associated with inflammation, a milky discharge from the nipple can occasionally be present. The presence of a new breast lump should always prompt an evaluation by a healthcare professional to ensure an accurate diagnosis.
Natural Timeline and Resolution
The natural course for most galactoceles is spontaneous resolution, particularly after the hormonal changes associated with lactation begin to settle. The cyst resolves as the body gradually reabsorbs the fluid trapped inside the retention cyst.
The timeline for this spontaneous resolution can vary significantly, ranging from a few weeks to several months. For people who have stopped breastfeeding, the cessation of milk production helps the process along, though it may still take weeks to months for the lump to completely dissolve. The size of the cyst and the person’s ongoing lactation status are the two primary factors influencing resolution speed.
Smaller galactoceles often disappear faster, while larger ones may take longer for the body to reabsorb the volume of retained milk. If the milk remains stagnant for an extended time, it can become thicker, a process known as inspissation, which may slow the reabsorption process. Continued, effective emptying of the breast, even with the galactocele present, is recommended to promote drainage and resolution.
Medical Management and Intervention
When a galactocele is symptomatic, large, or persists beyond the typical timeline, medical intervention may be necessary. Ultrasound is the first-line imaging tool used to evaluate the mass, which helps to confirm it is a benign, fluid-filled cystic collection.
The most common treatment is fine-needle aspiration (FNA), a procedure that is both diagnostic and therapeutic. This involves using a thin needle to drain the milky fluid from the cyst, which often results in the immediate resolution of the lump and provides symptomatic relief. However, repeated aspiration may be needed if the cyst refills, which can occur if the duct remains obstructed.
Surgical excision of a galactocele is rarely required and is reserved for complicated cases, such as those with infection, or when the lump does not resolve after repeated aspirations. A person should seek medical attention if the lump is growing rapidly, causing severe pain, showing signs of infection like redness or fever, or if it remains unchanged after several months.