Discovering a breast lump during pregnancy is a scary moment for mothers-to-be. While most women, by the time they reach their reproductive years, are aware that one breast might be larger than the other and changes in size are normal throughout their cycle, many aren’t aware of the changes they can expect while pregnant. Here’s what you can consider to be normal hormonal changes and what warrants more concern.
How Pregnancy Changes Your Body
When a woman becomes pregnant, changes in her breasts may be one of the first things that make her suspect she’s with child. The breasts begin to swell from the very start of pregnancy as a response to the body being flooded with higher levels of progesterone. In addition, the veins that have always presented across the breasts may become more prominent and seem bluer than before — sometimes even taking on a purple hue. As pregnancy progresses, the areolas may darken in response to chemical changes within the body, but the hormones aren’t just a case of happenstance; there’s a purpose for this change. After birth, babies can’t actually see very clearly, and the darkened nipple area helps direct them to the breast for nursing.
You may also experience soreness, either or the nipples, the whole breasts, or both. One thing that gives some women particular pause is leakage of colostrum, which can start as early as 16 weeks in some expectant mothers, per Belly Belly. Montgomery’s tubercles might also cause women to stop and stare in the mirror every morning. These tiny goose bump-like formations surrounding the areolas are perfectly normal during pregnancy and occur with purpose, as well. They keep the areola well-lubricated so moms don’t end up with dry skin and chafing when breastfeeding.
Another surprise many moms-to-be encounter during pregnancy are lumps and bumps forming within the breast. This is sometimes a cause for concern, but most of the time it isn’t. That being said, any kind of lump warrants a trip to the midwife or doctor to make sure all is well. In some cases, it may be nothing more than lumps in the breast tissue caused by rising levels of estrogen. There are also causes for concern where breast lumps are concern, such as:
- Clogged milk ducts
In many cases, perhaps most, breast lumps discovered during pregnancy are nothing more than benign cysts. They may very likely have existed prior to conception and the hormonal surges of pregnancy cause them to swell and become more obvious. Some women have fibrocystic breasts in which the breast tissue throughout their breasts becomes rubbery and lumpy. Cysts typically feel like a small grape with rounded, but obviously distinct edges. They are firm and can grow larger during the luteal phase of the menstrual cycle. Sometimes they’ll shrink back down in size during the follicular part of the menstrual cycle, but sometimes they don’t.
Sometimes small lumps are discovered in the breast and even reaching up into the armpit. Many women discover these when shaving or performing breast self-exams. Often, these lumps are actually swollen lymph nodes, which occur as a result to an infection in the body that it’s trying to fight off. Other signs of infection, such as fever, are important to look out for.
This is the most concerning type of lump found within the breast, because a tumor can often mean breast cancer. Johns Hopkins Medicine reports just 20 percent of lumps found in the breast turn out to be cancerous in any form. Screening for breast cancer while pregnant is entirely possible. There are some risks, such as radiation exposure, but the risk of waiting out the pregnancy is larger. If breast cancer is found and the pregnancy is far enough along that the baby would be likely to survive and fair well outside of the womb, induction may be proposed. If not, then it is likely still the best option as soon as that stage of development is reached. The reason for this is because the high amounts of estrogen produced during pregnancy also feed cancer and make it grow. Cutting off that hormone supply as soon as possible is best for the treatment outcome of the mother.
Fibroadenomas — tumors that are more common in younger females who use birth control — can be tiny or large and usually can be left alone and not even removed if they aren’t bothersome. Without diagnosis testing, it’s not generally possible to tell whether a tumor is cancerous or not. This form of testing often requires aspiration, biopsy, x-rays, mammograms, blood testing, and more. Mammography is the preferable method of scanning for breast tumors during pregnancy since it delivers less radiation to the body overall than x-ray does.
Clogged Milk Ducts
Since milk production and all it entails starts far before the baby is actually born, it’s actually possible to suffer from clogged milk ducts way before then, too. Although milk isn’t being produced early on, colostrum may be produced as soon as four months into pregnancy. This nutrient-rich, thick, golden substance can clump in milk ducts. Since moms should avoid pumping because of the risk of it causing contractions, they can’t nurse or pump the clog out the way they would be encouraged to postpartum. Instead, warm compresses and massage are the best way to handle this problem while pregnant.
Women of menstruating age and beyond should be performing breast self-exams every month. If you have to set a reminder on your phone, do it. The National Breast Cancer Foundation reports 40 percent of diagnosed cases are initially discovered when the patient finds them lump themselves. Fortunately, 80 to 85 percent of all breast lumps are totally benign, per Everyday Health. In some cases, a warm compress and a few days’ time can cause a cyst to subside. Cysts won’t go away that quickly, nor tumors, but clogged milk ducts certainly can. In addition, if an infection is present, other symptoms may appear within the following days or the infection may resolve itself. If pain, fever, swelling, itching, nipple discharge, or redness is apparent when you notice the lump, this warrants a more urgent trip to the doctor. Otherwise, it’s generally safe to wait it out a few days and see if the situation improves on its own.