Breast: Galactocele

Published on 06/06/2015 by admin

Filed under Obstetrics & Gynecology

Last modified 22/04/2025

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Chapter 151 Breast: Galactocele

INTRODUCTION

Description: Galactocele is cystic dilation of a duct or ducts, with inspissated milk and desquamated epithelial cells, that may become infected, resulting in acute mastitis or an abscess.
Prevalence: Common in asymptomatic form.
Predominant Age: Reproductive.
Genetics: No genetic pattern.

ETIOLOGY AND PATHOGENESIS

Causes: Ductal obstruction and inflammation during or soon after lactation may lead to cystic dilation of a duct or ducts and the subsequent development of a galactocele. Galactocele is generally associated with breastfeeding, but it may on rare occasions be associated with galactorrhea or oral contraceptive use.
Risk Factors: Breastfeeding, mastitis, galactorrhea, and abrupt weaning.

CLINICAL CHARACTERISTICS

Signs and Symptoms

• Painless mass palpable in the central portion of the breast

DIAGNOSTIC APPROACH

Differential Diagnosis

• Duct ectasia
• Lipoma
• Fibrocystic change
• Fibroadenoma
• Breast abscess

Associated Conditions: Mastitis, ductal ectasia, and nipple discharge.

Workup and Evaluation

Laboratory: No evaluation indicated.
Imaging: No imaging indicated.
Special Tests: Aspiration produces thick, creamy material.
Diagnostic Procedures: History and physical examination, needle aspiration.

Pathologic Findings

Cystic dilation of ducts with milky-white material made of lipid-rich foam cells and ductal epithelial cells, granular eosinophilic secretions, and lipids.

MANAGEMENT AND THERAPY

Nonpharmacologic

General Measures: Evaluation and reassurance.
Specific Measures: No specific therapy is required for a galactocele, and the mass will subside in a few weeks. When uncomplicated by infection, needle aspiration or drainage by gentle pressure is diagnostic and decompression is curative. Excision may be required for recurrences.
Diet: No specific dietary changes indicated.
Activity: No restriction.
Patient Education: Instruction on monthly breast self-examination; American College of Obstetricians and Gynecologists Patient Education Pamphlet AP145 (Breast Self-Examination), AP026 (Detecting and Treating Breast Problems), AP029 (Breastfeeding Your Baby), AP076 (Mammography).

Drug(s) of Choice

None.

FOLLOW-UP

Patient Monitoring: Normal health maintenance.
Prevention/Avoidance: None.
Possible Complications: Secondary infection and abscess formation.
Expected Outcome: The mass will subside in a few weeks with no therapy.

MISCELLANEOUS

Pregnancy Considerations: No effect on pregnancy.
ICD-9-CM Codes: 611.5.

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REFERENCES

Level III

Santen RJ, Mansel R. Benign breast disorders. N Engl J Med. 2005;353:275.

Seltzer MH, Skiles MS. Disease of the breast in young women. Surg Gynecol Obstet. 1980;150:360.

Smith RP. Gynecology in primary care. Baltimore: Williams & Wilkins, 1997;319.

Winker JM. Galactocele of the breast. Am J Surg. 1964;108:357.

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