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Mammography and Interventional Breast Procedures
Published in Raymond Taillefer, Iraj Khalkhali, Alan D. Waxman, Hans J. Biersack, Radionuclide Imaging of the Breast, 2021
A galactocele is a milk-containing cyst that develops during or within a few months after lactation. The mammographic appearance depends on the amount of fat and proteinaceous matenal within the milk. If the fat content is very high, the mass may be completely radiolucent, mimicking a lipoma. However, the mammographic finding of a circumscribed mass with a fat-fluid level on upright horizontal beam films (ML or LM views) is diagnostic [36]. In some patients, the fat and water densities may be mixed, producing a mottled pattern similar to hamartoma [36].
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
My primary differential for this patient is a breast abscess which may be secondary to lactation. My secondary differential would be breast malignancy. This can also present as a variably shaped breast mass(es), nipple discharge, surrounding skin oedema or peau d'orange and lymphadenopathy. This could also be a fibrocystic disease, which can present with non-bloody discharge – though I would expect a cyclical history of mastalgia that is related to the menstrual cycle. The patient may also have a milk retention cyst, or galactocele, which can similarly present as a tender lump but is not usually associated with localised breast inflammation or systemic illness.
The puerperium
Published in Louise C Kenny, Jenny E Myers, Obstetrics, 2017
A galactocele (or lactocele) is a sterile, milk-filled retention cyst of the mammary ducts following blockage by thickened secretions. It is identified as a fluctuant swelling with minimal pain and inflammation. It usually resolves spontaneously assisted by massage of the breast towards the nipple, but may also be aspirated; with increasing discomfort, surgical excision may become necessary.
Non-typhoidal Salmonella soft-tissue infection after gender affirming subcutaneous mastectomy case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2023
Branden T. Barger, Mikhail Pakvasa, Melinda Lem, Aishu Ramamurthi, Shadi Lalezari, Cathy Tang
Last, an infrequent, though well-documented complication following breast surgery is galactorrhea and galactocele formation [33,34]. Galactorrhea after breast surgery is thought to be due to increased levels of prolactin from stress as well as from inadvertent stimulation of nerves in the chest wall and breast tissue during surgery [35]. Galactorrhea can also be the result of an undiagnosed pituitary tumor, or a side effect of antipsychotic medications such as risperidone. In the case of antipsychotics, the D2-dopamine receptor blocking action of these medications turns off the dopamine-prolactin negative feedback loop leading to hyperprolactinemia [36]. To our knowledge, this phenomena has not yet been described among patients undergoing chest masculinization. The patient had recently transitioned to risperidone, which has the highest reported rates of hyperprolactinemia in the literature [37]. Confirmation of fluid as breast milk is not usually done by laboratory testing, and was not performed in our patient as it was not available at our institution. However, the copious white fluid diffusely present in our patient’s surgical plane along with his elevated prolactin levels raised suspicion for galactorrhea. After discussion with both endocrinology and psychiatry services, risperidone was discontinued and his prolactin levels down trended. It remains unclear, whether our patient’s high prolactin levels contributed to his complicated recovery.