Breastfeeding comes with a variety of challenges, anxieties, and most significant of all, changes to your breasts. Feeling an irregularity within your breast tissue while breastfeeding can undoubtedly spark concern. But knowing how to tell the difference between a clogged milk duct and a breast cancer lump can help put your mind at ease.
"A clogged milk duct usually feels like a lump in the breast, and it can be painful," lactation consultant Rebecca Costello of In the Flow Lactation tells Romper. And chances are, if you notice a knot, lump, or nodule in your breast, it can make your mind swirl with concern over the dreaded "c-word" whether you're breastfeeding or not. Anyone who has ever had a brush with this type of fear knows exactly what I'm talking about. Cancer concerns aren't something to take lightly, but when you're a nursing mom, breast changes and clogged ducts can be par for the course, so how do you know what you're dealing with?
"After breastfeeding, when the tissue is softer, clogged milk ducts and any other growths in the breast tissue should be expected to feel more noticeable as the surrounding breast tissue is decompressed and has less pressure in it with the milk having been drained," Dr. Heather Richardson, M.D., of the Bedford Breast Center tells Romper. "Clogged milk ducts however can vary in their texture, size, and how much pressure you might feel. A breast cancer lump will not undergo changes, and will not come and go, but remain."
Ashley Georgakopoulos, Motif Medical lactation director and IBCLC, tells Romper that for most breastfeeding moms, clogs can be felt externally, which is why it's important to understand the differences between this type of lump and potential breast cancer. "The knot that forms is almost like a small swelling, with the concentration of the congestion happening in the direction of the nipple, the swelling backed up with milk," she explains. "Occasionally, pumping mothers can see the relieved clog as a stringy substance floating in the milk."
If you have a painful lump, trying home remedies to relieve the potential clog can help you determine what type of lump you're actually dealing with. Georgakopoulos recommends applying heat and massaging the front side of the knot, as well as trying different nursing positions or using a hand pump with saline or salt and warm water.
"A clogged duct can take multiple days to resolve — two to three days is not uncommon," Costello says. "Some people see progress after a few days, but notice they continue to need to work it out past that time. As long as it is improving, usually it's not concerning."
However, Richardson explains that timing is important when determining whether or not you are dealing with a clogged duct or potential cancerous lump. "Stubborn milk ducts that are clogged may persist, but eventually over a few days will soften and change in their consistency, where as cancer will not do this. Cancer may have other associated changes such as pulling in of the nipple, pulling in the overlying skin, or making lymph nodes in the underarm firm and enlarged."
Reaching out for help from a lactation consultant to resolve a clogged duct may be necessary if your clog does not soften after a few days, or seems to be a recurring issue. Additionally, unchanging lumps may need to be evaluated by a physician.
"If a firm, painless lump is present in the breast tissue during breastfeeding and essentially feels unchanged despite changes in the breast issue with milk flow and engorgement, or if it persists beyond four to eight weeks, this is something that a breastfeeding mom should consider to bring to her doctor's attention," Richardson tells Romper.
Richardson also notes that there are many explanations for breast growths that aren't cancerous, including clogged ducts, milk cysts, and engorged tissue, but getting checked out can give you some peace of mind. "If you do feel a lump, and undergo an in-person exam by your practitioner, if it’s merely evaluated by having your doctor feel it with her hands, make sure that you ask about the possibility of imaging with ultrasound," she says. "If they feel it’s not necessary, make sure they instruct you with a plan to follow up with imaging if the area is persisting, and at what time interval. Mammograms aren’t the first or best way to image breastfeeding tissue, but are indicated in some specific situations."
Ashley Georgakopoulos, Motif Medical Lactation Director and IBCLC
Rebecca Costello, IBCLC, MPH of In the Flow Lactation