Lactating mother of twins presents with a palpable mass in the left breast.
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Ultrasound of the area confirms a mixed echogenicity mass lesion measuring 13 mm in diameter.
This lesion turned out to be a galactocele. At the insistence of the patient, the lesion was aspirated and milky fluid obtained. The lesion did not disappear completely on aspiration and was palpable for a couple of weeks after.
Galactoceles are difficult lesions to manage from an imaging perspective. They have widely different presentations on ultrasound and traditionally we have been loath to aspirate them due to the theoretical possibility of fistula formation. The wide variation in appearance on ultrasound and the relative infrequency with which we see these lesions, as well as the danger of missing a more sinister lesion, makes meticulous follow up mandatory.