Last updated: November 25, 2022

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Galactoceles are milk retention cysts that primarily occur during or shortly after lactation. The typical presentation includes a firm nontender or mildly tender breast mass. Ultrasound is the preferred modality to evaluate palpable breast masses in lactating patients. Galactoceles have a variable appearance on ultrasound, ranging from a simple anechoic cyst to a mass with internal echoes. Mammography may be required to evaluate inconclusive ultrasound findings; detection of an oil-fluid cyst is pathognomonic for galactoceles. Asymptomatic galactoceles typically regress and can be managed expectantly. Symptomatic galactoceles often require fine needle aspiration and drainage catheter placement, and in the case of infection, antibiotic therapy. See also “Breast abscess.”

  • Frequently occurs during or after lactation [1]
  • Most common benign breast lesion in lactating women who have recently stopped breast feeding [1][2]

Epidemiological data refers to the US, unless otherwise specified.

Obstruction of lactiferous duct distention of the duct due to collection of milk and epithelial cells → cyst formation

  • Firm, nontender mass, typically located in the subareolar region
  • Size may fluctuate (e.g., decrease in size after breastfeeding) [3]
  • Severe pain and systemic signs suggest secondary infection.

The diagnosis is primarily clinical and based on the patient's history and clinical presentation. A palpable breast mass always requires further evaluation. [2][4][5]

Breast imaging

Breast ultrasound


  • Indications [1][5]
  • Findings [1]
    • Well-defined mass
    • Depending on the fat and fluid content within the mass, the following features may be seen: [2]
      • Fat-fluid level
      • Uniformly radiolucent mass
      • Heterogeneous density

Imaging-guided fine needle aspiration [1]

  • Indications [2][6]
    • Diagnostic uncertainty or suspicious findings on imaging
    • Possible infection
    • Bothersome symptoms (e.g., pain, swelling)
  • Findings: milky aspirate [1]
  • Complications: milk fistula [2][5][7]

Asymptomatic galactoceles

  • Surveillance with clinical examination and/or imaging [8]
  • Treatment is usually unnecessary (most galactoceles resolve spontaneously). [6][9]

Symptomatic galactoceles [3][9]

Repeated needle aspiration increases the risk of infection but is typically required before a galactocele fully resolves. The placement of a catheter to allow continued drainage facilitates resolution. [3]

  1. Mitchell KB, Johnson HM, Rodríguez JM, et al. Academy of Breastfeeding Medicine Clinical Protocol #36: The Mastitis Spectrum, Revised 2022. Breastfeed Med. 2022; 17 (5): p.360-376. doi: 10.1089/bfm.2022.29207.kbm . | Open in Read by QxMD
  2. ACOG. Practice Bulletin No. 164 Diagnosis and management of benign breast disorders. Obstetrics & Gynecology. 2016; 127 (6): p.e141-e156. doi: 10.1097/aog.0000000000001482 . | Open in Read by QxMD
  3. Clark HR, Merchant KA, Omar LA, Compton LM, Hayes JC. Breast Lesions in Women Aged Younger than 30 Years: Clinical Presentation, Diagnosis, and Management. J Breast Imaging. 2020; 2 (1): p.72-80. doi: 10.1093/jbi/wbz086 . | Open in Read by QxMD
  4. diFlorio-Alexander RM, Slanetz PJ, Moy L, et al. ACR Appropriateness Criteria® Breast Imaging of Pregnant and Lactating Women. J Am Coll Radiol. 2018; 15 (11): p.S263-S275. doi: 10.1016/j.jacr.2018.09.013 . | Open in Read by QxMD
  5. Kieturakis AJ, Wahab RA, Vijapura C, Mahoney MC. Current Recommendations for Breast Imaging of the Pregnant and Lactating Patient. American Journal of Roentgenology. 2021; 216 (6): p.1462-1475. doi: 10.2214/ajr.20.23905 . | Open in Read by QxMD
  6. Vashi R, Hooley R, Butler R, Geisel J, Philpotts L. Breast Imaging of the Pregnant and Lactating Patient: Physiologic Changes and Common Benign Entities. AJR Am J Roentgenol .. 2013; 200 (2): p.329-336. doi: 10.2214/ajr.12.9845 . | Open in Read by QxMD
  7. Mitchell KB, Johnson HM, Eglash A, et al. ABM Clinical Protocol #30: Breast Masses, Breast Complaints, and Diagnostic Breast Imaging in the Lactating Woman. Breastfeed Med. 2019; 14 (4): p.208-214. doi: 10.1089/bfm.2019.29124.kjm . | Open in Read by QxMD
  8. Kaneda HJ, Mack J, Kasales CJ, Schetter S. Pediatric and Adolescent Breast Masses: A Review of Pathophysiology, Imaging, Diagnosis, and Treatment. AJR Am J Roentgenol .. 2013; 200 (2): p.W204-W212. doi: 10.2214/ajr.12.9560 . | Open in Read by QxMD
  9. Kornfeld H, Johnson A, Soares M, Mitchell K. Management of Infected Galactocele and Breast Implant with Uninterrupted Breastfeeding. Plastic and reconstructive surgery. Global open. 2021; 9 (11): p.e3943. doi: 10.1097/GOX.0000000000003943 . | Open in Read by QxMD

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