Breast tissue grows and changes during pregnancy. Although finding a lump may seem like a cause for alarm, most lumps found during this time are normal and benign (noncancerous). Talking to your healthcare provider and following up with recommended tests can help give you peace of mind if you feel a lump.

Around 1 in every 3,000 people develop breast cancer during pregnancy — most often, women between the ages of 32 and 38, according to the National Cancer Institute. In the rare case that breast cancer is the cause of breast lumps, knowing sooner rather than later will allow you to move forward with essential treatment. Read on to learn more about pregnancy and breast cancer.

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Normal Breast Changes During Pregnancy

Starting in the early stages of pregnancy, elevated hormone levels boost circulation to the breasts and may cause enlargement. Breasts can start to feel lumpy and usually increase by one or two cup sizes.

Some people also develop tiny bumps on their areolas called Montgomery’s tubercles. These are sebaceous glands that make oil and lubricate the nipple and aren’t anything to worry about.

After birth, you may notice hard lumps that feel tender once you start breastfeeding. These may be clogged milk ducts that are associated with active lactation and milk production.

Milk cysts are also common benign tumors found during breastfeeding. They are known as galactoceles and are caused by a blockage in a milk duct.

Other Noncancerous Lumps

People may develop other benign breast conditions during pregnancy, including lumps called fibroadenomas and lactating adenomas. Various types of cysts and infections may also lead to lumps. While some lumps benefit from treatment right away, many breast abnormalities in pregnancy resolve on their own after childbirth.

Diagnosing Breast Lumps During Pregnancy

Imaging tests, often starting with ultrasound — particularly in people younger than 30 — are usually the first step in determining the cause of a breast lump.

If there’s a need for further imaging or if the pregnant person is age 30 or older, diagnostic mammography or digital breast tomosynthesis may also be appropriate. Mammograms can be performed safely during pregnancy when ordered by doctors because the radiation dose is very low.

If imaging identifies a suspicious mass, an image-guided core needle biopsy is the most definitive diagnostic strategy and shouldn’t be delayed simply because of pregnancy. A biopsy entails removing a tissue or fluid sample for study under a microscope.

If you have a breast infection, antibiotics can help treat it safely during pregnancy to prevent further complications.

What if It’s Breast Cancer?

Despite the low risk of breast cancer during pregnancy, it’s still a possibility. Finding breast cancer early is crucial.

Many forms of chemotherapy can be started during pregnancy when the benefits of treatment outweigh the risk of waiting. Certain breast cancer chemotherapy regimens can be given during the second and third trimesters, but not every chemotherapy drug is appropriate during pregnancy.

Treatment and timing should be determined by an oncology and maternal-fetal medicine team, and chemotherapy is generally stopped before delivery. Sometimes, pregnant people undergoing chemotherapy deliver early or have a baby with a low birth weight. Radiation and endocrine therapy are generally avoided during pregnancy and postponed until after the baby is born.

The National Cancer Institute notes that terminating pregnancy doesn’t improve breast cancer outcomes for pregnant women.

When To See Your Doctor

You should always address concerns about your breast health and any changes you spot with your doctor as soon as you notice them. A persistent or concerning new breast mass warrants clinical assessment and appropriate imaging. A medical professional can evaluate if it is a normal pregnancy-related breast change or something else.

It’s important to make sure your concerns are heard and that there aren’t any unnecessary delays in confirming the cause of your breast lumps. Even if breast cancer is identified during pregnancy, there are options that can give you and your baby the best chances of remaining healthy and safe.