title: Breast Lesions during Pregnancy - a Diagnostic Challenge: Case Report.
abstract: BACKGROUND
  Palpable masses of the breast often occur during pregnancy and should be further investigated. The standard diagnostic during pregnancy is an ultrasound combined, if needed, with a core needle biopsy. Most lesions are benign in younger women but, nevertheless, the incidence of pregnancy-associated breast cancer is 1 in 3,000 deliveries and rising.
  
  
  METHODS
  We report the case of a 24-year-old patient diagnosed with a palpable breast lesion at 37 weeks of gestation. An ultrasound was performed and the lesion was rated BI-RADS 4. The initial core needle biopsy showed a ductal carcinoma in situ. After delivery and ablactating, a mammography, breast magnetic resonance imaging and a second ultrasound-guided biopsy was performed. Due to the inconclusive imaging and histological results, a wide excision was performed and a juvenile papillomatosis was confirmed. No further resection was necessary as the initial margins were sufficient.
  
  
  CONCLUSIONS
  This case suggests that the diagnosis of masses of the breast during pregnancy and lactation can be quite difficult. Diagnosis should be confirmed by an excision biopsy and by histological examination through an experienced pathologist. As a significant proportion of papillomas contain malignant regions, an argument exists for the complete excision of all papillary tumours.
authors.affiliation: Department OB/GYN, University Hospital Duesseldorf, Germany.
authors.forename: Ines
authors.initials: I
authors.lastname: Beyer
authors.affiliation: Department OB/GYN, University Hospital Duesseldorf, Germany.
authors.forename: Nikola
authors.initials: N
authors.lastname: Mutschler
authors.affiliation: Department OB/GYN, University Hospital Duesseldorf, Germany.
authors.forename: Katrin S
authors.initials: KS
authors.lastname: Blum
authors.affiliation: Department OB/GYN, University Hospital Duesseldorf, Germany.
authors.forename: Svjetlana
authors.initials: S
authors.lastname: Mohrmann
keywords: Diagnosis; Juvenile papillomatosis; Pregnancy-associated breast lesions