BreastTalk@KK

Hello doctor, I am 29, married. I have 2lumps in my left breast(one about 3cm) and 2 in right(they are in mm) and doctors say it’s fibroadenoma.
I haven’t done any biopsy(only scan is done). What type of biopsy is to be done since i am having multiple lumps. I don’t want to surgically remove the lump. Please give me ur opinion. Thanks

THE BREAST DOCTORS SAY:

The small lumps that are in mm usually do not need to be biopsied, unless they have unusual features on ultrasound. However, the 3cm lump is of significance size and cannot be presumed to be a fibroadenoma unless proven with tissue diagnosis.  Tissue diagnosis can be done either by surgically removing the lump, or by a needle biopsy.  Several types of needle biopsy are available, including fine needle aspiration cytology, core needle biopsy or vacuum assisted biopsy. You may wish to check out the section in our website “Library” -> “General” -> “What you need to know about breast biopsy” for more information.

Hi, I also wish to know about inverted nipple and if it can be corrected with surgery. Does the aesthetic Dept of your hospital do such procedure and how much would it cost. Thank you.

THE BREAST DOCTORS SAY:

Surgical procedure to correct nipple inversion can be done by most plastic surgeons. However, depending on severity of the inversion, sometimes it can recur again despite surgery. The surgical procedure is a minor operation and is usually done as day surgery. Cost of the procedure, however, will vary between plastic surgeons.

Hi, I breast fed my daugter til she was 14 months, she is now 17 and i just recently felt a lump in my left breast. milk still comes out and can there still be a build up of milk in there?

THE BREAST DOCTORS SAY:

Sometimes milky discharge can persist for years after breastfeeding, especially if you breastfed for a long duration. If the milky discharge is of recent onset and occurs on both breasts, it would be useful to screen for high prolactin levels as a cause. The lump in the breast you have detected is unlikely to be related to the milky discharge you have.  You should have the lump checked out by your doctor.

I have been diagnosed with granulomatous mastitis and have been prescribed with prednisone. I took “batch tyep” prednisone for six days. During this time, my breast swelling shrunk. After the six days, I took prenisone (three tabs for 5 days, two tabs for 2 days and 1 tab for 5 days). The discharge has reduced. Now I am taking one tab per day and will take it for a month. However, I am on the second week of the once a day prednisone, but i feel that the swelling is going back and the discharge is going back as well. Is there any other treatment available? Or can you give me names of doctors who are experts in this area in Austin, Texas. Thanks very much for your help.

THE BREAST DOCTORS SAY:

The treatment of granulomatous mastitis utilizes steroids (prednisone), which you are taking. This is a relatively rare condition which is thought to be autoimmune in etiology. Steroids usually works, but you will need to be patient. It can take months or even a couple of years to control the condition with steroids. Patients often experience a relapse of the condition when the steroids are tailed down to a lower dose. You will need to have your prednisone dose increased back up to reduce the swelling, and then maintain the dose for some time before weaning down again. Other immunosuppressants such as methotrexate has been used successfully occasionally to treat granulomatous mastitis but there is little experience with it.

I’m a 22yrs old girl and have inverted nipple. When i squeeze hard at my nipple, some white substance which smell weird will come out and sometimes is clear.. i’m very worried i wont be able to breastfeed or having some cancer.

THE BREAST DOCTORS SAY:

Long standing nipple inversion is often associated with some nipple discharge which is usually somewhat thick in consistency and sometimes smells. It is due to inflammation and a condition called duct ectasia.  There is no need to squeeze hard at the nipple during breast self examination. If the discharge is of significance, it will be demonstrated with just gentle pressure over the nipple area, or the discharge will be spontaneous, without squeezing the nipple.  Breast cancer, when present under the nipple, causes nipple retraction which will be of recent onset, and not longstanding.  If you are not sure, you may see your doctor for some advice. Some women with nipple inversion may still be able to successfully breastfeed, depending on how severe the nipple inversion is. If it is not severe, the nipple can be manually everted out when the baby suckles at the breast.

Dear doctor,
6 years ago my mother was diagnosed with breast cancer. I then got pregnant within 6 mos. of that and received a non cancerous lump on my right breast near armpit that had to be removed during pregnancy. Last night I noticed pain under my right arm pit and along the underarm while breast and nipple was massaged. Today I went to the tanning salon. I looked down at my breast and I had yellow milk discharge coming from right nipple. More came out as I squeezed the nipple. I am not pregnant. I am beginning to worry. I have not been feeling very well and have had low- no energy for the last 8 mos. Example: go for walk one day and sleep for two days. I have been diagnosed with anemia with very low hemoglobin levels. Nothing has been looked into further because of being depressed (15 years of my life) my doc thinks that all my weakness, aches and pains are from my depression. I am now 36 years old. I have been in a lot of pain all over my body in the last 8 mos. For the last 2 months I have a lot of pain in my feet and hands ( painful but numb) from knees down and from elbow down on my arms. I am also very dizzy and my vision along with depth perception is getting really bad. I am so disappointed in going to the doctors. I am now in a position that I have so many symptoms that if I do see any kind of doctor, I don’t know who to see first. I do not have anyone to talk to about this matter. Should I contact the Doctors office that removed the previous lump? I do not feel my PCF will do anything about this. I am almost at the point to where I don’t want to do any thing at all.

THE BREAST DOCTORS SAY:

The nipple discharge you have should be investigated with at least a mammogram and ultrasound of the breast to look for an underlying cause for the discharge. You may also benefit from a ductogram or ductoscopy if that is available at your centre. If you have a family history of breast cancer, you will be at a higher risk for breast cancer too. It is not really necessary to return to the office if the previous lump removed was non cancerous. The aches and pains you have described do not appear to be related to the breast problem. However, your anaemia should also be investigated by your doctor. It could be related to the joint pains you have.

Recently i started working 10 hours days at work and all i do is pick up boxes that weigh that least 35lbs. the second day of work i started to feel pain in my right breast. i felt around and nothing was there. the next morning there was something that felt like a small ball in the bottom on my breast. that night i put a heating patch on it and it felt a lot better the next day. could i have pulled something picking up the heavy boxes at work?

THE BREAST DOCTORS SAY:

Yes you could have pulled the chest wall muscles (pectoral muscles) that are situated immediately behind the breast if you are involved in lifting heavy objects.  However pulling a muscle should not result in a lump that you can feel in the breast. If the lump persists, you should have a doctor check it out.

I had a needle biopsy at the end of April, to check on tiny calcifications seen on my mammogram. Other than the mammo, I had no indications of anything abnormal. The test results were negative. The first month or so I had pain from all the ‘abuse’ I had been through, but even now, in mid-June, there are days when my breast has small sharp pains…not all the time….just sometimes. Is it normal to experience pain so long after a biopsy? Thanks for your help.

THE BREAST DOCTORS SAY:

If your biopsy test was negative for cancer, the tiny calcifications are probably due to fibrocystic change in the breast.  Women with fibrocystic change often experience intermittent sharp stabbing pains in the breast, which may or may not be related to the menstrual cycle. These pains can occur anywhere in the breast.  If however, your pain is limited to exactly the area that was biopsied, then the pain may be due to healing within the breast.  If a large area of tissue was removed for testing, there may be mild pain over several weeks as the cavity in the breast heals over.

Lately my mother has developed extremely swollen nipples. The symptom do not last long, but this is the 3rd time in 5 months. Each time they swell, she complains on how painfully sensitive they feel. At first I thought that it might be related to menopause since she is in her 40`s, but now I am not so sure. Please advise.

THE BREAST DOCTORS SAY:

The sensation of painful and swollen nipples is not uncommon. Often it is related hormonal changes of the menstrual cycle and is harmless. Physical examination by a doctor is usually normal.  Sometimes these symptoms can be due to duct ectasia. Duct ectasia is a benign condition, and may be associated with a long standing nipple inversion, or nipple discharge.  In this condition, the milk ducts behind the nipple are inflammed and swollen, so this may give the symptoms of painful and swollen nipples. The condition is benign and no treatment is required unless recurrent abscesses occur under the nipple. Surgery may then be needed.

I have a question I found a lump in my left breast and the doctor said I do have a couple of lumps in my left breast. My nipple is also a dark purple I am not pregnat I had my tubes tied after my second child. I dont know much family history my real grandma on my moms side died at 30 and my uncle died at 32 from hodgekins. My dad Wasnt around after i was born but i did find out from my sister who does talk to him that my aunt had breast cancer and had lost both breast. I am 27 years old I do have other health problem graves diease and Vitiman D deifency I had a tyroidectomy a few years ago maybe this is all related. My doctor just said yep you have lumps and sent me on my way. the one is on the side inside close to my under arm and the other is on top and that one is painful they do not go away after my menstal cycle either they are just there. Should I see another doctor or should i dimiss it like he did. Thanks in advance

THE BREAST DOCTORS SAY:

It would be useful to at least obtain an ultrasound of the breast to determine if the “lumps” are true lumps.  Most of the time, the ultrasound can differentiate between “lumpy” breasts, or lumps due to cysts or solid tumours, which fortunately are mostly benign in your age group. Your doctor may decide to send you on your way as most lumps in women in their late 20s are benign fibroadenomas or sometimes even cysts.  If you would like to be more certain about the nature of your lumps, you can ask your doctor for an ultrasound.