Breast soreness

I am a 37 year old female with 3 children, 19, 11, & 8. I nursed all three. I had a mammogram that showed a small cyst in my left breast, it was aspirated and deemed “normal”. This was over 8 months ago. Two days ago I woke up with a feeling of bruising directly under my left nipple, with no visual bruising. The pain under the nipple has subsided, but now my upper left breast area is sore and under my arm feels tender too. Nothing feels swollen, and now it’s hard to know if it’s tender or just bruised from all my prodding! The left side still feels bruised to the touch, however it doesn’t hurt if I don’t touch it. Any ideas? I’m a worrier, so this has really upset me. Thanks.

THE BREAST DOCTORS SAY:

Feeling of bruising or soreness in the breast can be due to hormonal changes in your body and the response of the breast tissue to these changes. Most of the time they occur in the premenstrual period, and form part of PMS (premenstrual syndrome). However, as you grow older, you might develop similar sensations even in the post menstrual period, especially if you have a known history of fibrocystic change of the breasts. These sensations, if they are due to hormonal effects, should subside within 2 weeks.  If they persist after 1 month, then it is recommended that you seek professional advice.

Fibroadenomas

Dear Doctor,  I am 33 years old and last week after I have my mammografi & USG, the doctor said I have fibroadenoma on my breast , right & left. Actually I did not feel pain but I feel not comfortable during my menstruation period. In the next 3 months I have to see my doctor again for the USG to see the development of the fibroadenoma. Doc, if I want to take it out the fibroadenoma, do I have to get the surgery or only some treatment??? If I want to get the surgery in Singapore (in KK womens hospital), how much estimation cost for the surgery. how many days I should stay in Singapore ? I lived in Jakarta and thank you so much for helping me.

THE BREAST DOCTORS SAY:

Not all lumps in the breast needs to be removed. The reason lumps are removed is firstly, for histological confirmation and secondly, for lumps that have been confirmed to be benign via previous needle biopsy but continue to grow significantly in size.  Have you undergone any needle biopsy test before to confirm the lumps are fibroadenomas? What are the size of the lumps and have they grown in size?  Type of treatment of the lumps will depend on what the size and location of the lumps are.

Lymph node swelling after surgery

Dear Doc, I am 35 year old and had a microdochectomy done in end Aug’07 due to nipple discharge on left breast. But 2 months after the surgery, I have swelling of lymp nodes under the armpit. U/s was done and doc. finds that everything was fine. The swelling get worse and more painful every now and then.
Sometimes, I felt that the nipple is rather sticky and oily. It has an odour too. The swollen lymp nodes under my armpit is almost 10 months now. It doesn’t seem to subside completely. Can u advise me on the swelling and how can i cure it fully or prevent it from getting worse. I have another lump on the right breast , initial measuring 1.2 x 1.0 x 0.4cm, 2nd u/s measured 1.3 x 1.0 x 0.6cm.What should i do, should i remove the lump?  Is it advisable to have a blood test on breast cancer since I have 2 complications listed above. Thank you for your time

THE BREAST DOCTORS SAY:

Lymph nodes in the armpit may swell as reaction to the surgical manipulation of the breast on the same side. Reactive lymph nodes should resolve on its own, or at least reduce in size over time.  If you feel the swelling is worse, it might be worthwhile to repeat the ultrasound and consider a fine needle aspiration of the lymph node for confirmation, if the lymph node is found to be swollen. As for the right breast lump, it does not appear to have grown significantly in size.  However, at your age, depending on the appearance of the lump on ultrasound and whether you have other risk factors, a biopsy for histological confirmation can be considered. The commonly used tumour marker blood test for breast cancer, CA 15-3, is not useful to diagnose early breast cancer as its level only becomes abnormally raised in late breast cancer.

Breast lump

Dear doc, i have a lump above the nipple,and it is quite pain sometimes especially when i m tension.i have see a doctor,she advise me to have a operation to take out the lump.actually i m worry because i m still young,20 yr old.is it possible for me to have a breast cancer?what should i do?

THE BREAST DOCTORS SAY:

It would be unlikely for a female your age to develop breast cancer. However if the lump is of significant size then it would be worthwhile to have it investigated. If you do not wish to have the lump removed, a simple needle biopsy test can be done to ensure it is not breast cancer.

Biopsy during breastfeeding

Through a recent ultrasound, 4 lumps/cysts were found in my right breast, of which 2 had suspicious characteristics according to my consultant. One was an ill-defined solid nodule less than 1 cm, its margins ill-defined, with some degree of posterior acoustic shadowing. The other was a complex cyst with thick septations. I am currently breastfeeding and was adviced to stop breastfeeding so i can go for a mammotome. I learnt that fine needle biopsy has its limitations in terms of accuracy of diagnosis. Is it possible to go for a mammotome without having to give up breastfeeding? Else would core needle biopsy be more accurate than FNB, and would it be possible in my case if i wish to continue breastfeeding?

THE BREAST DOCTORS SAY:

It is advisable to stop breastfeeding first if you are going for a mammotome, or vacuum assisted biopsy. Otherwise you could get a galactocele, or milk trapped within the biopsy cavity, which may then get infected. Rarely a milk fistula may form. It is not necessary to stop breastfeeding for a core biopsy, although I usually recommend my patients to discard the milk expressed from the breast that day. However, if the lumps are very ill defined and small, the core biopsy may not give as good a tissue yield for diagnosis compared to the mammotome.

Discolouration of bra

My both nipple is very oily, especially a week before my period. But when i pressed my nipple, i dont see any discharge. But my bra always turn darker colour in the middle when my nipple will. I see many doctor, but non able give me an answer. I did ultrascan and mammogan, it didnt show any problem. I very worry? Can u help? I m 39 years old.

THE BREAST DOCTORS SAY:

It is normal to observe slight discolouration of the inside lining of the bra where the nipples sit. This is due to normal secretions from the glands of the nipple.  As long as there is no discharge from the nipples when you squeeze it gently, this observation is acceptable within normal limits.

Hair around nipples

HI Doctor, Im 22 years old and I am quite worried as I have quite a bit of hair that grows around the outskirts of my nipples….their quite long too….. What does this mean?

THE BREAST DOCTORS SAY:

It is considered normal to have some strands of hair growing around the pigmented areolar region of the nipple. How much hair and how long the hair is would be due to your genes. It is harmless though some may consider them unsightly. 

Cysts turning into cancer?

I had to have ultra sound on my left breast due to an abnormal mammogram. The radiologis found several small cysts about 3-4 — he claims that there are benign without removal, or draining or any testing to ensure that they are not cancerous.
What if these cysts are left unremoved or untested, years later — can trhey turn into pervasive cancer?

THE BREAST DOCTORS SAY:

It is extremely common to have small cysts scattered in the breasts; it is part of fibrocystic change and it is completely benign.  Fibrocystic change can be somewhat dynamic and small cysts can appear and disappear intermittentIy within the breast. It is said that 70% of women will have some cysts in the breasts at some point in their lives.  Cysts are hardly ever cancerous. The so called cancerous “cysts” tend to be large, often can be felt by the doctor’s hand during examination, and have unusual features on the ultrasound such as solid areas within the cyst.  If these factors are present, then the cyst could be drained or biopsied for a test. 

Type of fibroadenoma

Thanks doctor. Please tell me whether a needle/core biopsy can be used to find the type of fibroadenoma? (whether it is composed of fat or….)

THE BREAST DOCTORS SAY:

A fibroadenoma is composed of fibrous and glandular tissue with no significant fat tissue within.  A fibroadenoma is a benign tumour in itself and there is no subdivision of fibroadenomas into fat types or others. Both a needle and core biopsy when properly performed, can tell between fatty tissue in the breast and other tumours in the breast such as fibroadenomas. However, in general, a core biopsy is more accurate with less false positive and false negative results.

Biopsy for breast lumps

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.