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Wednesday, July 31, 2013 alicia, Community Member, asks

Q: My left breast suddenly grew bigger than the other, unaffected by my periods. My other symptoms are intermittent soreness and a small spidery rash at the most swollen point, no redness or warmth.

Last month, about three days after my period ended I noticed that one of my breasts had grown suddenly significantly bigger than the other, about a cup size larger judging from my bras. My breasts were never affected before by my cycle, but I monitored it over the next month. Before, during and after my next cycle there was no change at all in my breasts - the left one was still bigger (heavy and hanging to one side) and has stayed that way. It was also intermittently sore and I've been experiencing extreme fatigue. There is no redness or warmth but there is a slight spidery rash at the most swollen point of the breast. I went to a gynecologist who found a mass upon physical examination. An ultrasound was clear and after a second physical examination the doctor couldn't find the original mass, though because the breast was still swollen and misshapen he referred me to a breast specialist. I'm seeing the specialist in two weeks, so I'm not using this as a replacement for medical advice, but I'm curious about what could possibly be causing these symptoms. (For further background: I'm a monogamous lesbian and have never been pregnant/no risk for pregnancy. I'm not on BC or any other medication. No dietary or weight changes recently. No injuries and no surgery ever to either breast.)
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Answers (2)
PJ Hamel, Health Guide
7/31/13 8:30pm

Alicia, there's a possibility this could be inflammatory breast cancer, but it would be more usual for there to be a progression of symptoms in the timeframe you mention; cancer doesn't usually stand still. Also, the likelihood would be you'd have more soreness/redness. The ultrasound must have ruled out a cyst or cysts; so I'm wondering why your doctor didn't just go ahead with the next logical step, which would be a mammogram. You might want to ask him/her why that test wasn't ordered. I'd assume the breast specialist will use a mammogram to help diagnose what's going on, but you still might want to question your doctor about it. 

 

We're not doctors here, and can't diagnose medical issues; we're here to offer support and advice as you go through diagnosis and treatment. Hopefully the breast specialist will be able to determine what's causing this swelling/pain, and find a way to deal with it. Best of luck to you - PJH

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alicia, Community Member
7/31/13 8:51pm

Hello PJ, thank you for the prompt response. The doctor didn't order a mammogram because I'm 32 and he felt it wouldn't be helpful due to my age (I'm assuming because of dense tissue).

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PJ Hamel, Health Guide
7/31/13 9:06pm

Well, unless you've had a mammogram in the past, there can't be any clinical diagnosis of breast density; it's true, mammograms aren't very accurate for women with dense breasts, but they can't know you have dense breasts until they do a mammogram - kind of a Catch-22. Anyway, the breast specialist will be able to give you much better guidance as you go through the steps of diagnosis. An MRI, while it tends to yield a certain percentage of false positives, is usually the next step (after mammogram) for trying to identify a breast issue, so perhaps that's the route you'll end up going. Good luck - I hope you get good results, whatever the test ends up being. PJH

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Phyllis Johnson, Health Guide
8/ 1/13 12:14pm

Alicia, you've ruled out many of the reasons for a swollen breast, so the main two ones left that I am familiar with would be an infection and cancer, especially inflammatory breast cancer. Although a fever often accompanies an infection, I'm a bit surprised that your doctor didn't order an antibiotic to rule out infection.  

 

It's great that you will be seeing a breast specialist.  I'm wondering if there is a way to either move up your appointment or to schedule some of the methods that the specialist might want to use in diagnosing you between now and then.  Some of these might include:  an antibiotic to see if there is an infection of some sort, a mammogram, or an MRI.  While it is true that mammograms are not as useful in younger women, I would think that they would want a baseline mammogram done to check for future changes.  

 

There could also be something hormonal going on.  Usually breasts are most swollen before a period, but if your hormones are out of adjustment, perhaps they are affecting your breast.  There could be a benign lump deep on the chest wall where it can't be felt distorting the shape of your breast.

 

As PJ points out, we are not doctors here, so there are probably plenty of other possibilities that we don't know about.  It is too soon to panic about this being a rare form of cancer since you don't have all of the symptoms of IBC.  However, it is good that your doctors have taking this seriously and have referred you for further evaluation.  Let us know what you find out.  I wish you the best.

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alicia, Community Member
8/ 1/13 11:16pm

Thank you very much for the thoughtful reply, Phyllis. 

 

My doctor only mentioned hormonal changes as a possible cause and not infection. I don't know why. Based on my online research, my guess is that he ruled it out because I don't have either of the two common risk factors (smoking or breastfeeding) and I don't have a fever. I also don't have any obvious visual signs on the breast that would indicate infection. (There's a slight rashtype thing but no warmth or overall redness, and it's not near the nipple.) Or maybe he ruled it out via the examination. What seemed to bother him the most and prompt the referral to a breast specialist is that the breast hasn't gone down or up over the past month, even during menses, and I guess that fluctuations would be more typical or something hormonal or an infection. 

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Phyllis Johnson, Health Guide
8/ 2/13 6:54am

Alicia, it sounds like you are doing a good job of combining your own research with good medical care.  You are thinking through all of your symptoms and comparing them to common breast problems.  As far as I can tell, you don't have the typical symptoms for any one breast problem that I am familiar with.  So whatever is going on, your presentation seems to be unusual.  I hope your appointment with the breast specialist goes well.  

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By alicia, Community Member— Last Modified: 08/02/13, First Published: 07/31/13