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Thursday, October 21, 2010 cmmommy asks

Q: Breast Lump, Odd Sensations

Hi!
I have some confusing symptoms-just wonder if anyone else out there has experienced this or has any input. I am 34 years old.  For a bit of background, I had a core biopsy on the left breast 18 mos ago for a probable fibroadenoma (turned out to be fibroadenomatous change and fibrocystic change)-I still don't really understand that diagnosis and all they told me was that it was benign and not to worry about it when I asked.   For the past two months I have felt "sensations" in one area of the right breast but thats it. About a month ago I found a small lump where the sensations were. It is about the size and shape of a piece of cooked rice. It is squishy, smooth and moveable-and quite small. I went back to my breast surgeon and he felt it and said it was probably normal glandular tissue or a cyst. He did an ultrasound and said it "might" be a cyst but wasn't sure what he saw on his monitor was where I was feeling the lump-I do have several small cysts in both breasts. Nevertheless, he said to come back in 3 mos and we can recheck it. He is the top breast cancer Dr in my city and said if he thought for a minute it was an issue, he would have biopsied it right then.  I decided to seek a second opinion at Wake Forest Baptist Breast Center which is one of the best in the Southeast. I was seen by a NP there who did a thorough exam and told me it by no means felt like anything cancerous, but at my insistence, had an ultrasound done.  The radiologist there does the exam and she couldn't find anything where the lump is.  Mammo was also negative. She said that the only thing showing up where I feel it, is a dilated duct (which I have multiple of, on both sides-all benign looking and they believe is a result of 4 years of breastfeeding) She also felt the lump and said she didnt feel it was anything of concern.  They told me I didn't need to do any additional follow up.  So now what do I do?  Do I take this and go on?  I also wanted to mention that none of the above people felt the lump without my showing them exactly where it was. Do I insist on a biopsy? The NP at Wake Forest did not think that was necessary at all. How would they do it without seeing it and knowing where to find it with imaging?  I also notice that it seems irritated where the lump is-almost an itchy sensation at times.  I asked about an MRI and they said I didn't have reason for one.  Can a dilated duct cause these symptoms? I am confused and just not sure what to do! I don't want to overreact, but I don't want to miss something. My family thinks I should take the advice of experts-and they really are the best of the best who I saw..but I just am confused. Thanks if anyone has any insight!

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Answers (1)
Phyllis Johnson, Health Guide
10/21/10 9:43pm

I'd be inclined to follow the advice of the doctor who wants to take another look in three months.  That doctor seems to be taking the spot more seriously when he says in effect, "This doesn't seem to be a problem to worry about, but let's keep an eye on it."  Although I don't know anything about dilated milk ducts, I know that ultrasounds are very good at seeing veins and other fluid-filled parts of our bodies.  So it makes sense to me that an ultrasound could identify dilated milk ducts.  Two experts are reasonably sure that the spot isn't dangerous, so asking for a biopsy right now doesn't seem wise.  An unnecessary biopsy could create scar tissue that might make other imaging tests hard to read.

If the lump gets larger or you develop new symptoms, don't wait the three months.  I hope the problem resolves on its own as breast problems often do.

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10/22/10 7:34am

Thank you very much for your reply! I am planning to revisit the surgeon in January. Its just going to be really hard waiting through these weeks-the what ifs are tough! I am at least taking comfort that it is small. squishy, oval and moveable-all good things for the most part. I am going to try and concentrate on other things.

 

I really appreciate you taking the time to answer me. You are a great service to many worried women!

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By cmmommy— Last Modified: 12/26/10, First Published: 10/21/10