Monday, November 08, 2010 Sylvia asks

Q: I began having pain under my right breast, close to my sternum in January.

Finally in May, I had a mammogram and discovered I have breast cancer -- but not where the pain is. They did an MRI, Catscan, and Bone scan and nothing. So they told me it's probably Costochondritis. It's now November and I still have the original pain in my chest. Should I go for a second opinion somewhere or is it possible that Costochondritis can last a whole year?

I am scheduled for a mastectomy next week, so I also wonder whether I should ask the surgeon to look around the area to see if he sees anything unusual, but I don't know if that's appropriate or if he could even tell anything. Also, they removed half my thyroid last week because of a growing follicular tumor. I'm still waiting on the lab tests, but the surgeon mentioned it had inflammation around it. So, of course, now I'm wondering if it's related to my chest pain, since it's supposed to be an inflammation of some kind. Regarding the pain, it goes back and forth from being a stabbing pain to a dull, bruised feeling pain. When I woke up from the thyroid surgery, the only pain I had was not in my neck, but the stabbing pain in my chest. I don't have any heart problems that I know of. And I am in really good health, other than the cancer. So of course, I have become cancer phobic wondering if it's a metastasis to my esophagus or my bones that doesn't show up on tests. So my other question is, do I just wait some more and see if things get better? or should I be more vocal and either demand more tests or go somewhere else?

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Answers (2)

PJ Hamel, Health Guide

11/ 8/10 5:32pm

Sylvia, you might want to ask for another mammogram and/or MRI prior to surgery, just to be sure they still don't see anything. The fact that all of those screens were negative in May is a good sign that this pain isn't related to your breast cancer. Breast cancer can spread, it's true; but only to bones, liver, lungs, or brain, not to your esophagus or thyroid (if you were worried about the two being connected).

You don't mention if the pain is in the breast that's going to be removed. If so, they'll do a thorough examination of the tissue they remove, and they'll be able to see if there was another, hidden tumor. I don't believe that, during the course of the mastectomy, the surgeon would be likely to go probing around your sternum to try to discover something that doesn't show up on any tests; I'd think he'd need more hard information before he'd just "explore."

If the pain continues, you might want to get a second opinion at a Comprehensive Cancer Center. That would be the logical way to find out what's causing this pain, and put your fears to rest once and for all. Good luck - PJH

Sylvia

11/ 8/10 5:51pm

I think that's a good idea about getting another MRI and the Comphrensive Cancer Center. I'm going to the best cancer center in my city, so I wasn't sure where to turn.

Phyllis Johnson, Health Guide

11/ 8/10 5:47pm

Costochondritis, an inflammation of rib cartilage, can last a long time. In fact, for some people it's a chronic condition that flares up from time to time. The pain can be intense and is sometimes mistaken for a heart attack. When I was really worried about some breast pain that I was having, the doctor's ultimate diagnosis was costochondritis. Sometimes where we feel a pain is not where it originates, and that was apparently the case with my pain. So the May to November timeline would not be unusual for costochondritis. As PJ says, if the breast being removed is the one with the pain, the pathology report will go through all the breast tissue. If it is the other side, I agree with her suggestion to ask about having a new set of tests just to make sure nothing has changed since May.

Q: I began having pain under my right breast, close to my sternum in January.

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