Painful Areolar Nodules: When to Seek Medical Advice

Nipple lump

Hello doctor, yesterday I suddenly discovered a hard lump on one side of my breast areola that is painful.
I squeezed out a white, pus-like substance that had no odor.
There is also a small raised area on the areola with a white head.
I initially thought it was a pimple, but after squeezing, the lump remained and is very painful to touch.
I have researched a lot and scared myself.
My last menstrual period started on the 16th of last month, and I had my previous period on the 14th.
Could it be that the Montgomery glands are more developed before my period? However, I read that this condition usually doesn’t cause pain, so I’m worried that it might not be this symptom.
I have been observing the lump for the past few days and waiting for my period to come.
If there is no improvement, should I wait until after my period to see a breast specialist? When would be the most appropriate time for an appointment? Thank you for your response.

Ms. Chen, 20~29 year old female. Ask Date: 2016/07/12

Dr. Wu Jianting reply Breast and Thyroid

Montgomery glands are present on the areola and are essentially sebaceous glands.
Their secretions are similar to the contents expelled from acne.
If they are squeezed, they may become painful and hard, so it is important to be cautious of any signs of infection.
If you have any concerns, please consult a breast surgeon or dermatologist.
Thank you for your question.

Reply Date: 2016/07/12

More Info

It sounds like you are experiencing a concerning issue with a painful areolar nodule on your breast, and it's understandable that you're feeling anxious about it. Let's break down the situation and discuss when it might be necessary to seek medical advice.

Firstly, the presence of a hard lump in the areola, especially one that is painful and produces a white, pus-like discharge, can be indicative of several conditions. One possibility is a Montgomery gland cyst or an infection of the Montgomery glands, which are sebaceous glands located in the areola. These glands can become blocked or inflamed, leading to the formation of a painful lump. While it is true that these lumps can sometimes be painless, the presence of pain does not rule out this diagnosis.

Another possibility is a condition known as a breast abscess, which is a localized infection that can occur in the breast tissue. This condition often presents with swelling, redness, and tenderness, and it may require medical intervention, such as drainage and antibiotics.

Given that you mentioned your menstrual cycle, hormonal changes can indeed affect breast tissue, leading to tenderness and changes in the breast. However, the pain and the presence of a hard lump that produces discharge should not be ignored, especially if it persists.

Here are some guidelines on when to seek medical advice:
1. Duration of Symptoms: If the lump does not improve or resolve within a few days, it is advisable to seek medical attention. While waiting for your menstrual cycle to see if symptoms change is reasonable, if the lump continues to be painful or if you notice any changes in size or appearance, it would be wise to consult a healthcare provider sooner.

2. Characteristics of the Lump: If the lump becomes larger, changes in texture, or if you develop additional symptoms such as fever, chills, or increased redness in the area, these could be signs of a more serious condition that requires immediate evaluation.

3. Personal Health History: If you have a history of breast issues or if there is a family history of breast cancer, it is particularly important to have any new breast changes evaluated by a healthcare professional.

4. Consulting a Specialist: If you decide to see a doctor, a breast specialist or a general surgeon with experience in breast conditions would be appropriate. They can perform a physical examination and may recommend imaging studies, such as an ultrasound, to better understand the nature of the lump.

In summary, while some breast lumps can be benign and related to hormonal changes, the combination of pain, discharge, and the persistence of the lump warrants a medical evaluation. It is better to err on the side of caution when it comes to breast health. If you are still experiencing discomfort or if the lump does not improve, I recommend scheduling an appointment with a healthcare provider as soon as possible, regardless of your menstrual cycle. Early evaluation can provide peace of mind and ensure that any necessary treatment is initiated promptly.

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