Breast Lumps and Pain: When to Seek Medical Advice

There is a hard lump when touching the left side of the breast?

Hello Doctor: I noticed that my breasts have been uneven since I was around 14 years old, with the left breast being larger.
In recent years, the difference in size has become more pronounced.
Recently, I have experienced occasional sharp pain in my left breast, and upon touching the painful area, I found a hard lump near the side of the breast (close to the armpit).
There is slight tenderness when I press on it.
When I touch the areola, I feel small bumps, but there are no visible abnormalities.
Occasionally, I notice something that resembles skin flakes coming from the nipple.
What kind of examinations should I undergo?

Niming, 20~29 year old female. Ask Date: 2016/07/18

Dr. Wu Jianting reply Breast and Thyroid

Self-examination is recommended to be performed about a week after menstruation has ended.
If you still feel any lumps, you should visit a clinic for an examination.
Young women primarily use palpation or ultrasound for assessment.
Thank you for your question.

Reply Date: 2016/07/18

More Info

When it comes to breast lumps and pain, it is essential to understand the various factors that could contribute to these symptoms and when to seek medical advice. Breast pain, also known as mastalgia, can be cyclical or non-cyclical. Cyclical breast pain is often related to hormonal changes, particularly those associated with the menstrual cycle, while non-cyclical pain can be due to other factors such as trauma, infections, or even stress.

In your case, you have noted a significant difference in breast size since adolescence, with the left breast being larger and now experiencing occasional sharp pain. The presence of a hard lump near the armpit and a grainy texture when touching the areola raises some concerns that warrant further investigation.

When to Seek Medical Advice
1. Persistent Symptoms: If you experience ongoing pain or discomfort that does not resolve, it is crucial to consult a healthcare professional. Since you mentioned that the pain is intermittent but has recently become more pronounced, this is a sign that you should seek further evaluation.

2. Changes in Breast Tissue: The discovery of a hard lump, especially if it is new or has changed in size or texture, should prompt a visit to a healthcare provider. Lumps can be benign, such as fibroadenomas or cysts, but they can also indicate more serious conditions, including breast cancer.

3. Skin Changes: The presence of flaky skin or discharge from the nipple can also be a cause for concern. While some skin changes can be benign, they can also indicate underlying issues that need to be addressed.

4. Family History: If you have a family history of breast cancer or other breast-related conditions, it is advisable to be more vigilant and consult a healthcare provider sooner rather than later.

Recommended Actions
1. Clinical Breast Exam: Schedule an appointment with a healthcare provider for a thorough clinical breast examination. This will help assess the size, shape, and texture of the lumps and any other abnormalities.

2. Imaging Studies: Depending on the findings during the clinical exam, your doctor may recommend imaging studies such as a mammogram or breast ultrasound. These tests can provide detailed images of the breast tissue and help determine the nature of any lumps.

3. Biopsy: If a lump appears suspicious, a biopsy may be necessary to determine whether it is benign or malignant. This involves taking a small sample of tissue for laboratory analysis.

4. Hormonal Evaluation: Given that breast pain can be related to hormonal fluctuations, discussing your menstrual cycle and any other symptoms with your healthcare provider may be beneficial. They might suggest hormonal evaluations to rule out any imbalances.

5. Lifestyle Modifications: While waiting for your appointment, consider lifestyle changes that may alleviate breast pain, such as wearing a supportive bra, reducing caffeine intake, and managing stress through relaxation techniques.

Conclusion
In summary, while breast lumps and pain can often be benign, it is essential to take any new or changing symptoms seriously. Given your description of the symptoms, it is advisable to seek medical attention promptly. A healthcare professional can provide a comprehensive evaluation and guide you through the necessary steps for diagnosis and treatment. Remember, early detection and intervention are key to managing breast health effectively.

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