Should I See a Doctor Again? Navigating Persistent Breast and Chest Pain

Do I need to see a doctor again? I find it frustrating myself?

Hello Doctor: I have a noticeable swelling and pain under my right armpit, while the left armpit has a smaller lump that does not hurt.
I also experience pain in my right chest and rib area, which becomes more pronounced when pressed.
This condition has persisted for nearly a month and a half.
Occasionally, I feel a bit better for a day or two, but then the pain returns.
During this time, I have consulted a breast surgeon, undergone ultrasound and mammography, which showed no issues.
I also saw a pulmonologist who performed a chest X-ray, and that was normal as well.
An orthopedic doctor mentioned that since the breast and chest were deemed fine, I could take anti-inflammatory and muscle relaxant medications, but the swelling and pain in my right armpit, as well as the discomfort in my right chest and ribs, persist.
Based on my consultations, it seems the doctors suspect I might be experiencing health anxiety.
However, the pulmonologist acknowledged that discomfort is the reason patients seek medical help; if I were comfortable and pain-free, I wouldn't be here.
After a month and a half, the pain continues, and I truly do not know which specialist to turn to for help.
Should I seek further medical attention?

Lillian, 30~39 year old female. Ask Date: 2016/08/14

Dr. Wu Jianting reply Breast and Thyroid

Breast pain is related to the muscles of the breast, chest, and back, and it is not necessarily a breast issue.
It is also not significantly associated with the feared breast cancer.
It is recommended that you take medications prescribed by an orthopedic specialist and pay attention to a few points: 1.
Is the pain cyclical, especially related to your menstrual cycle? 2.
Does the pain occur during a specific movement? 3.
Is the pain getting worse or improving? 4.
Have you noticed any lumps or other accompanying symptoms, such as difficulty breathing? If so, please seek medical attention again.
You can start by describing your observations for the physician's reference.
Thank you for your inquiry.

Reply Date: 2016/08/14

More Info

It sounds like you have been experiencing persistent pain in your right chest and axilla (armpit) area for over a month and have already consulted multiple specialists without a definitive diagnosis. Given the complexity of your symptoms and the duration of your discomfort, it is understandable that you are feeling frustrated and uncertain about your next steps.

First and foremost, it is essential to recognize that persistent chest pain, especially when accompanied by other symptoms such as swelling or tenderness, should not be ignored. While you have undergone various imaging studies (ultrasound, mammogram, chest X-ray) that have not revealed any significant issues, the fact that your symptoms continue to affect your quality of life warrants further investigation.

Here are some considerations and recommendations based on your situation:
1. Follow-Up with a Specialist: Since you have already seen a breast surgeon, a pulmonologist, and an orthopedic specialist, it may be beneficial to consult a pain management specialist or a rheumatologist. These specialists can help assess whether your pain may be related to musculoskeletal issues, inflammation, or even nerve-related problems that might not have been fully addressed in previous evaluations.

2. Consider a Comprehensive Evaluation: Sometimes, persistent pain can be multifactorial, involving both physical and psychological components. A comprehensive evaluation that includes a thorough history, physical examination, and possibly additional imaging or diagnostic tests (such as MRI or CT scans) may be necessary to rule out less common conditions.

3. Physical Therapy: Engaging in physical therapy may provide relief, especially if your pain is related to muscle tension or postural issues. A physical therapist can design a tailored exercise program to strengthen the muscles around your chest and improve flexibility, which may alleviate some of the discomfort.

4. Pain Management Strategies: Since you have been prescribed anti-inflammatory and muscle relaxant medications, it may be worth discussing with your doctor the possibility of other pain management strategies, such as nerve blocks, acupuncture, or even cognitive behavioral therapy (CBT) to help manage chronic pain.

5. Monitor Symptoms: Keep a detailed diary of your symptoms, noting when they occur, their intensity, and any potential triggers. This information can be invaluable for your healthcare providers in determining the underlying cause of your pain.

6. Addressing Psychological Factors: If you feel that your concerns are being dismissed or that you are being labeled as a "worrier," it may be helpful to seek support from a mental health professional. Chronic pain can often lead to anxiety and depression, which can exacerbate the perception of pain.

7. Trust Your Instincts: If you feel that your symptoms are not being adequately addressed, it is perfectly reasonable to seek a second opinion or to continue advocating for your health. You know your body best, and if something feels off, it is important to pursue further evaluation.

In conclusion, while it is encouraging that initial tests have not shown any serious underlying conditions, the persistence of your symptoms suggests that further investigation is warranted. Do not hesitate to seek additional medical advice or explore alternative treatment options. Your health and well-being are paramount, and finding the right approach to manage your pain is essential for your quality of life.

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