Breast Lumps: Should You Be Concerned?

Palpable mass in the chest?

Hello Doctor: Due to endometriosis, I recently started taking progesterone (Dydrogesterone), and I have not had my period for a while.
Recently, while lying on my right side, I felt a small, rice-sized lump just below the areola.
It is neither hard nor soft, and it feels smooth.
I'm unsure if this is related to the medication.
Should I just monitor it?

Fang, 20~29 year old female. Ask Date: 2020/08/06

Dr. Yuan Tianmin reply Breast and Thyroid

If you haven't had an examination yet, it is still recommended that you visit a breast surgery clinic for an ultrasound examination to confirm.

Reply Date: 2020/08/06

More Info

When it comes to breast lumps, especially in the context of hormonal treatments such as progestins (like the one you mentioned, "異位寧"), it is essential to approach the situation with caution and awareness. The presence of a lump in the breast can be concerning, but not all lumps are indicative of serious conditions.
In your case, you described a small, smooth lump located just beneath the areola of your right breast. The fact that it is not hard or soft, and is about the size of a grain of rice, is a positive sign, as many benign conditions can present in this manner. Hormonal changes, particularly those induced by medications like progestins, can lead to breast tissue changes, including the development of cysts or fibrocystic changes. These are often benign and can fluctuate with hormonal cycles.

However, it is crucial to monitor any changes in the lump. Here are some considerations:
1. Observation: If the lump remains the same size, shape, and consistency over time, it may be safe to observe it. However, if you notice any changes—such as an increase in size, hardness, or if it becomes painful—seek medical advice promptly.

2. Consultation with a Healthcare Provider: Given your history of endometriosis and the recent initiation of hormonal therapy, it would be wise to consult with your healthcare provider or a breast specialist. They can perform a clinical examination and may recommend imaging studies, such as a breast ultrasound, to evaluate the lump further. This is particularly important if you have any family history of breast cancer or other risk factors.

3. Hormonal Influence: Hormonal treatments can cause various breast changes, including tenderness, swelling, and the formation of lumps. These changes are often temporary and may resolve after discontinuation of the medication or after your body adjusts to the new hormonal levels.

4. Breast Self-Exams: Regular self-exams can help you become familiar with the normal texture and feel of your breasts. This familiarity can make it easier to notice any changes. If you find any new lumps or changes, document them and discuss them with your doctor.

5. Follow-Up: If your healthcare provider suggests follow-up imaging or monitoring, it is essential to adhere to those recommendations. Regular check-ups can help ensure that any changes are addressed promptly.

In conclusion, while the lump you described may not be immediately concerning, it is essential to remain vigilant and proactive about your breast health, especially in the context of hormonal treatments. Regular communication with your healthcare provider and adherence to recommended follow-up care are key components of managing your health effectively. If you have any doubts or concerns, do not hesitate to reach out to a medical professional for personalized advice and reassurance.

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