Managing Unexplained Pain in Left Breast Tumor: Should You Consider Surgery?

Recent unexplained pain in a tumor in the left breast; I'm unsure how to proceed?

Hello, doctor! I discovered tumors on both the left and right sides during an ultrasound examination in 2009.
I have undergone examinations and follow-ups at a major hospital until 2017, when the doctor suggested a biopsy.
Out of fear, I switched to another hospital and had a biopsy and aspiration on the left side in March 2018, which turned out to be benign.
However, in September of this year, I experienced unexplained pain in my left breast.
I asked the doctor if the benign tumor needed to be removed.
The doctor scheduled a follow-up ultrasound for mid to late October.
During that follow-up, the attending physician suggested that if I was overly anxious, we could proceed with the removal.
Currently, the tumor measured approximately 1.25 cm on ultrasound, but since the follow-up in mid to late October, the pain on the left side has become more frequent, sometimes radiating to my collarbone, left axilla, and occasionally to my left neck (suspected thyroid area).
However, as of yesterday, the pain has somewhat subsided.
I am worried whether it has turned malignant.
All these uncertainties are troubling me, and I am unsure whether I should proceed with the surgery.
Additionally, although minimally invasive surgery has smaller incisions, will the removal of such a tumor affect my appearance?

ACELU00, 50~59 year old female. Ask Date: 2020/11/08

Dr. Yuan Tianmin reply Breast and Thyroid

My personal recommendation is that if the biopsy of the left breast is benign, then a minimally invasive surgery to remove it would be appropriate.
As for your pain frequently shifting locations, it is likely not caused by any growth in the breast but rather influenced more significantly by female hormones.
Additionally, shoulder joint pain may also indicate the possibility of frozen shoulder (adhesive capsulitis).

Reply Date: 2020/11/08

More Info

When managing unexplained pain in a breast tumor, particularly in the context of a previously diagnosed benign tumor, it is essential to approach the situation with a combination of medical insight and personal consideration. Given your history of benign tumors in both breasts, and the recent onset of pain in the left breast, it is understandable that you may feel anxious about the possibility of malignancy, especially considering your family history of breast cancer.

Firstly, it is important to recognize that benign breast tumors, such as fibroadenomas, can sometimes cause discomfort or pain. This pain can be influenced by hormonal changes, particularly in women, as breast tissue is sensitive to fluctuations in estrogen and progesterone levels throughout the menstrual cycle. The fact that your pain has been intermittent and varies in location—from the breast to the collarbone and underarm—suggests that it may not be directly related to the tumor itself but could be due to other factors, such as muscle tension or nerve irritation.

Regarding the recommendation for surgery, it is crucial to weigh the benefits and risks. If the tumor has been confirmed as benign through biopsy, and there are no significant changes in its characteristics (such as size or appearance on ultrasound), the decision to proceed with surgery may depend on your level of discomfort and anxiety. If the pain is affecting your quality of life or causing significant distress, surgical removal could provide peace of mind and relief from symptoms.

Micro-invasive surgery is often an option for removing benign tumors like fibroadenomas. This type of surgery typically results in smaller incisions, which can lead to less scarring and a better cosmetic outcome compared to traditional surgical methods. However, the impact on appearance can vary depending on the size and location of the tumor, as well as individual healing processes. It is advisable to discuss these concerns with your surgeon, who can provide insights based on their experience and your specific case.

In terms of timing for surgery, if you decide to proceed, it is generally acceptable to have the procedure done several weeks after your last biopsy, as long as your healthcare provider is comfortable with the timing. The healing process post-surgery can vary, but many patients return to normal activities within a week, depending on the nature of their work and the extent of the procedure.

Ultimately, the decision to undergo surgery should be made collaboratively with your healthcare provider, taking into account your medical history, the characteristics of the tumor, and your personal feelings about the situation. Regular follow-ups and imaging studies are essential for monitoring any changes in the tumor and ensuring that any potential issues are addressed promptly. If you have ongoing concerns or if the pain persists or worsens, do not hesitate to seek further evaluation from your healthcare provider.

In summary, while the presence of unexplained pain in a benign breast tumor can be concerning, it is often manageable through careful monitoring and, if necessary, surgical intervention. Open communication with your healthcare team is key to navigating this situation effectively and ensuring that your health and peace of mind are prioritized.

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