Painful Lumps in the Armpit: When to See an Oncologist

There is a hard lump in the armpit?

Hello Doctor, I have a hard lump under my left armpit that is painful when pressed.
There is no redness, no pus, and no opening on the surface, and it does not hurt when not touched.
I have visited two dermatologists; one suggested it might be a sebaceous cyst because it doesn't look quite like one, so I went to another dermatologist.
The second dermatologist indicated it could be hidradenitis (the lump appeared 3-4 days after I shaved).
However, it also doesn't look quite like that since the skin surface is not red.
Should I see an oncologist for further evaluation? Thank you.

Lin, 20~29 year old female. Ask Date: 2022/03/20

Dr. Chen Sirong reply Oncology

Lin, 23 years old, female, can visit the general surgery and breast surgery departments for examination.
Wishing for a speedy recovery.
Taoyuan Hospital, Dr.
Chen Sih-Rong.

Reply Date: 2022/03/20

More Info

When it comes to painful lumps in the armpit, particularly in the context of a history of breast cancer, it is essential to approach the situation with caution and thoroughness. Given your description of a hard lump that is painful upon pressure but does not exhibit signs of redness, pus, or an open wound, there are several potential causes to consider.

The first possibility is that the lump could be a benign condition such as a lipoma or an epidermoid cyst (commonly referred to as a "sebaceous cyst"). These types of lumps are generally harmless and may not require any treatment unless they become bothersome or painful. However, the fact that you have a history of breast cancer raises the concern for possible malignancy, particularly if there is any change in the characteristics of the lump or if it persists.

Another consideration is lymphadenopathy, which refers to swollen lymph nodes. This can occur due to various reasons, including infections, inflammatory conditions, or malignancies. Given your history of breast cancer and the recent treatments, it is crucial to rule out the possibility of cancer recurrence or metastasis. Lymph nodes can become enlarged in response to cancer cells spreading from the original tumor site, and they may present as painful lumps.

The dermatologists you consulted suggested conditions like a cyst or sweat gland inflammation (hidradenitis suppurativa), which are common in the armpit area, especially after shaving. While these conditions can cause discomfort and lumps, they typically do not present with significant pain unless there is an infection or inflammation.

In your case, considering the complexity of your medical history and the potential implications of a new lump, it is advisable to consult with an oncologist. An oncologist can perform a thorough evaluation, which may include imaging studies such as an ultrasound or a mammogram to assess the lump further. If necessary, a biopsy may be performed to determine the nature of the lump definitively.

In summary, while there are benign explanations for the painful lump in your armpit, the history of breast cancer necessitates a careful and proactive approach. Consulting with an oncologist will provide you with the best course of action, ensuring that any potential issues are addressed promptly. Early detection and intervention are key in managing any potential recurrence or new malignancy, and your health and peace of mind are paramount. Don't hesitate to seek further evaluation; it is always better to err on the side of caution when it comes to changes in your health, especially after a cancer diagnosis.

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