Breast Lumps: What You Need to Know About Symptoms and Concerns

Breast lump?

Hello doctor, four years ago I experienced sharp pain in both breasts and consulted a physician who performed an ultrasound, which was normal.
I would like to ask about the hard areas I feel when I lie down and palpate my breasts in a clockwise direction; they feel quite firm, around 0.5 to 1 cm in size.
I am quite thin and have small breasts (which has always been the case).
Additionally, I noticed something similar to a scab on my right nipple that was grayish-white and could be removed; this has occurred twice but has not appeared again for a long time.
I also feel some movable lumps in my armpit; could this be considered lymphadenopathy? I can't really determine their size, but I feel them on both sides.
I also have some in my groin area, but I never specifically checked my axillary lymph nodes before, so I am unsure if there have been any changes.
Is it normal to be able to palpate lymph nodes? I have no other symptoms, and no one in my family has had cancer, but I am very worried about the possibility of breast cancer.
:(

Xiao Bu, 20~29 year old female. Ask Date: 2013/11/07

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear Xiao Bu,
1.
Lymph nodes are generally not palpable; those that can be felt are mostly due to infections.
However, if there are lymph nodes in the axillary and groin regions, it is advisable to seek further examination at an outpatient clinic to rule out any lymphatic tumors.
2.
The flaky substance on the nipple is usually dried secretions, which is considered normal.
However, if there is any bleeding or foul-smelling discharge, it is recommended to consult a breast surgeon for evaluation.
3.
If you feel many small hard lumps in the breast, they are mostly benign glandular hyperplasia.
Generally, if they are present on both sides and fluctuate in size, it is less concerning.
However, if there is a persistent increase in size, it is essential to consult a breast surgeon for further assessment.
Wishing you peace and health.
Sincerely,
Zhou Jiazhen
Director of Surgery, Taoyuan Hospital, Ministry of Health and Welfare

Reply Date: 2013/11/07

More Info

When it comes to breast health, understanding the symptoms and concerns surrounding breast lumps is crucial. Based on your description, it seems you have experienced various breast-related issues, including pain, the presence of hard lumps, and changes in your nipples. Let's break down these concerns and provide some insights.

Firstly, breast pain, or mastalgia, is a common issue that many women experience, often linked to hormonal fluctuations during the menstrual cycle. It can manifest as tenderness, heaviness, or sharp pain, and while it can be alarming, it is not always indicative of a serious condition. However, if the pain persists or worsens, it is essential to consult a healthcare provider for further evaluation.

Regarding the hard lumps you feel in your breasts, it is not uncommon for women to notice small, firm areas in their breast tissue. These can be benign conditions such as fibrocystic changes, which are often influenced by hormonal levels. However, any new or unusual lumps should be assessed by a healthcare professional, especially if they have changed in size or shape, or if you notice any associated symptoms like discharge or skin changes.

You mentioned observing a grayish-white substance on your right nipple, which you were able to remove. This could be related to a benign condition known as nipple discharge, which can occur for various reasons, including hormonal changes or ductal ectasia. While it is usually not a cause for concern, any persistent or unusual discharge should be evaluated to rule out any underlying issues.

The lymph nodes in your armpit (axillary lymph nodes) can also be a source of concern. It is normal for lymph nodes to be palpable, especially if they are reactive due to infections or other benign conditions. However, if you notice significant changes, such as increased size, firmness, or if they become fixed (not movable), it is advisable to seek medical attention. The presence of movable lymph nodes is generally considered a normal finding, but any new or concerning changes should be discussed with a healthcare provider.

Family history plays a significant role in breast cancer risk, but it is important to remember that most breast lumps are benign. Regular self-examinations and awareness of your breast health are essential. If you have concerns about breast cancer, especially given your family history, discussing these with your doctor can help determine if further imaging or testing is necessary.

In summary, while many breast changes are benign and related to hormonal fluctuations, it is crucial to remain vigilant and proactive about your breast health. Regular check-ups, self-examinations, and open communication with your healthcare provider are key to addressing any concerns you may have. If you experience any new symptoms or changes, do not hesitate to seek medical advice for peace of mind and appropriate care.

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