Unexplained Breast Itching: Is It a Nerve Issue?

Itchy breasts, is it a nerve issue?

Dear Dr.
Gao,
I have been experiencing a sensitive itching sensation inside my right breast (not on the surface).
I have undergone a breast ultrasound, but the doctor did not find any breast-related issues.
I also consulted a dermatologist.
The first family medicine doctor suggested seeing a neurologist.
After visiting the neurologist, I had a nerve conduction study done on my limbs, and the doctor mentioned that the lumbar region showed slightly slower conduction, but stated it was unrelated to the area where I feel the itching.

I am very concerned about my health and unsure which specialist to consult next.
I asked another family medicine doctor, who suspected there might be an issue with the thoracic nerves and recommended an MRI for clarification.
Since I have seen several specialists without finding a cause, I am quite worried.

I would like to ask you, Dr.
Gao, if I should get a detailed chest MRI? Additionally, do you have any recommendations for further tests (including self-paid options)? I feel lost in this medical journey and would greatly appreciate your guidance.
Thank you.
Sincerely,
Ms.
Lin

Miss Lin, 40~49 year old female. Ask Date: 2015/12/24

Dr. Gao Chunde reply Neurology

Nerves are actually quite small, and magnetic resonance imaging (MRI) of the nervous system is mostly limited to the brain and spinal cord.
Unless there is a specific mass compressing or invading peripheral nerves, or if there are particular formations such as neurofibromas or neuromas, it is generally more difficult to detect nerve issues.
According to your description, it is reasonable to consider nerve-related problems; however, it is important to determine whether the distribution of symptoms is localized to the anterior chest wall or if it follows a dermatomal pattern along the thoracic spinal nerves from the back, which would present with a band-like sensation.
The imaging locations would differ: the former would involve imaging the breasts and chest wall, while the latter would focus on the thoracic spinal nerves.
However, there is still a significant chance that the examination results may be normal.
The physician may suggest that you pay out of pocket for further testing, or they may recommend monitoring the symptoms for changes before proceeding with any examinations.

Reply Date: 2015/12/24

More Info

Dear Lin,
Thank you for reaching out with your concerns regarding the unexplained itching and sensitivity in your right breast. It’s understandable to feel anxious when multiple medical consultations have not provided a clear answer. Based on your description, it seems that you have already taken several important steps by consulting various specialists, including a breast ultrasound, dermatology, and neurology.

First, let’s address the symptom of itching, particularly the sensation you describe as being deep within the breast rather than on the surface. This type of sensation can sometimes be associated with nerve-related issues, especially if there is a history of nerve compression or irritation. The fact that your nerve conduction studies showed some abnormalities in the lumbar region may suggest that there could be a connection between your spine and the symptoms you are experiencing in your breast. However, it’s important to note that not all nerve issues will present clear findings on imaging or nerve conduction tests.

Given that your breast ultrasound did not reveal any abnormalities, and dermatological evaluations have ruled out skin conditions, it may be worthwhile to consider further imaging studies, such as an MRI of the breast and possibly the thoracic spine. An MRI can provide detailed images of soft tissues and may help identify any underlying issues that could be contributing to your symptoms, such as nerve entrapment or other structural abnormalities.

Additionally, it’s essential to consider other factors that could contribute to your symptoms. Hormonal fluctuations, particularly those related to your menstrual cycle, can sometimes lead to breast sensitivity and itching. Stress and anxiety can also exacerbate physical symptoms, including sensations of itching or discomfort. Therefore, it may be beneficial to explore stress management techniques or consult with a mental health professional if you feel that anxiety is impacting your overall well-being.

In terms of next steps, I recommend discussing the possibility of an MRI with your healthcare provider. If they agree, this could provide valuable information that may help in diagnosing the cause of your symptoms. If the MRI does not yield any findings, you might also consider a referral to a pain management specialist or a neurologist who specializes in complex pain syndromes. They may offer additional insights or treatment options that could help alleviate your discomfort.

Lastly, I want to emphasize the importance of advocating for your health. If you feel that your concerns are not being adequately addressed, do not hesitate to seek a second opinion or ask for referrals to specialists who may have more experience with your specific symptoms.

In conclusion, while it is possible that your symptoms may be related to nerve issues, further investigation through imaging studies and possibly a multidisciplinary approach involving pain management may be necessary to find relief. Please take care of yourself, and I hope you find the answers and support you need soon.

Best wishes,
Doctor Q&A Teams

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