Right Chest Discomfort: Thyroid Cancer Survivor's Concerns

Q: Right Chest Discomfort: Thyroid Cancer Survivor's Concerns

Dear WINI： The abnormal sensation in breathing does not seem to be related to the hard mass in the right pleura. <br>Thyroid cancer can potentially metastasize to the lungs, and further examination can be conducted at the thyroid outpatient clinic. <br>As for the hard mass in the

There is sometimes a feeling of tightness or pain in the right chest during breathing?

Since I discovered thyroid antibodies at the age of 18, I have been undergoing treatment without interruption.
In 2011, I was diagnosed with a malignant papillary thyroid carcinoma after finding a thyroid nodule, which led to a total thyroidectomy and radioactive iodine (I-131) treatment.
Although the doctor did not specify the stage, it was likely detected at an early stage.
Since then, no other issues have been found, and I have been continuously supplementing with thyroid hormone.
In June 2015, I accidentally found a small hard lump in my right breast and went to see a gynecologist.
The doctor noted that it felt small, but recommended an ultrasound with a breast surgeon for confirmation.
Due to the absence of pain, I did not rush to get it checked.
In October, my endocrinologist arranged a chest X-ray to check my lungs, which showed no issues.
However, in the past month or two, I have occasionally felt a slight pulling pain in my right chest.
To ease my concerns, I decided to undergo a breast ultrasound.
The lump is very small and can only be felt when soapy, and the doctor could not feel it either.
During the ultrasound, the doctor reported that nothing was detected (even though I can clearly feel it at home).
Recently, I have also experienced occasional mild discomfort in my right chest when taking deep breaths, as if something is pressing down.
I wonder if the ultrasound might have missed something because the doctor could not feel it, or if you would recommend any other specialty examinations?

WINI, 30~39 year old female. Ask Date: 2016/01/19

Dr. Zhou Jiazhen reply Breast and Thyroid

Dear WINI: The abnormal sensation in breathing does not seem to be related to the hard mass in the right pleura.
Thyroid cancer can potentially metastasize to the lungs, and further examination can be conducted at the thyroid outpatient clinic.
As for the hard mass in the right chest, it should be monitored for any increase in size or symptoms; if any arise, further investigation will be necessary.

Reply Date: 2016/01/19

More Info

It's understandable to feel concerned about any new symptoms, especially as a thyroid cancer survivor. Your history of thyroid cancer, particularly the diagnosis of papillary thyroid carcinoma and subsequent total thyroidectomy, adds a layer of complexity to your current health concerns. Let's break down your situation and address your questions regarding the right chest discomfort and the findings related to your breast.

First, regarding the small hard lump you felt in your right chest, it's important to note that not all lumps are indicative of malignancy, especially if they are small and have been evaluated by a healthcare professional. The fact that your obstetrician suggested an ultrasound is a good step, as imaging can help determine the nature of the lump. However, if the lump is not palpable by the physician and was not visualized on ultrasound, it raises the question of whether it is indeed a significant finding or if it might be something benign, such as a lipoma or a cyst.

The discomfort you are experiencing in your right chest, particularly the occasional sharp pain and the feeling of pressure during deep breaths, could be attributed to several factors. These may include musculoskeletal issues, such as muscle strain or costochondritis, which can cause localized pain in the chest area. Anxiety and stress can also manifest as physical symptoms, including chest discomfort. However, given your history, it is prudent to rule out any serious underlying conditions.

Since your ultrasound did not reveal any concerning findings, it may be beneficial to follow up with additional imaging if your symptoms persist. A chest X-ray or a CT scan could provide more detailed information about the structures in your chest and help identify any potential issues that were not captured on the ultrasound. Additionally, if you continue to experience discomfort, consulting with a pulmonologist or a thoracic surgeon may be warranted to evaluate your symptoms more thoroughly.

Regarding your concerns about whether the ultrasound was thorough enough, it is possible that the lump is small enough that it may not have been detected during the examination. If you feel strongly about the presence of the lump, you might consider seeking a second opinion or requesting a more comprehensive imaging study, such as a mammogram or MRI, which can sometimes provide better visualization of breast tissue.

In summary, while your history of thyroid cancer is important, it is equally crucial to address your current symptoms with a comprehensive approach. If the discomfort persists or worsens, do not hesitate to seek further evaluation. Regular follow-ups with your healthcare provider are essential, especially as a cancer survivor, to monitor for any new developments and ensure your overall health is maintained. Remember, it's always better to err on the side of caution when it comes to your health.

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