Tiny breast lump

[Sregeem]

I have an appt to see my doctor, but it is not until Nov., and I'm going insane with worry in the meanwhile. I realize you can tell me nothing without seeing me, but while I wait for the next 6 weeks, I am hoping to benefit from some information of some kind.

I'm 31, with a 2-year old son whom I am still breastfeeding.

My maternal grandmother died of breast cancer when she was 41. My mother is now 60 and has never had cancer, and her grandmother on that side lived to be almost 100 with no cancer. My grandmother was one of 10 children, and they all had many children/grandchildren themselves. Up until recently, no one else had bc in my extended family (that I knew of), although some had other cancers. Recently, my grandmother's sister, who is in her 80s, had a cancerous lump removed from her breast (no chemo or anything). I say all this because my primary concern is my grandmother's BC diagnosis at such a young age (37).

I started my period very late (15), and still haven't gotten a period since giving birth 2 years ago (my son remains a pretty frequent nurser).

I have fibrocystic breasts and have had mastitis once and a clogged duct one or two other times.

I recently discovered a tiny area on the lower half of one breast that feels harder than the rest of my lumpy breasts. It is about the size of half an uncooked grain of rice, which makes it hard to tell if it's round (it's so tiny). It takes me a long time to locate it, and sometimes I'm unable to, at which point I begin to think I imagined it, until I locate it again a few days later (I'm sort of obsessively doing BSEs, as you can probably tell). I can't really find anything similar in the other breast or elsewhere in this breast.

Again, I'm going to the doctor, and will request a mammogram/biopsy. For now, can you give me any sense of if this could be cancer, and if so, does its tiny size mean I've caught it early? What about the fact that it's sometimes really difficult to locate?

Thanks so much.

[Indranil Ghosh, MD]

Dear Sregeem,

Thanks for writing back.

Now that the physical examination by the doctors and the sonogram are both negative, you should stop worrying about the lump. Many times self breast examination detects so-called lumps, which are not actually lumps. We have a modality called triple diagnosis, which incorporates clinical findings (by a doctor), USG or mammography and if needed FNAC or biopsy to reach a diagnosis of cancer. The last step is done only if one of the two above are suspicious. In your case as both are negative, there is no need for biopsy.

The thing you have learnt from the net about biopsy in USG negative nodules, is true for the lumps which are felt suspicious by the doctor but nothing is found on imaging. This is not so in your case.

And, lastly, fullness of the breasts due to not nursing for a period has got nothing to do with accuracy of USG.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Indranil Ghosh

[Sregeem]

thanks so much for gettng back to me.

due to my high anxiety about this, my husband insisted i call the doctor and although i didn't speak to him, the nurse squeezed me in for a sonogram.

i was hoping they'd diagnose a cyst and i could be done with it. unfortunately, they couldn't find ANYTHING, cyst or otherwise. the tech and two doctors both looked and felt and none of them could feel it, but since then i've been able to determine that there is NOTHING similar elsewhere in either breast, and it's really hard, like a tiny bb. if it's not a cyst, what can it be? the second doctor noted some "ductal ectasia" but said it wasn't severe or anything to worry about (i did try to nurse my son right before the appointment, but my breast was relatively full). could this be what i'm feeling? it's not behind the nipple, but rather the lower left quadrant of my breast so i doubt it's a duct.

i'm still very concerned, as i've read online (i know i shouldn't do this!) that a palpable breast mass with a negative ultrasound warrants a biopsy. i am quite familiar with how my fibrocystic tissue feels--lumpy but squishy. although what i'm feeling is small and round, it's incredibly hard and very distinct from surrounding tissue.

thanks again.

[Indranil Ghosh, MD]

Dear Sregeem,

Thanks for the query.

First of all, I must appreciate your awareness about breast health and also the details in which you have analyzed your family history.

Your grandmother's diagnosis of breast cancer was certainly at a young age and I am sorry to hear that she died at such an young age. However, the occurrence of breast cancer in your grandmother's sister at 80 years is of much lower concern. As many as one in eight women who live till 80 years do have breast cancer.

Having period late and nursing for long time only decreases the risk of breast cancer, not the other way round. You are doing great! The fibrocystic disease and mastitis are not of major concern.

Now, coming to the tiny thing that you are noticing, it is probably part of the fibrocystic disease or probably nothing at all. I feel that you can certainly wait it out till November without worrying too much.

Mammography is not very informative at your age due to dense breasts; USG(ultrasound) of the breasts may be done if need be. I don't think you will need biopsy at all.

I don't think you have got cancer, but still it is prudent to consult a doctor.

Hope that this information helps and hope that you will get better soon.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Indranil Ghosh