painful lump not found on mammo or US

[metalgirl70]

I have been having pain in the lower portion of my right breast for about 3 years.  This pain was a on again off again type of thing.  I do regular self exams and never found a lump in that area until this Oct 2007.  Since I'm 36 years old, my doctor did not think it was necessary to do a mammogram when I complained of pain in the past.  Now this pain is persistant in the breast although the intensity of the pain has fluctuated from week to week.

During this same time period, I started getting persistant pains in and around my right shoulder blade area right spine area.  So now I'm totally freaking out that I have advanced cancer.

I should note here that I also do have multiple sclerosis, and often have neuropathy in my arms and hands, but never in my shoulder blade or back area.  This new shoulder blade  pain came on suddenly and very acute and has persisted ranging between a dull ache, to a stabbing pain.

Anyway, so my doctor can feel the lump that I am now feeling.  It's oblong shape, maybe 1/2 inch long.  He ordered a mammogram and ultrasound.  I also have breast implants (for 9 years) so that complicated the issue.  I had to wait an excruciating 16 days to get the mammogram and ultrasound.  I was so anxious and sure I had cancer, I lost my composure  during the tests and broke down in tears.

Anyway, the results of the mammogram and ultrasound were normal.  It gave me a bi-rad 1 score. Those tests could not even find the lump in question.  How can this be, when it is easily felt?  

So now I have to wait again, until Dec 10th to see a general surgeon (waiting again, another 13 days!).  I want a biopsy so I can put my fears at ease. All this waiting is aggrevating my MS and my blood pressure.  I am a fit person who goes to the gym 4-5 times a week, and my blood pressure is normally 115/70.  A few days ago at my doctor's office, my blood pressure rose to 150/90.

Any thoughts on why the mammo or US didn't pick up my  painful lump?

What should be the next step for a person with breast implants?

Thanks

[riley180]

Hi.
There are a couple of scenarios that come to mind.

On all symptoms taken together:
Are your implants silicone? Did you have the breast augmentation before the multiple sclerosis?
Multiple sclerosis destroys nerve sheaths due to an abnormal reactivity of the immune system towards normal nerve sheaths. Some women with silicone implants have been known to develop MS like symptoms (probably as a reaction to the implants). Other rheumatic-like pains may be present as well (on the arms and shoulders), again due to hyperreactivity of the immune system.

On the lump:
Implants may produce scarring and this may be felt on examination. It should also however show up on the mammogram/ultrasound, though if it is too close to the implant, delineating the area may not be possible. Areas of contracture on the implant capsule may also cause pain.

On what to do now:
If the surgeon concurs that there might be something hyper-reactive against the implant, there are blood tests that can be done to estimate if there is indeed significant inflammation going on. Should this be the reason, you may need to consider removing the implants.

On the other hand, I hope I’m completely wrong.
It is also possible, that everything is not connected, that it is all some painful scar that will improve with some analgesics.

[metalgirl70]

Thanks for your repsonse.

I've had the saline implants for 8-9 years.  I was diagnosed with MS 2 years ago.

I am aware that silicone implants may cause autoimmune symptoms and the jury is still out if saline implants can also cause the same.

My doctor does not think my implants have capsular contracture because they are still soft and not misshaped.

What is the blood test that you are reffering to?

If I have a problem with the implant, I'll just take them out and replace with a new set.  Most websites say that implants are only good for about 10 years or so.