swollen underarm

[jnn]

I am 36 and have fibrocystic breast disease.  Last year I had a mammogram that showed microcalcifications.  Six months later the follow up mammogram showed no changes to the microcalcifications.  I am due for the one year follow up in 5 wks.  2 days ago I did my monthy BSE and found thickening and swelling under my arm, the arm attached to the breast with the calcifications.  It is not painful, but is slightly tender.  It is not hard and is about 1 inch.  My GP could find no cause for it and my OB Gyn and GP both examined my breast and found no lumps in the attached breast.  I am waiting for my CBC results.  My OB Gyn feels cancer is unlikely,  do you agree?  Should I ask for a second opinion or push to have my mammogram moved up.  Can a mammogram and BSE miss cancer that would have already progressed to the lymph node?  I did have a slight sorethroat and cold sore the weeked before the armpit swelled.

[CCF-RN,MSN-rf]

Dear jnn:  Neither mammogram nor BSE are perfect tests.  However, they are the best we have.  If your doctors are not currently concerned about the lump, I would try to calm yourself.  If you feel uncomfortable, you can certainly have your mammogram moved up, if for no other reason than peace of mind.  Given your age, cancer is not likely, but it is possible.  Your armpit can also swell if you have an ingrown hair or other infection.  Try not to panic.

[surgeon]

many things can cause a lump under the arm: enlarged lymph nodes (most of the time due to inflammation or infection, not tumor), benign tumors such as lipoma, and something called ectopic breast tissue, meaning breast tissue in an unusual place. If that's what it is, it's been there forever, but can enlarge and get sore when fibrocystic changes take place. It also could be related to the skin, such as a sebaceous cyst. Sometimes seeing a surgeon is helpful, since they tend to have lots of experience with lumps and bumps, and can help decide if a biopsy is warranted.

[jnn]

my CBC came back normal today.  I have a follow up mammogram on Monday.  Is there anything else you suggest.  Is it true that it is unlikely to be cancer if the mammogram, Doctors exam both are negative for a lump. I am very anxious about cancer.  Is there anything else you can tell me about breast tissue being in my armpit, because it does ache the way my breast does with the fibrocystic changes.

[surgeon]

if it feels ok and the mammogram is ok, the likelihood of cancer is very low. It matters a bit if the area in question actually showed on the mammogram. Sometimes a fine-needle aspiration of a lump (putting in a needle and sampling a few cells for examination under the microscope) can help. As to ectopic breast tissue, it's harmless in general (it's possible to develop cancer in breast tissue whereever it is) and the main reason it's sometimes removed is if it's bothersome enough in terms of discomfort for the woman to want it gone. It's a fairly minor operation to remove it. The main thing is becoming sure of what it is, which may be aided by a surgical consult, with or without some kind of biopsy.

[jnn]

thanks for all your help.  jnn

[jnn]

I had my mammogram and a ultrasound of the underarm.  The calcifications have not changed and the ultrasound looked okay.  The chain of lymph nodes did show on the mammogram, but only on the side that hurts.  The surgeon felt that it would resolve itself and set me up for a followup a month later.  My appointment is next week.  
Meanwhile, it has not gotten better.  It is more painful and radiates down my left arm.  (I do have MVP and RA)  and sometimes feels as if my left rib cage or lung is sore.  
Do I need to see anyone other than a surgeon.  What may the next step be.  I tried letting it resolve itselp, but after two months I am ready to know exactly what is going on.  any tips?
thanks again Jnn

[jnn]

The left breast sometimes itches also      Jnn

[jnn]

MY SURGEON HAS SET ME UP FOR A BOIPSY NEXT WEEK.  HE IS REMOVING THE WHOLE LYMPH NODE  I WAS HOPING FOR A LESS INVASIVE BIOPSY.  WHAT ARE THE POSITIVE REASONS FOR DOING THE REMOVAL, AND RISKS.  HOW LONG BEFORE SURGERY DO I STOP FROM TAKING ANTI INFLAMMATORY DRUGS TO DECREASE BLOOD LOSS         THANKS JNN

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