Breast Dimple

[mathilda]

I am a 52 year old woman who has a history of fibrocystic breasts.  I was on HRT but discontinued use almost one year ago.  In doing my breast self-exam I noticed a dimple in my left breast (it's been there awhile, but seems bigger).  I immediately went to my surgeon and he did a thorough exam and said he didn't think it was anything to be worried about.  I didn't think at the time to ask him what else would cause a breast dimple other than a tumor.  He didn't seem concerned and I see him every six months.  Should I be concerned enough to request an ultrasound?  I felt relieved when he told me he didn't think it was anything, but have since read lots about breast dimples and am a little concerned.  What other conditions cause breast dimples?  I have found little info on the Internet ... all info I have found says that this should be a concern.  Thank you.

[CCF-RN,MSN-rf]

Dear mathilda:  The first step would be a mammogram, if you did not already have one.  Ultrasound is usually best at distinguishing a solid mass from a fluid filled cyst and may not be helpful in determining the source of your "dimple."  If you have had a mammogram and it is negative, you might ask your doctor about a breast MRI.  Another option is to gather a second opinion from a breast specialist.  If all is negative, then early follow-up may be acceptable but a growing dimple needs explanation.

[surgeon]

Mammogram would be the most important step: you didn't mention having it, although I find it hard to believe a surgeon would evaluate your for a new dimple and not order one, so I assume one was done and was ok. Ultrasound isn't all that helpful as a solitary screening device. If the exam and mammogram were ok, then followup is acceptable, although with a perceived change, I'd be inclined to make it more like 3 months than 6, initiallyl.

[mathilda]

I had my last mammogram in May and everything was okay.  Should I go ahead and have another one.

[surgeon]

Given that there's a change in your breast, I'd be ordering another mammogram if you were seeing me: 7 months is a long enough time that it's possible something new would show.