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Avatar universal

Sudden large lump 3 months after exam/mammo/ultrasound

I am 39 years old. Nonsmoker. There is no breast cancer in my family with the other women ranging from 62 to 99 years old. I have extremely fibrocystic breasts. I had a lumpectomy at age 25—benign fibroid. I had a bad breast infection and trauma at age 29 that resulted in a (temporary) 12cm solid lump, with about 6cm remaining as internal reshaped tissue enclosing small. Dozens upon dozens of other lumps and bumps that were diagnosed as benign via ultrasound and/or mammogram over the years, and fluctuated or disappeared.

I get yearly manual exams, diagnostic digital mammograms, and immediate comparison ultrasounds--at a very respected location (Beth Israel). I had a full set in mid-June. The manual found nothing of concern and the mammo/sono were benign—multiple cysts up to 11cm, scattered microcalcification that hadn’t changed in at least 2 years.

I am trying to get pregnant and just did a cycle of Clomid/follistim/Lupron this month. I am 9 days post ovulation/insemination. I'm scheduled for a pregnancy test on Friday.

This morning I woke up and noticed a huge lump or thickening—at least 9cm—beneath my right nipple. It is in the exact same place, and feels exactly the same, as the lump from the infection 10 years ago (where the scar tissue is. In fact I can feel the scar tissue bump "attached" to it like it's normally "attached" to my central breast tissue). No pain. The lump is rounded, and it moves around within my breast, not attached to the chest wall.  I can move my nipple completely away from it to the side and see the shape of the lump under the stretched skin of the rest of my breast--it's not attached to the nipple or skin.

Because my breasts are very small, it's almost like the whole central area--that feels sort of squishy/firm when I squeeze it on the left--is much more solid/firm when I squeeze it on the right. It feels like the entire central tissue of my breast is suddenly hardened and the usual benign scar tissue bump area riding atop it is more swollen than usual.

I have a vague memory that this sort of central thickening/hardening feeling may have happened at one point in my left breast, where I do have an 11cm cyst, and then went away a few weeks later.

I called my doctor—didn’t see him, just phone/email. He is not concerned at this point. He wants me to have a pregnancy test on Friday since it could be hormonal changes to the breast tissue from either pregnancy or Clomid or PMS. If the pregnancy test is negative, he wants me to wait until after my period and see how the area feels. If it doesn’t diminish within the next 2 weeks, he’ll send me to a surgeon for follow up.

This all sounds accurate, but I am very freaked out. I'm reading about ILC and panicking. My nipples mostly look the same as each other--but there is a slight crease across the lower middle of the affected nipple that could well been there since puberty--it's nothing I would have noticed. There is slight striation of the skin of the inner halves of both breasts--but again I'm pretty sure that I've had stretch marks there since my teen years--I"m very pale and I have very thin skin and my breasts grew very fast. No reddening, itching, heated skin, leathery skin, scabs, bruises, pimples, or other marks on either breast except the possible stretch marks. No discharge. No inversion. Nipples are both oddly sensitive but I'm either pregnant or have PMS following Clomid. No swollen or sore lymph nodes (I'm very skinny and can usually feel them if they swell at all.)

The doctor insists that sending me to a breast surgeon now, instead of waiting 2 weeks, would result in possibly unnecessary procedures. Especially considering that my body is clearly having other hormonal changes from either pregnancy or Clomid (acne, increased cervical mucus, nipple tenderness, nausea.) But I am very, very, very panicked. I have no friends who have been pregnant or on fertility drugs to compare notes with on early breast changes.

He says the best thing for my health is to calm down, do some yoga, and call him in 2 weeks if there are no changes. In my head I know he is right, but it's so scary to wait.

Reassurances that a two week wait is OK would be very helpful right now! I can't believe that after 15 years of repeated scares, endless testing, and completely benign results, I'm this freaked out YET AGAIN. FWIW, I do have medication to help with the panic attacks, but because of the possible pregnancy I can't take it.

Jennifer
2 Responses
1119363 tn?1330359040
It sounds like you have been doing a solid job of keeping track of your breast health issues.  With your history of fibrocystic  breasts, you are probably going to have to deal with this issue repeatedly for a long time.  It is just going to be part of your physical makeup.  Adding to that history, the fertility drug and pregnancy are going to affect your breast tissue.  I do not have a fibrocystic condition, but I have been pregnant and can tell you that there are lots of things change physically.  My earliest changes, within two weeks of getting pregnant, were with my breasts.  

To get control of your panic attacks when you can't take the medicine, you will need to resort to other measures.  Your doctor suggested yoga, that's good.  Relaxation techniques are good during pregnancy and throughout parenthood (my girls are 22 and 13,) so incorporating them into your life regularly will be good for a long time.

Unemotionally evaluate what you know and focus on that instead of letting your mind spiral through "what-ifs."  First, this is most likely not breast cancer.  Second, you are going to check this out and have it evaluated.  Two weeks is not a long wait.  It just feels like a long time when you don't know what the outcome is and you've got so many important things going on.  Third, taking fertility drugs and getting pregnant make your emotional state more likely to be a roller coaster ride.  This is a good time to surround yourself with supportive family and friends to help you through.  

I am thinking of you.
Avatar universal
Thanks so much!
I do understand the roller coaster of motherhood--I've been a mom for 6 years, but via adoption rather than biology.
Last night my husband was able to confirm that the striations on my breast skin are stretch marks that have ALWAYS been there. What can I say, he looks at them more than me! So I do feel better knowing that the skin isn't showing any suspicious changes.
I posted to a Johns Hopkins University help site, and the expert there also said that my doctor is correct in having me wait 2 weeks rather than rushing into tests. She says its likely hormonal changes. My nipples on both sides are extremely, extremely sore today so it's clear something is going on in there.
Still, I'm not enjoying this new absolutely enormous lump! But I'm trying to take one hour at a time and stop with the "what ifs."
Thanks again!
Jennifer
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