What is wrong with my breast

[hrmanager]

I am 42 and have been experiencing pain in left breast.  Had a mammogram and ultrasound with no abnormalities found.   However, during the mamogram I had yellowish discharge come out.   Because I have dense tissue my primary dr. referred me to a breast surgeon.  Since then I have greenish discharge from both breast.  The breast surgeon said it doesn't think that my pain is anything to worry about.  He did a test and said there was no blood in the discharge, however he wants me to have an MRI.  The pain is usually sharp to dull, and located at the same place in the breast but can run in arm pit, under my arm and down my side.  The pain worsens if I lean on my arm or carry something with that arm.  Sometimes the pain is a burning sensation.  I'm so scared and am not coping well waiting for all of this.  I just wish it would go away.  Does it sound like a symptom of cancer to you?

[sonu78]

Hi,
The medial aspect of the right breast inferiority points to the region between 3’0 clock position and 6’0 clock position and the nipple areola region being the pivot point of the needle of the clock. Hope this clears your query.

[hrmanager]

I do feel relieved and I hope that you are right.  The surgeon and nurse both feel that it is me and or hormonal but just want to make sure.  Thanks for being there for me.  By the way...how are you doing?  Are you ok?  

[hrmanager]

Thanks for your feedback again.  Regarding the 5-mm focus in the medial aspect of the right breast inferiority, where is that located on my breast?  I would like to know so that I can know where the area of concern is when I do self exams.
Thanks.

[sonu78]

Hi,
The MRI report sounds to be normal and is not an area of concern at the moment. Now the point to be looked into is the 5mm mass noted in the inferior quadrant. There  is nothing to worry about has it is a benign finding.
The next step would be to conduct self breast examination on daily basis.
Have the mammogram screening done annually. MRI can be done if and only your surgeon feels so.
Good Luck

[Dani904]

I think birad 3 means probably benign and from what I can translate sounds to me like everything is okay and they just want to follow up early in your cycle maybe because they feel it's hormonal.  I have found out follow ups are very common, wish I had known that before I got one :)

I am not a Doctor but it sounds good from what I can read.

[hrmanager]

sonu78
Good news however I received the but/however news.  My breast I was having pain in seem fine, but the MRI detected something in my rights.  

Here is the radioligist's lowlights...

The breasts are dense by MRI (so tired of hearing the dense term).  There are inumerable small (5 mm or smaller) foci of enhancement throughout both breasts that become more numberous and more intense with time, as well as a significant amount of late diffuse parenchymal enhancement bilaterally.  On the T2 images, there are a couple of widely scattered subcentimeter smoothly marginated hyperintese nonenhancing mass-like structures, doncistent with small cysts.  There is no evidence of any spiculated or lobulated enhancing mass.  There is no conclusive evidence for any pathologic non-mass enhancement.  Chest wall is intace.  No pathological enlarged axillary lymph nodes are seen.  All of the foci and areas of enhancement are characterized by slow to medium rapid rise, followed by a continual rise, typically a benign pattern.  A 5-mm focus in the medial aspect of the right breast inferiority has somewhat of a plateau and so this will need follow-up.  There are no specific MRI features of breast cancer.  No evidence of duct dialation or any fluid within the ducts or any enhancing mass in the retroareolar region of either breast to explain discharge.

Repeat MRI in 6 months early in my menstraul cycle.  Birad code of 3.

What do you think?  Should I be concerned?  I asked the nurse what she said that they needed to  follow-up on that area because it could be an area of concern or an area that is me and not of concern.

I had already almost diagnosed myself with cancer of the left breast and it is ok but the right breast is now concerning.  The doctor said to not squeeze my breast anymore for discharge and to call if I notice a lump or any changes.  It seems this area that they are concerned will be difficult to detect a lump especially if I have dense breasts.

Please let me know what you think.
Kim

[sonu78]

Hi,
You are welcome for any clarifications.
Do not forget to post the MRI reports.

[hrmanager]

Sonu78,
Thanks for getting back to me.  I am so thankful to have your comments because they are encouraging.  I should get the results of my MRI on Monday or shortly there after.  I'm having a better day to day coping but everyday is different.  Again, thanks for you taking the time to answer my questions.  We are all lucky to have this forum.
Kim

[hrmanager]

Dani,
Thanks for reading my post.  I really appreciate you taking the time to try to help me.  

The pain all began in August when I was on my period.  It became better, but yes I did notice that it was worse around my period.  However, at this point it doesn't matter as far as the left breast goes.  I have sharp pains in it on the left side of it and even under my arm, down my arm, etc.  I should start my period any day now and today both breasts were hurting worse than ever.  However, the right breast doesn't have that sharp pain like the left one.  For the past 10 years I have had unbearable periods but for the past few months they are almost normal.  I'm really praying that the MRI is normal and this is all hormonal.  Thanks again.
Kim

[sonu78]

Hi,
Appreciate your feedback.
Fine now that it is not the lump and just a tender spot, it is more likely to be fibroadenosis of breast. There other reason for the pain could be costchondritis of the ribs underneath the breast tissue.
With reference to  nipple discharge, causes are
1. Galactorrhoea - milky discharge (prolactin production in absence of lactation)
2. Solitary intraductal papilloma - is the most common cause for spontaneous discharge from a single duct.
3.Fibrocystic change or cystic mastopathy
4.Mammary duct ectasia --- is one of the most common causes of abnormal nipple discharge. One or more of the ducts beneath your nipple becomes inflamed and clogged with a thick, sticky, green or black substance.

NIPPLE DISCHARGE IS COMMON AND IS RARELY ASSOCIATED WITH UNDERLYING MALIGNANCY.

[Dani904]

I can't offer any medical advice, but I do know when I was younger I had breast pain here and there, a week before my period, now as I am getting older (43)  I notice more pains in my breasts and swelling for longer periods of time.  I figure it's something to do with menopause and my cycle changing.  I can't say if that is what is happening, but thinking back have you noticed more tenderness at a certain time?

[hrmanager]

Sonu78
I made it through the MRI.  You were right, the test was for both breasts.  The tender spot does not appear to be a lump, it is just tender.  Could this be related to pain in my breast?  Like referred pain?  What else causes pain of the breast and nipple discharge that is green?
Thank you.

[hrmanager]

Still anxious about getting the MRI test on Thursday and especially the results.  What is a bilateral MRI?  

Also I noticed a tender spot on my side, on the rib area next to the breast that is hurting.  It is tender to the touch and when I move around that area.  I don't notice a lump or bump and it feels the same as the other side.  Could that be a node?  Could I be getting referred pain in my breast from that area?  Would that make the nipples discharge the green substance.  Does it sound like an infection still or oh my gosh the worst case?  I'm not coping well still because I am fearing the worst.

Thank you so much.

[sonu78]

Hi,
Relax, Relax and Relax.
There is no terminology as Bilateral MRI as far as my knowledge is concerned. Probably, it should have been MRI of breasts bilaterally. This means that both breasts are to studied.
Probably, the tender spot with lump mentioned by you, could be something in relation to  chest wall like chondritis,......
Will await the MRI report to be released. Best of luck for MRI

[hrmanager]

Still anxious about getting the MRI test on Thursday and especially the results.  What is a bilateral MRI?  

Also I noticed a tender spot on my side, on the rib area next to the breast that is hurting.  It is tender to the touch and when I move around that area.  I don't notice a lump or bump and it feels the same as the other side.  Could that be a node?  Could I be getting referred pain in my breast from that area?  Would that make the nipples discharge the green substance.  Does it sound like an infection still or oh my gosh the worst case?  I'm not coping well still because I am fearing the worst.

Thank you so much.

[sonu78]

Hi,
The sensitivity test is a test done after an organism is grown in the culture media and this helps us to know an appropriate antibiotics for the grown microbe.
This is basically done for any infective pathology. This test was suggested since you had made an mention of greenish discharge from both the breasts. As you are about to undergo  MRI , let's await the reports. Hope for the best.

[DrBhumikaMD]

Hi,
Dont worry and let the MRI report come in. Discuss with your radiologist the report in detail. A sensitivity test is done after a culture where in the microbiologist finds some organisms like bacteria in the sample to suggest an infective etiology. Then the sensitivity of these organisms or resistance thereof is seen to various antibiotics. This helps the physician to decide which antibiotic medication should be prescribed. Goodluck with the MRI.

[hrmanager]

I appreciate your feedback.  I do not notice any lumps or skin changes at the site.  My other breast and underarm area is starting to experience pains but not as severe as the other breast.  I have seen a breast specialist a week ago and am having an MRI next Thursday.  Say a prayer please.

[hrmanager]

Thanks for getting back to me.  My primary doctor did a slide discharge test and it came back ok.  However, she couldn't get much discharge on the slide.  My breast specialist did an instant test in his office by putting the discharge on a tester and adding drops.  He said that if it turned a color (I believe blue) that there was blood in the discharge.  Thank goodness it did not turn blue.  I don't know that he did a sensativity test?  What is that?  The pain under the arm sometimes coincides with the breast pain but at other times the breast has sharp pains alone.  Now my other breast seems to have pains and both nipples are sensative.  What the heck?

[DrBhumikaMD]

Hi,
The nipple discharge needs to be sent for lab examination to see if a diagnosis can be made. A discharge from the nipple in most women is common due to squeezing or breast self exam. Pain in the breast could be due to an infectious process like mastitis or breast abscess, hormonal fluctuations during the menstrual cycle, tight clothing or trauma or injury to the breast tissue. Wear lose clothing and apply some soothing creams at the sight. Do you notice a lump, or any skin changes at the site? You need to get a clinical evaluation done by a physician and ask him whether you need to take any painkillers or antibiotic medication. Goodluck.

[sonu78]

Hi,
Going through your post, it points towards some type of inflammation probably infection. Have u been submitted for a culture and sensitivity test of the discharge. Pain under the arm could be due to the inflamed nodes. If this is the diagnosis, then u may be required to take a  course of appropriate antibiotics. with this history to speak of cancer would be premature.