breast abnormalities

[gradysmom]

I am 31 yrs old and recently presented to my GYN w/ left breast pain (sharp, shooting pain in one area). Sent for mammo and ultrasound. Mammo saw nothing, but ultrasound discovered one simple cyst, one complex cyst, and one solid nodule that was said to be a fibroadenoma. GYN said original radiologist did not suggest follow up. I then saw a surgeon who suggested three month ultrasound follow up (agreed with original findings) and had a different radiologist read films who agreed with findings. Now, one month later am having pain in two areas of the same breast and can feel a knot or something where the simple cyst was said to be located. I do not feel doctors are being aggressive enoough by not performing biopsy. Was told all discoveries were so small (imagine a lentil) that needle biopsy may not be successful. Can such abnormalities cause such pain and is it typical to wait with a complex cyst and unidentified solid nodule?

[CCF-RN,MSN-rf]

Dear gradysmom:  Cysts are generally benign.  Breast cancer is typically not painful.  From what you have said and from the agreement from 3 different doctors, it seems reasonable to wait the recommended 3 months.  Cysts may be aspirated or removed if they are causing discomfort.  If you are still uncomfortable with this approach, get another opinion from another surgeon, preferably a breast specialist.

[surgeon]

pain is typical of fibrocystic breasts. If there's a feelable lump, the easist thing is to poke a needle into it: if it's a cyst, fluid comes out which proves the diagnosis and makes it go away. As to the non-feelable solid image, the choices are close followup (as was recommended) versus some sort of guided biopsy. When there is a high degreee of confidence that it's not cancer from the appearance, a threemonth follow is reasonable. But if the woman who has the lump isn't comfortable with that approach, biopsy needs to be strongly considered, for peace of mind.