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Breast Cancer

Breast nodule

09/18/2006

Question:

I went to my family doctor because I had severe tenderness in my left nipple and areola. So tender that I couldn`t stand a sheet or anything touching it. He sent me for a mammogram. The radiologist said that he couldn`t find any reason for the pain in my left nipple (no discharge by the way) but did find a nodule in my right breast. I have had no pain in my right breast but a few months ago did get a mysterious rash over the entire breast. My family doc had given me a couple ointments for the rash but they never helped. I quit using them and it went away about a month later. The radiologist compared my mammogram to my last one and said I had the same nodule ( of which my previous family doctor didn`t tell me about) and that he noted that the nodule was denser than in the former mammogram. He recommended a repeat mammogram in 6 months. My family doctor says that it is "probably benign". He says..."If the radiologist thought it was anything to worry about that he would recommend biopsy". I am not too comfortable with this. What do you suggest? I do have some risk factors. I started at the age of 10, am overweight,I have always had very large and dense breasts since the age of 12, because I had a complete hysterectomy with removal of both ovaries,I have been on estrogen therapy for more than 6 years.

Answer:

Breast pain is usually a sign of benign problems in the breast, not cancer.  The rash is also probably unrelated to any underlying breast problem.  If it recurs, I would recommend seeing a Dermatologist since the ointment from your PCP didn't help.

Based on the information that you've provided, the right breast nodule seen on mammogram has been designated a "Category 3" mass by the Radiologist.  This means that it is "probably benign" and a 6 month follow-up is recommended.  The Radiologists are correct that this mass is benign 98-99.5% of the time.  The chance that this is really cancer is only 0.5-2%.  If the mammogram in 6 months shows any change, then biopsy will be recommended at that time.

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Response by:

Jean T Stevenson, MD, FACS Jean T Stevenson, MD, FACS
Associate Professor of Surgery
School of Medicine
Case Western Reserve University