Constant breast pain with lump and previous FIBROADENOMA.

Resolved Question:

For the past two months, I've been dealing with breast pain. It started off with where I had a lump, with the flak jacket pushing on it, however, it quickly started to escalate in the both breasts were constantly in pain, originally it was a dull ache, that just got more painful. I also had pain shooting through the breast. Over a week ago, I had a fibroadenoma removed, which took care of the shooting pain, however the other pain only got worse, and it feels as though something is clawing at my chest with pain still under the breasts and the outside to under the armpit. It's been getting bad enough to keep me from doing my job- I'm a US Marine and Combat Engineer. It randomly started about two months ago, and I'm only 21. The pain isn't cyclical and the doctor's I'm seeing haven't been able to help, so I'm simply trying to find the solution so I can, hopefully, continue on with my life and my job.
At 18 years old patientold, I had a fibroadenoma removed, however it never got close to this bad. I only suffered pain when my bra's underwire pushed on it or I slept on that side. But after it got removed, I haven't had any issues with breast pain, for almost 4 years.


Category: OBGYN

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.

Hello
Thanks for writing to us with your health concern.
I would like to request for a few more details.
Have you seen a Specialist for this pain ?
Has any workup been done for the lump and the pain ?
Would you mind uploading the images / scanning that has been done so far ?
What is your age ?
Are your cycles regular ?
Is there any other palpable reason for this pain and discomfort ( I am asking this since the commonest reason - fibrocystic breast disease - FBD - is cyclical and related to periods ) ?
Such other causes can include - ill fitting wired bras, tight military gear, uncomfortable chaffing or sleeping postures, lots of sweat and humidity, rough fondling during sex etc.
I guess if these factors are ruled out, the cause remains FBD - fibrocystic breast disease.
Women with FBD have denser and more sensitive breasts than others, which are more prone to pain.
The treatment consists of Vitamin E supplements and Evening Primrose oil supplements, along with a sensible diet and daily exercise ( of which I am sure you get a lot ! ).
From your history, I gather that you have had fibroadenomas twice, and that too happens in women prone to FBD.
Looking forward to hearing from you.
Take care.


Patient replied :

I've seen a surgeon- who removed one of the fibroadenomas. Which helped with the shooting pain through the breast tissue that it was causing. They said that it was a benign fibroadenoma after the surgery and that's it. I never recieved any paperwork or anything on it after the surgery.
I'm 21 and my cycles are normal. However the pain does not get worse during my periods and better afterword, every day it just seems to get a little worse. It sometimes feels as though someone is taking their fingers and jamming them into my chest and pulling them along with the ribs. It does not go deeper than the chest wall, and feels purely muscular. It hurts worse with movement too, any stretching or moving of the chest causes pain. I can't run, jump, or go do stairs rapidly, without pain. However, I still get bad pain when I sleep at night, and the pain medicine (oxycodone) helps dull it, but it still gets in the way.
As for causes, not that I know of. I only wear sports bras. My military clothing is loose fitting, and for the past 2 months, I have not worn my flak. I haven't been sleeping any differently that I know of. I'm stationed on Okinawa Japan, which is much more hot and humid than I am used to, so I have been sweating a little more than usual, but when I was at school it was humid and I was sweating there too. I came to island just over 2 1/2 months ago. And for the rough handling, nope.
The fibroadenomas were spaced almost 4 years old patientapart, at least the pain was. The thing for me is that it isn't cyclical. It just has been getting progressively worse over the two months. Again, it feels like someone is pulling, as if following the ribs, but I also have a lot of pain underneath the breasts, and on the outsides of them, to include the side and sometimes the back, as it seems to wrap around my chest. The pain, without pain meds are generally between 6-8, with pain meds it ranges from 3-8. As in some cases, like last night, nothing I did seemed to help. I took the oxycodone (2) as diagnosed. I tried putting ice wear it was hurting, I tried hugging a pillow, as I sleep on my side, and it lasted for about 4.5 hours finally after taking another dose of oxycodone (as I was told to take it every 4 hours as needed for pain) I was finally able to get some sleep. I also have been taking ibuprofen every 8 hours for the past month and a half, and been taking oxy for the past month, and it keeps getting worse. The all the time pain gets more severe and the times of the 8 level pain get more frequent, longer, and were for a while getting more intense.
The only other history I have of injury to the area was a left shoulder injury, but that was over 6 years old patientago. It was never diagnosed as anything, as Drs couldn't find out what it was. This pain has been worse than that most of the time. Other than that, my mom was diagnosed with breast cancer, but she was diagnosed with it post menopause at the age of 51.
Thanks,
Sarah


Expert:  Dr. Aarti Vazirani replied 3 Days.

Thank you so much for the detailed update.
In my opinion, it is more likely to be a muscular problem, something to do with the rib cage.
You should be having a more thorough evaluation.
Was the fibroadenoma surgery not preceded by imaging ?
Please get a sonomammogram of the breast done, and also consult an Orthopedic surgeon to rule out any muscular / bony cause for the pain.
Your pain certainly does not sound like FBD - fibrocystic breast disease.
With a personal history of breast cancer, it is imperative to have breast imaging done as a primary step, and also a complete physical evaluation by a Specialist OB - GYN and an orthopedic surgeon.
Please get that done, this amount of pain is not normal at all.
Take care.
Please keep me posted.
Wish you loads of luck and a speedy recovery !


Dr. Aarti Vazirani
Category: Infertility Specialist
Experience: 
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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