[18F] With left breast pain and lump

Patient Description

An 18-year-old female reports constant pain in the left breast, which began yesterday and is rated as 7 out of 10 in severity. The pain worsens when laying down on that side. The patient noticed a lump in the top left of the left breast, which has grown in size and feels stiff. There is no associated fever, redness, changes in the skin over the lump, nipple discharge, or retraction. The patient also mentioned a history of trauma to the breast, having hit it on a door approximately three weeks ago. No other symptoms, pre-existing conditions, or medications are reported.

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Arora's Assessment

What might be happening

Based on the information you provided, here are some possible explanations for your symptoms:

  • Breast Trauma: Given your history of hitting your breast on a door three weeks ago, it's possible that the pain and lump are related to that injury. Trauma can cause bruising, swelling, and the formation of a hematoma (a collection of blood outside of blood vessels) which can feel like a lump.

    • Treatment typically involves rest, ice, and over-the-counter pain relievers. However, if the lump persists or grows, further evaluation is necessary.
  • Fibrocystic Breast Changes: This is a common condition where the breasts feel lumpy or rope-like. These changes can cause breast pain, tenderness, and lumps, especially before your menstrual period.

    • Treatment often involves over-the-counter pain relievers, wearing a supportive bra, and applying warm or cold compresses.
  • Breast Cyst: A fluid-filled sac within the breast, which can be painful and feel like a lump. Cysts can fluctuate in size and tenderness with your menstrual cycle.

    • Treatment may not be necessary unless the cyst is large or painful, in which case it can be drained by a healthcare provider.
  • Infection (Mastitis or Abscess): Although you don't have fever or redness, an infection can cause pain and lumps in the breast. This is more common in breastfeeding women but can occur in others as well.

    • Treatment typically involves antibiotics and sometimes drainage of an abscess if present.
  • Breast Cancer: While less common in young women, any new, persistent lump in the breast should be evaluated by a healthcare provider to rule out breast cancer.

    • Treatment varies widely depending on the type and stage of cancer but can include surgery, radiation, chemotherapy, and other targeted therapies.

What you can do

  1. Monitor the Lump: Keep an eye on the lump and note any changes in size, shape, or pain.
  2. Apply Ice or Heat: To alleviate pain, you can try applying an ice pack or a warm compress to the affected area.
  3. Over-the-Counter Pain Relievers: Medications like ibuprofen or acetaminophen can help manage the pain.
  4. Wear a Supportive Bra: A well-fitting, supportive bra can help reduce discomfort.
  5. Avoid Lying on the Affected Side: Since lying on your left side worsens the pain, try to avoid this position.

What you should look out for

Seek medical attention if you notice any of the following:

  • The lump continues to grow or becomes more painful.
  • You develop fever, chills, or redness over the lump.
  • You notice any changes in the skin over the lump, such as dimpling or puckering.
  • You experience nipple discharge or retraction.
  • The pain becomes unbearable or significantly interferes with your daily activities.

Important Reminder

While this information can help you understand what might be happening, it is crucial to consult a healthcare provider for a formal diagnosis and appropriate treatment. If you have any concerns or if your symptoms worsen, please seek medical attention promptly.

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People Also Ask


What could cause a lump in the breast after trauma?

A lump in the breast after trauma could be due to a hematoma, which is a collection of blood outside of blood vessels caused by the injury. This can feel like a lump and may be accompanied by pain and swelling.


How can I differentiate between a breast cyst and a more serious condition?

A breast cyst is typically a fluid-filled sac that can fluctuate in size and tenderness, often related to the menstrual cycle. A more serious condition, like breast cancer, may present as a persistent, hard lump that doesn't change with the menstrual cycle. It's important to have any new or persistent lumps evaluated by a healthcare provider.


What are fibrocystic breast changes and how are they treated?

Fibrocystic breast changes are a common condition where the breasts feel lumpy or rope-like, often causing pain and tenderness, especially before menstruation. Treatment usually involves over-the-counter pain relievers, wearing a supportive bra, and applying warm or cold compresses.


When should I be concerned about a breast lump?

You should be concerned about a breast lump if it continues to grow, becomes more painful, is accompanied by fever or redness, causes changes in the skin over the lump, or if you experience nipple discharge or retraction. In such cases, it's important to seek medical attention.


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