[26F] With persistent breast pain, swelling, and systemic symptoms

What might be happening

Based on the symptoms you’ve described—persistent right breast pain, swelling, and axillary lymph node pain for the past 3 years, along with fatigue, migraines, irregular body temperature, weakness, lack of appetite, lack of sleep, and nausea—here are the most likely explanations:

1. Chronic Inflammatory Breast Condition (e.g., Mastitis or Abscess):

   • Chronic inflammation in the breast tissue can lead to persistent pain, swelling, and tenderness. This could also explain the involvement of the lymph nodes in your armpit, as they often react to inflammation or infection in nearby tissues.
   • Treatment typically involves antibiotics if an infection is present, drainage if there is an abscess, and addressing any underlying causes, such as blocked ducts.

2. Lymphedema or Lymphatic Obstruction:

   • Swelling in the breast and axillary lymph nodes could be due to a blockage in the lymphatic system, leading to fluid buildup. This condition can cause chronic discomfort and worsen with physical activity.
   • Management may include physical therapy, compression garments, and addressing any underlying causes.

3. Hormonal Imbalance (Linked to PCOS):

   • Your history of PCOS and systemic symptoms like fatigue, nausea, and irregular body temperature suggest that hormonal imbalances might be contributing to your breast pain and swelling. Hormones can affect breast tissue, leading to tenderness and enlargement.
   • Hormonal therapy or lifestyle changes may help manage these symptoms.

4. Breast Cancer (Less Likely but Important to Rule Out):

   • Persistent unilateral breast pain, swelling, and lymph node involvement warrant ruling out breast cancer, even though it is less common at your age. This is especially important if there are changes in the skin, nipple discharge, or a lump.
   • Diagnosis involves imaging tests like a mammogram or ultrasound and possibly a biopsy if needed.

What you can do

Here are some steps you can take to manage your symptoms and prepare for further evaluation:

1. Seek Medical Evaluation:

   • It’s important to schedule an appointment with a healthcare provider for a thorough breast exam and imaging studies (e.g., ultrasound or mammogram). Blood tests may also be needed to check for signs of infection, inflammation, or hormonal imbalances.

2. Symptom Management:

   • Apply warm compresses to the affected area, as you’ve found heat to be helpful in relieving discomfort.
   • Wear a supportive, well-fitted bra to minimize movement and reduce pain during physical activity.
   • Avoid activities that exacerbate the pain, and try to rest your right arm when possible.

3. Track Your Symptoms:

   • Use MDandMe to journal your symptoms, including the severity of pain, swelling, and any triggers or patterns you notice. This information can be invaluable for your doctor.
   • Record any changes in the appearance of your breast, such as redness, dimpling, or nipple discharge.

4. Lifestyle Adjustments:

   • Ensure you’re staying hydrated and eating a balanced diet, especially since you’ve reported a lack of appetite and fatigue.
   • Consider relaxation techniques or gentle exercises to manage stress and improve sleep quality.

What you should look out for

It’s important to monitor your symptoms closely and seek urgent medical attention if you notice any of the following:

• A new lump in your breast or armpit.
• Skin changes on the breast, such as redness, dimpling, or an "orange peel" texture.
• Nipple discharge, especially if it is bloody or clear.
• Fever, chills, or other signs of infection.
• Worsening pain or swelling that does not improve with rest or heat.

Your symptoms are concerning enough to warrant further evaluation, so please don’t delay in seeking care. Early diagnosis and treatment can make a significant difference in managing your condition. Let me know if you’d like help preparing for your doctor’s visit or writing a summary of your symptoms!