[35F] With breast pain, warmth, bruising, and visible veins

Patient Description

A 35-year-old female has been experiencing breast pain for a little over a month, which is worsening. The pain appeared suddenly and is not exacerbated by any specific activities. There is no history of chest or breast injuries. Additional symptoms include weird bruising, visible veins, and warmth in the breast area. The patient has noticed changes in the right nipple, which randomly flattens and appears misshapen. An abnormal mammogram identified a lump in the medial posterior upper quadrant, described as an intramammary node requiring close observation. The patient has not observed changes in the size or shape of the lump. The unusual bruises appeared this week, are yellow, and do not hurt. The patient occasionally experiences fever, fatigue, and night sweats (noting a complete hysterectomy 13 years ago). There is a significant family history of breast cancer. The patient does not have pre-existing conditions or chronic illnesses and is only taking ibuprofen (400mg every 4 hours). No other medications, supplements, or topical treatments are used, and there are no medication allergies.

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Arora's Assessment

What might be happening

Based on the information you’ve provided, there are several potential explanations for your symptoms. Here are the most serious ones that need immediate attention:

  1. Inflammatory Breast Cancer (IBC): This is a rare but aggressive form of breast cancer that can cause symptoms like breast pain, warmth, visible veins, and unusual bruising. The sudden onset of symptoms and the abnormal mammogram findings are concerning. IBC often presents with redness, swelling, and a feeling of heaviness in the breast. Immediate medical evaluation is crucial.

  2. Breast Infection (Mastitis or Abscess): Although more common in breastfeeding women, breast infections can occur in others as well. Symptoms can include pain, warmth, redness, and sometimes fever. If left untreated, an infection can lead to an abscess, which is a collection of pus that needs to be drained.

  3. Thrombophlebitis of the Breast (Mondor’s Disease): This is a rare condition involving inflammation of the veins in the breast, which can cause pain, visible veins, and sometimes bruising. It is usually not life-threatening but requires medical evaluation to rule out other serious conditions.

  4. Breast Trauma or Hematoma: Even if you don’t recall an injury, minor trauma can sometimes cause bruising and pain. A hematoma is a collection of blood outside of blood vessels, which can cause visible bruising and swelling.

What you can do

Given the severity and potential seriousness of your symptoms, it is crucial to seek immediate medical attention. Here are the steps you should take:

  1. Visit the Emergency Room: Due to the combination of symptoms and your family history of breast cancer, it is important to get evaluated as soon as possible. Go to the nearest emergency room or urgent care center.

  2. Call Your Doctor: If you have a primary care physician or a specialist, call their office to inform them of your symptoms and the abnormal mammogram. They may be able to expedite further testing or refer you to a breast specialist.

  3. Monitor Symptoms: Keep track of any changes in your symptoms, such as increased pain, swelling, or new bruising. Note any new symptoms like shortness of breath, chest pain, or severe headaches, and report these to a healthcare provider immediately.

  4. Avoid Self-Medication: While ibuprofen can help with pain, it’s important not to rely solely on over-the-counter medications. They can mask symptoms that need medical evaluation.

  5. Seek Support: If possible, have a family member or friend accompany you to medical appointments for support and to help you remember important information.

Remember, I am not a doctor, and this information is not a substitute for professional medical advice. Please seek care from real health professionals to receive a formal diagnosis and appropriate treatment. If you feel that your symptoms are worsening or you are in immediate danger, call 911 or have someone take you to the hospital right away.

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2 mo ago


People Also Ask


What are the common symptoms of Inflammatory Breast Cancer (IBC)?

Common symptoms of Inflammatory Breast Cancer (IBC) include sudden breast pain, warmth, redness, swelling, visible veins, and changes in the nipple such as flattening or inversion. It is a rare but aggressive form of breast cancer that requires immediate medical attention.


Can breast infections occur in women who are not breastfeeding?

Yes, breast infections can occur in women who are not breastfeeding. Symptoms may include breast pain, warmth, redness, and sometimes fever. It is important to seek medical evaluation to rule out other conditions and to receive appropriate treatment.


What is Mondor’s Disease and how is it treated?

Mondor’s Disease is a rare condition involving inflammation of the veins in the breast, leading to pain and visible veins. It is usually not life-threatening and may resolve on its own, but medical evaluation is necessary to rule out more serious conditions. Treatment may include pain relief and anti-inflammatory medications.


What should I do if I notice unusual bruising on my breast?

If you notice unusual bruising on your breast, especially if it is accompanied by other symptoms like pain, warmth, or changes in the breast or nipple, it is important to seek medical evaluation. This could be a sign of a serious condition such as Inflammatory Breast Cancer or a breast infection.


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