[36F] With sharp pain and swelling under right breast

Patient Description

A 36-year-old female reports experiencing sharp pain under her right breast for the past two weeks. The pain is rated as a 10 out of 10 when coughing or moving her arm or chest, and a 5 out of 10 at rest. The pain is exacerbated by all movements and activities. The patient denies any injuries or accidents, but notes that the pain began suddenly, initially affecting her shoulder, then her neck, and now her chest and underarm. There is noticeable swelling, with the right breast appearing larger and the underlying bone feeling larger compared to the other side. Breathing is painful but not difficult. The patient works as a Certified Nursing Assistant (CNA) and frequently lifts heavy objects, which may contribute to her symptoms. No other symptoms are reported.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Costochondritis: This is an inflammation of the cartilage that connects a rib to the breastbone. It can cause sharp pain in the chest area, especially when moving or breathing deeply. It is often caused by physical strain or repetitive activities, which could be related to your work as a CNA or driving a car that is hard to turn.

    • Treatment typically involves rest, avoiding activities that worsen the pain, and taking over-the-counter pain relievers like ibuprofen or acetaminophen.
  2. Muscle Strain: Given your occupation and the physical demands it involves, it's possible that you have strained the muscles in your chest or shoulder area. This can cause sharp pain and swelling.

    • Treatment usually includes rest, ice application to reduce swelling, and pain relief medications. Gentle stretching and strengthening exercises may also help once the acute pain subsides.
  3. Rib Fracture or Injury: Although less likely without a specific injury, a rib fracture or bruise could cause sharp pain and swelling. This could occur from repetitive strain or an unnoticed minor trauma.

    • Treatment involves rest, pain management, and avoiding activities that exacerbate the pain. In some cases, a doctor may recommend imaging tests to confirm the diagnosis.

What you can do

  1. Rest and Avoid Strain: Try to rest the affected area as much as possible and avoid activities that worsen the pain, such as heavy lifting or strenuous movements.

  2. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage the pain and reduce inflammation.

  3. Apply Ice: Applying ice packs to the swollen area for 15-20 minutes several times a day can help reduce swelling and alleviate pain.

  4. Monitor Symptoms: Use MDandMe to journal your symptoms, track your progress, and note any changes. This information can be valuable for your healthcare provider.

What you should look out for

  • Seek Medical Attention: If the pain worsens, you experience difficulty breathing, or notice any new symptoms such as fever or redness, it's important to seek medical attention promptly.
  • Persistent or Severe Pain: If the pain does not improve with rest and over-the-counter medications, or if it significantly impacts your daily activities, consult a healthcare professional for further evaluation.

Remember, while these suggestions can help manage your symptoms, it's important to consult a healthcare provider for a formal diagnosis and appropriate treatment.

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3 mo ago

People Also Ask


What is costochondritis and how is it treated?

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone, causing sharp chest pain, especially with movement or deep breathing. Treatment typically involves rest, avoiding activities that worsen the pain, and taking over-the-counter pain relievers like ibuprofen or acetaminophen.


Can muscle strain cause swelling and sharp pain in the chest area?

Yes, muscle strain can cause swelling and sharp pain in the chest area, especially if the muscles in the chest or shoulder are overused or strained due to physical activities. Treatment usually includes rest, ice application to reduce swelling, and pain relief medications.


Is it possible to have a rib fracture without a noticeable injury?

Yes, it is possible to have a rib fracture or bruise without a noticeable injury, especially if it results from repetitive strain or minor trauma that went unnoticed. Treatment involves rest, pain management, and avoiding activities that exacerbate the pain.


What should I do if my chest pain worsens or I experience difficulty breathing?

If your chest pain worsens or you experience difficulty breathing, it is important to seek medical attention promptly. Persistent or severe pain that does not improve with rest and over-the-counter medications should also be evaluated by a healthcare professional.


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