[41F] With well-circumscribed breast masses and variable heart rate

What might be happening

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

• Fibrocystic Breast Changes: Given your history of fibrocystic breasts, the small, well-circumscribed masses could be related to this condition. Fibrocystic breast changes are a common, benign (noncancerous) condition in which the breasts feel lumpy. These changes can often fluctuate with the menstrual cycle.

  • Treatment typically involves managing symptoms. Over-the-counter pain relievers and supportive bras can help with breast discomfort.

• Breast Cysts: These are fluid-filled sacs within the breast, which are usually noncancerous. They can appear as well-circumscribed masses on a mammogram.

  • Treatment may involve monitoring the cysts, using a fine needle to drain the fluid and collapse the cyst, or using medication to regulate your menstrual cycle if the cysts are related to hormonal fluctuations.

• Breast Cancer: While less likely given the well-circumscribed nature of the masses and your age, it is important to rule out breast cancer.

  • Treatment would depend on the type and stage of the cancer but may include surgery, radiation, chemotherapy, or hormone therapy.

Regarding your symptoms of fatigue, low blood pressure, and episodes of both fast and slow heart rate (tachycardia and bradycardia), these could be related to a number of conditions, including heart disease, certain types of infections, or hormonal imbalances such as thyroid disorders.

What you can do

Given the complexity of your symptoms, it is important to seek medical attention. Here are some steps you can take:

1. Schedule a follow-up appointment with your healthcare provider to discuss your mammogram results in more detail. They may recommend further tests such as an ultrasound or biopsy to better understand the nature of the masses.
2. Monitor your breasts for any changes such as new lumps, changes in the size or shape of your breasts, nipple discharge, or changes in the skin over your breasts.
3. Discuss your symptoms of fatigue, low blood pressure, and changes in heart rate with your healthcare provider. They may recommend further tests to investigate these symptoms.

What you should look out for

Please seek immediate medical attention if you experience:

• A new lump in your breast that does not go away after your menstrual cycle
• Redness, swelling, or warmth in your breast
• Dimpling or puckering of the skin over your breast
• An inverted nipple
• Nipple discharge that is not breast milk
• Chest pain, shortness of breath, or severe fatigue

Remember, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examination, testing, and care recommendations.