[46F] With painful lumps in left breast and armpit

Patient Description

A 46-year-old female presents with a painful lump in her left breast and another in her left armpit, both of which have been present for a couple of weeks and seem to have gotten bigger. The lumps are hard and there is redness over them. The patient denies any injuries to the area and has not noticed any discharge from the nipple. She has experienced chills a couple of times but no fever, unexplained weight loss, or fatigue. There is no swelling or tenderness in the right breast or armpit. The patient has had some night sweats, which she attributes to her age. Her menstrual periods are regular but shorter than they used to be. Family history includes cancer in the maternal grandmother's lymph nodes and lung cancer in an aunt. The patient had a benign lump removed from her breast 16 years ago. Past medical history includes back problems, precancerous cells removed from the cervix, endometriosis surgery, and a tumor removed from the vocal cords. She is allergic to bug bites and bees and is not currently taking any medications.

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Arora's Assessment

What might be happening

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

1. Breast Infection (Mastitis)

  • Rationale: The sudden onset of a painful, hard lump with redness could indicate an infection in the breast tissue, known as mastitis. This is more common in breastfeeding women but can occur in others as well.
  • Typical Treatments: Antibiotics are usually prescribed to treat the infection. Warm compresses and over-the-counter pain relievers can also help alleviate symptoms.

2. Breast Abscess

  • Rationale: If an infection is left untreated, it can lead to an abscess, which is a collection of pus. This could explain the hard, painful lump.
  • Typical Treatments: Treatment often involves antibiotics and drainage of the abscess, either through needle aspiration or surgical drainage.

3. Lymphadenopathy

  • Rationale: The lump in your armpit could be an enlarged lymph node, which can occur due to infections, inflammation, or more serious conditions like cancer.
  • Typical Treatments: Treatment depends on the underlying cause. If it's due to an infection, antibiotics may be prescribed. If cancer is suspected, further diagnostic tests like a biopsy may be needed.

4. Breast Cancer

  • Rationale: Given your family history of cancer and the presence of a hard, painful lump, breast cancer cannot be ruled out. The redness and rapid growth are concerning signs that warrant immediate medical attention.
  • Typical Treatments: Diagnostic tests such as a mammogram, ultrasound, or biopsy are essential to determine if the lump is cancerous. Treatment options vary widely and may include surgery, radiation, chemotherapy, or targeted therapies.

What you can do

Immediate Steps

  1. Seek Medical Attention: Given the severity and rapid progression of your symptoms, it's crucial to see a healthcare provider as soon as possible. They will likely perform diagnostic tests to determine the cause of the lumps.
  2. Monitor Symptoms: Keep a detailed record of any changes in the size, shape, or pain level of the lumps. Note any new symptoms that may arise.

At Home

  1. Pain Management: Over-the-counter pain relievers like ibuprofen or acetaminophen can help manage pain. Follow the dosage instructions carefully.
  2. Warm Compresses: Applying a warm compress to the affected area can help alleviate pain and reduce swelling.
  3. Avoid Irritants: Refrain from using deodorants or lotions that could irritate the skin further.

Using MDandMe

  • Journal Your Symptoms: Use the MDandMe app to track your symptoms, including the size and pain level of the lumps, any redness, and other associated symptoms.
  • Share with Your Provider: The app allows you to share your symptom journal and medical history with your healthcare provider, which can be helpful for diagnosis and treatment planning.

What you should look out for

Given the potential seriousness of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Rapid Growth: If the lumps continue to grow quickly.
  • Increased Pain: If the pain becomes unbearable or significantly worse.
  • Fever: If you develop a fever, which could indicate an infection.
  • Nipple Changes: Any changes in the nipple, such as discharge or inversion.
  • Systemic Symptoms: Unexplained weight loss, severe fatigue, or night sweats.

Remember, while I can provide information and suggestions, it's essential to consult a healthcare professional for a formal diagnosis and appropriate treatment.

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5 mo ago

People Also Ask


What are the possible causes of a painful lump in the breast and armpit?

Possible causes of a painful lump in the breast and armpit include breast infections (mastitis), breast abscesses, lymphadenopathy (enlarged lymph nodes), and breast cancer. Each condition has different implications and requires specific diagnostic tests to determine the exact cause.


How can I differentiate between a breast infection and breast cancer?

Breast infections often present with sudden onset of pain, redness, and warmth, and are more common in breastfeeding women. Breast cancer lumps are typically hard, painless, and may be accompanied by changes in the skin or nipple. However, any new or changing lump should be evaluated by a healthcare provider for an accurate diagnosis.


What should I do if I notice a lump in my breast or armpit?

If you notice a lump in your breast or armpit, it's important to seek medical attention promptly. A healthcare provider can perform necessary diagnostic tests, such as a mammogram, ultrasound, or biopsy, to determine the cause and appropriate treatment.


How does family history affect the risk of breast cancer?

Family history can significantly affect the risk of breast cancer. If close relatives have had breast or related cancers, it may increase your risk. It's important to discuss your family history with your healthcare provider, who may recommend more frequent screenings or genetic testing.


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