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Breast pain, lump under chin, itching area at hair line, sweating, buttock pain, sleepiness. Your thoughts?

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Practicing since : 2004
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If a new female 60 yr old (post menopausal for 6 or 7 years) patient were to come to you with the following symptoms, what would be your first thought as to a diagnosis without doing any lab tests: pain in side of left breast (for sure not breast cancer) for 3 yrs, small lump left side throat just under chin (prominent when that area itches) - just discovered, area on back of right side of head at hair line that is sore, raised and itches on occasion (not sure it is a lump yet), dull pain left side under ribs (9 years), trouble breathing as if my throat is closing up, exterior muscles of jaw and next feel "tight", my whole head (and hands at times) itch(es) at various times during the day, sweating all day off and on, sweating at night especially back of neck (for over one year), pain in butt area, both sides (for over a year), where you sit (like sitting on two rocks), pain in a small specific genital area above the vagina (like a cramp - has been there for 4 years), AND Last of all - excess sleepiness - several hours after I wake I take a 3 hr nap every day (for almost 2 yrs) - it is not sleep apnea).
I have been diagnosed with two diseases, lupus neuphritis (17 years) and Sjogren's (30 yrs) and have many doctors. But I believe they are so focused on the specific areas they treat, that when I mention other symptoms I'm dismissed. AND I DO NOT WANT TO OVER REACT EITHER. Would just appreciate your first thoughts on what these symptoms might mean and what to do next. Thank you.
Posted Sat, 10 Aug 2013 in Cancer
Answered by Dr. Indranil Ghosh 12 hours later
Thanks for your query.
Some of your symptoms may be due to lupus, like itching, sore over hairline, sweating, etc as lupus involves not only the kidneys but also skin, blood vessels, joints, etc.
Some symptoms do not seem to be of concern, like breast pain without any lump, pain in genital area for 4 years, dull pain under rib for 9 years. For these nothing else needs to be done.
The trouble breathing as if throat is closing up may be due to dryness of mouth caused by Sjogren.
For excessive sleepiness, if sleep apnea has been ruled out, then you may need to exclude low hemoglobin, low sodium, potassium, etc. If no cause is found then we may end up attributing it to lupus.

Overall, I don't see any symptom of immediate concern. Your doctors also probably felt the same and hence 'dismissed' your complaints.

Hope I have answered your query. I will be available to answer further follow-up queries, if any.
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