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What Causes A Lump On The Breast?
Question: My just turned 11 year old daughter had a breast ultrasound for a lump felt beneath her left nipple (just on outer edge or areola). She has had discharge from this nipple for about 2-3 weeks. I see it on her bras..it appears army green or brown in colour, sometimes lighter like the colour of spilled coffee). I felt the lump about 2-3 weeks ago as well. The radiologist said their was a "complex cystic structure " with recommendation to repeat ultrasound in about 6 weeks. Her pediatrician is also sending her to a general surgeon. I must note that she had the same discharge about 1 year ago that was dismissed by physician and since it went away after a few months I did not pursue. She has already started menstrusing (9 years 9 months) and is quite developed (tanner 4 ?). I am VERY worried. My family history of breast cancer is not strong. My maternal grandmother had breast cancer in her 60's. But my sister (her aunt) had ovarian cancer at 54 years old). Any insight would be apprecated.
Brief Answer:
No need to be worried
Detailed Answer:
Hi and welcome to HealthcareMagic.
First, if you are afraid of some serious diagnoses such as malignant tumors, then you should not be. Such diagnoses in this age are almost never seen even if there were close relatives with breast cancer.
Second, on the other hand, cysts are common in girls at the start of puberty due to imbalanced hormonal secretion and breast growth especially if she is XXXXXXX 4 already. Few years may pass till hormones stabilize and during this time she may experience nipple discharge or lumps due to cysts, fibroids or abscesses.
A complex cystic structure is indicating a cyst with multiple walls which may sound like a problem but in this age, I don't think that it would raise suspicion of malignancy, so I would not force invasive procedures such as surgical or needle biopsy. There is no need to hurry with any other tests as well.
Ultrasound can be repeated and if there is any suspicious change or rapid cyst growth then you can do an MRI scan which will be more accurate and rule out anything serious. But as I said, at this point, only observation and follow-up ultrasound is required.
If breast redness, fever, and pus discharge occur then it may indicate breast abscess and surgical consultation is necessary in this case.
I hope I have answered your query.
Feel free to ask any further questions.
Wish you good health.
No need to be worried
Detailed Answer:
Hi and welcome to HealthcareMagic.
First, if you are afraid of some serious diagnoses such as malignant tumors, then you should not be. Such diagnoses in this age are almost never seen even if there were close relatives with breast cancer.
Second, on the other hand, cysts are common in girls at the start of puberty due to imbalanced hormonal secretion and breast growth especially if she is XXXXXXX 4 already. Few years may pass till hormones stabilize and during this time she may experience nipple discharge or lumps due to cysts, fibroids or abscesses.
A complex cystic structure is indicating a cyst with multiple walls which may sound like a problem but in this age, I don't think that it would raise suspicion of malignancy, so I would not force invasive procedures such as surgical or needle biopsy. There is no need to hurry with any other tests as well.
Ultrasound can be repeated and if there is any suspicious change or rapid cyst growth then you can do an MRI scan which will be more accurate and rule out anything serious. But as I said, at this point, only observation and follow-up ultrasound is required.
If breast redness, fever, and pus discharge occur then it may indicate breast abscess and surgical consultation is necessary in this case.
I hope I have answered your query.
Feel free to ask any further questions.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you for your reply. Just now I checked her breast and the lump is MUCH bigger ( maybe triple in size ) and she complains that it is very painful when touched. ( her period is due to start today ). She had no fever and their is no change in the outward appearance of the breast. I have an appointment with her pediatrician tomorrow. Can this sudden change wait till then or should I take her to emergency ?
Brief Answer:
you can wait
Detailed Answer:
Hi again.
Well, then this is most likely clogged cystic gland and its size may vary in different phases of the cycle.
You can wait till tomorrow, nothing serious should happen. You can give her some painkillers for pain and just reassure her. It should be fine.
Wish you good health. Regards
you can wait
Detailed Answer:
Hi again.
Well, then this is most likely clogged cystic gland and its size may vary in different phases of the cycle.
You can wait till tomorrow, nothing serious should happen. You can give her some painkillers for pain and just reassure her. It should be fine.
Wish you good health. Regards
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Final question i hope. I took her to the pediatrician today. She believes that an infection has set in and gave her a 10 day course of cephalexin. The radiologist report specifically said ...." oval shaped hypoechoic cyst up to 1.6 cm sized slightly thickened septations are identified. No vascularity is noted.There does appear to be some small calcifications identified within the cyst. Findings could be related to a long-standing cyst in this location. Early infectious collection or hematoma would be unlikely".... Any additional insight ? She had no signs of infection (pain tenderness) at time of ultrasoud.. exactly 1 week ago.. and today I can barely touch her. I did palpate her and try and squeeze out some discharge on the 30th of April..(only 1 tiny drop came out). Could I have made it worse ?
Brief Answer:
no
Detailed Answer:
Hi again.
No, you cant make it worse,but there may be an inflammatory component which is common in these cysts. When there is discharge it means that cyst empties out. If there is less discharge then it may mean that it got clogged and then infection and pain may develop. Antibiotic course should work, but it is also possible that abscess or inflamed hematoma forms and then surgical incision and drainage may be necessary but this can be done under local anasthesia.
Wish you good health. Regards
no
Detailed Answer:
Hi again.
No, you cant make it worse,but there may be an inflammatory component which is common in these cysts. When there is discharge it means that cyst empties out. If there is less discharge then it may mean that it got clogged and then infection and pain may develop. Antibiotic course should work, but it is also possible that abscess or inflamed hematoma forms and then surgical incision and drainage may be necessary but this can be done under local anasthesia.
Wish you good health. Regards
Note: For further inquiries on surgery procedure and its risks or complications book an appointment now
Above answer was peer-reviewed by :
Dr. Raju A.T
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