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Thread: Painful lump?

  1. #1
    Join Date
    Aug 2012
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    200

    Default Painful lump?

    A few days ago I noticed a painful lump on the side of my left breast. About 2 weeks ago I had redness in that area that went from quarter-sized to about tennis ball-sized and thought mastitis. I went to the Dr, and having had staph-related mastitis before (because of a persistent cracked nipple), my Dr put me on clindamycin. I took 7 days of meds and by the end of the week the redness was almost gone. Well this week I noticed a small pink area where it was originally. The culture that my Dr did of the bm turned up nothing, no staph, so I thought it was just b/c LO has been nursing less and the breast was engorged. But 2 days ago I noticed that at the site of the redness there is a small lump that is painful. My MIL, who is a nurse, felt it and said it felt like a swollen milk gland, oval in shape.

    I've had plugged ducts before on the other breast, but the whole side of the breast swells painfully hard with milk, and the skin never turns red. This is different; it's just a small area, it's tender but not rock hard like what I've experienced previously. It feels like a small knot of tissue, like the gland itself is just swollen. I don't have a fever or chills or any mastitis symptoms, and the skin is just a bit pink, not bright red. I can nurse off that breast until the whole breast is floppy except for this spot. I'm guessing it's been like this for at least 2 weeks.

    I'm not sure what to do here. I was on a week of antibiotics that apparently didn't solve the whole problem. Could it be an abscess? I'm not sure that it feels big enough to contain fluid that needs to be drained. Can milk glands or ducts just get swollen? What should I do? I'm puzzled by this one, and I'm not sure my OB Dr will know much what to do--I'm thinking she'll just refer me to the ultrasound clinic or the breast-surgeon, which I can do, but it might be awhile before they can see me and it will be expensive (not that I would mind paying to have this go away!). Any thoughts?
    Andie

    born 6/13/2012

    ~First-time Mama~
    and now finished with

  2. #2
    Join Date
    May 2006
    Posts
    19,893

    Default Re: Painful lump?

    There are various options here, including but probably not limited to the following:
    - it's just a plugged duct
    - it's a repeat bout of mastitis (the pinkness of the skin suggests that this is a possibility, despite the recent course of Clindamycin)
    - it's a galactocele (see http://en.wikipedia.org/wiki/Galactocele)
    - it's an abscess
    - it's something like a cyst or (please don't freak out because this is the absolute least likely option) a tumor

    If you are unable to get this to go away soon, I would see a breast specialist. It's probably nothing to worry about. But this is definitely something where you want to be sure. If the specialist suggests biopsy, surgery, or weaning, please check back with us! There are several mamas here who have had suspicious lumps that required biopsies or abscesses that needed surgery, and they have a lot of useful knowledge!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
    Join Date
    Aug 2012
    Posts
    200

    Default Re: Painful lump?

    Mommal, thanks. I've considered all of these. I don't think it's a galactocele because I had one on the other breast last summer and it was much different (bigger, felt more like a fluid-filled sac, was not painful). I did have an ultrasound, and then aspirated, then biopsied just to be sure, and it was nothing bad, though the hole that was left from the biopsy needle leaked milk for 3 weeks. It's different because it's painful, the skin is red, and it just feels different. I'm going to call my Dr tomorrow and see what she wants to do. I hope it's nothing bad--my MIL assured me that she didn't think it was a tumor (cancer) and not to freak about it.

    If it is just a plugged duct that is stubbornly not going away, possibly with mastitis, then what should I do?

    Will also keep post updated with what I find out from the Dr.
    Andie

    born 6/13/2012

    ~First-time Mama~
    and now finished with

  4. #4
    Join Date
    Dec 2008
    Posts
    399

    Default Re: Painful lump?

    If I were your doctor, I would suspect strongly that it was an abscess after mastitis. I would want an ultrasound and to have it aspirated. The redness overlying it would be why I would think this, especially with your recent history of mastitis.
    Ellen

    Mama-surgeon;
    DS Ethan 12/16/2008
    Breast fed/pumped 11 months as a surgical resident, 80 hours a week at work
    DS Abram Daniel 12/20/2012
    Feel like we've gotten a strong start

  5. #5
    Join Date
    Aug 2012
    Posts
    200

    Default Re: Painful lump?

    I talked to my Dr today (her nurse, actually) and she seemed to want me to try heat packs and see if it gets any better. I think this is because when she saw me for the mastitis initially she did a breastmilk culture that did not grow any kind of bacteria, and I also took 7 days of antibiotics. I will try heat for several days, but if there's no change or if it gets worse, I will go see her (and then she will probably refer me to a breast specialist who knows more about it). At this point, based on everything I've read, I'm either thinking plugged duct or abscess.

    As a sidenote, why does it seem like there is no Dr. who is a "breast doctor"? Having had breastfeeding/nipple/mastitis/etc issues over the past year, it seems that no one, in my town anyways, is a specialist in these things. When I have mastitis, I saw an LC and then my OB, and when I had a lump I went to my OB who sent me to the ultrasound clinic where I was treated by a general radiologist (galactocele), then saw a breast surgeon who I think deals more with cancer for the hole left by the biopsy site (who didn't have any advice about cracked nipples). I think there should be a specialization for Drs who just do lactating breasts. How convenient would it be to go to one person for all breastfeeding questions/problems?
    Andie

    born 6/13/2012

    ~First-time Mama~
    and now finished with

  6. #6
    Join Date
    Aug 2012
    Posts
    200

    Default Re: Painful lump?

    Hi, just wanted to give an update about this situation: Over the past 2 days the pain and redness has faded, and I think the lump is shrinking. I went to my (ob) Dr. who was like "I don't know, let's schedule an ultrasound." So I got an ultrasound yesterday. The radiologist said that it looked like a fluid-filled area and that there wasn't even enough fluid to aspirate. She didn't think it was anything bad and said based on the fact that it was larger, red, and painful, but has become significantly less so made her think that my body was healing itself. She didn't want to stick a needle in and make it potentially worse. She scheduled me to come back in 6 weeks to recheck just to make sure everything was better (no infection, etc). So I feel a lot better about it. Really today I can hardly tell there is a small lump--I'm thinking it was/is a blocked duct that turned into an abscess and mastitis, that was healed/helped by the 7 days of antibiotics I took. Thanks for everyone's opinions and support!
    Andie

    born 6/13/2012

    ~First-time Mama~
    and now finished with

  7. #7
    Join Date
    May 2006
    Posts
    19,893

    Default Re: Painful lump?

    So glad to hear that things are looking up!
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

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