Expert: Claes-Gustaf Nordquist, M.D. - 7/5/2008

Question
QUESTION: Hello.. today when I was doing my self breast examination at home I discovered that my left nipple is more elongated than the left one. It just stands out more and when erected does not goes back for a while. No discharge, skin discoloration or orangle like, but I have had an itchness in this nipple for years and years. It comes and goes. But I do not remember ever seeing it so pointed out. Also my left breast appears a bit fuller than the other one but just a bit and it can be that it always has been so but I am not sure anymore.. even if I examine myself once a month, now I am too distressed and I do not remember. Also, I felt for lumps or masses and only when I lean forward I can feel a mass in my left breast. The mass is sligltly painful and moves but is quite big like 2cm. I would say it is more like a rope that can be felt between my thumb and forefinger and which moves at the back but is more attached at the front. I am sorry if this is confusing. At the age of 21 I was diagnozied with benign breast cyst, very painful at that time, but which over time become less painful and smaller. I still have it and hurts before my periods and I think maybe it is a connection between the cyst and the 'rope' that I now feel. Are there differencies between breasts, like what is inside ? And asymetrical breasts, can they happen ? Can this appear at a later stage in life (I am 31 now).
Please tell me if an elongated nipple can hide cancer beneath it and if a plumper breast is a sign of danger ? It is just a tiny bit rounder, not too much I think. Also, is that mass that I feel dangerous ? Thank you so much, I am quite desperate, your answer will be aprreciated.

ANSWER: Asymetrical breasts are rather common. An elongated nipple is not anything that I would ordinarily consider a cancer sign. However you feel a mass. That should be investigated. Mammography and a needle biopsy of the mass should be able to secure a diagnosis! Good luck!


---------- FOLLOW-UP ----------

QUESTION: You have just sent me an e-mail, much appreciated. I will book an appointment with my OB this week, but in the meantime, should I be worried about inflammatory BC ? Because my left breast is slightly bigger than the other one, can this happen and it is not cancer ? I think it happened gradually not just from yesterday to today. Also the mass that I feel is sort of symetrical in both breasts, just that in the left one it is tenderer and moves slightly like a rope. The other breast is the same as always. Can it be that is not cancer ?
Sorry if I asked too many questions in a go, I am a week pregnant I want to see my baby and if costly procedures can save me from whatever I have, I won't hesitate.I'm just very afraid.

Answer
Aha, you are pregnant, congratulations! However that eliminates the possibility of mammography. But needle biopsies (by touch or by ultrasound guidance) are like ultrasound scans still possible. Without an examination I can not with any certainty confirm or exclude any possibility of an inflammatory breast cancer. That must be checked by your dr. But such tumors are rather rare. In your case too your breasts will undergo normal changes due to your pregnancy that MAY cause these findings.