Expert: Claes-Gustaf Nordquist, M.D. - 8/14/2009

Question
I noticed a lump in my right breast last week(im 26, by the way), mostly because I had breast tenderness (it was a week before my period). My ob/gyn has told me in the past I have lumpy breasts due to my caffeine intake. However, I am scared. Today is the first day of my period, and the lump is still painful. I can just be sitting down on the couch and feel the throbbing. I have felt it many times...it moves, and is pretty soft. I think it's sore cause I keep pressing on it! I do have a doctor's appointment Monday with my primary care doctor, but I am going to try to see my ob/gyn tomorrow. I should mention that I had a skin biopsy on my breast over about two months ago for a skin cancer check. The area was suspicious but everything turned out fine. The doc dug pretty deep...and the lump is right under the scar. Could it be scar tissue?? It opened up after the sutures were removed and it healed open, so its a round scar. Sorry this is long winded...im freaked out!

Answer
Lumpy breasts are a common problem in young females (and it has not much to do with caffeine by the way). It is a hormone dependent phenomenon. That is why the lumpiness, soreness, tenderness & pain all increase around the time of your periods (sometimes also when your ovaries release eggs). It is called a fibrocystic breast condition. It is so common that I do not want to call it an illness. I doubt very much that you were cut so deeply for a skin biopsy that you can have scar tissue inside your breast even if there is a scar in your skin. So I believe this to be a sign of a fibrocystic condition. To verify that I suggest that you let a dr. check your breasts INCLUDING both mammography & ultrasound breast scans AND an ultrasound guided needle biopsy of your lesion. That way you will KNOW what it is and you will most probably not need to worry any more! Pain, soreness & tenderness are NOT usual symptoms of early breast cancer but they certainly are for cysts, fibroadenomas & fibrocystic conditions, all harmless! Good luck!