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Breast Cancer/Breast pain and lumps

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Four weeks ago I noticed intense pain in my left breast, with swelling, heat and a palpable lump.  I have had pain before which has resolved, so I thought I would wait and see if it resolved this time. When it didn't, I went to a doctor at my regular doctor's practice (my doctor was away) and she ckecked both breasts. On ultrasound, a number of lumps were found, including an abnormal axillary lymph node. The right breast ultrasound was normal, but on that day I noticed the beginnings of pain int he right breast too. Based on the ultrasound results, my regular doctor ordered FNA biopsy of the lumps. The biopsy people decided to only biopsy the large hard lump, and the axillary lymph node. Results of the biopsy said: Site 1 (the breast) showed highly cellular sheets suggesting hypercellular stroma within which there are large numbers of spindle cells. There is a background of acute inflammation and histiocytic cells as well as large multinucleated cells resembling either histiocytic cells or osteoclastic-like cells. The appearances may be those of a resolving inflammatory process and the cellular sheets may represent granulation tissue. However, an infarcted or inflamed phyllodes tumour or a spindle cell soft tissue lesion cannot be excluded.
Site 2 ( the lymph node) smears are highly cellular and show a mixed lymphoid population with appearances suggesting a reactive lymph node.  No atypical features are seen. No atypical epithelial cells are identified. The appearances are suggestive of a reactive lymphadenopathy. Flow cytometric analysis of the lymphoid cells demonstrates a mixed population of T and B cells with no light chain restriction and no aberrant antigen expression.

So, given that the pain and heat in the left breast has resolved but the lump is still there, and given the pain and possible lumpiness now in the right breast, is it reasonable to follow my doctor's recommendation that we follow up in about six weeks, allowing time for any inflammation to settle, or should I push for further investigation immediately? If the latter, what should I ask for?

Answer
Based on your information it is most probable that this was an infection/inflammation process. I think your doctor's advice was good and should be followed. Good luck!


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Claes-Gustaf Nordquist, M.D.

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I`m a doctor of medicine and a specialist in radiation therapy and medical oncology. I have long experience in diagnostics and treatment of breast tumours.

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I'm a Doctor of Medicine and specialist in Medical Oncology and Radiation Therapy educated & trained in Sweden. Now retired. Background in Radiation Therapy, Medical Oncology, Radiation Protection, Nuclear Medicine, Diagnostic Radiology, Gynecological Oncology, Clinical Pathology, Clinical Cytology,Hematology and Internal Medicine. M.D. from the faculty of medicine, Royal Karolinska Institute, Stockholm, Sweden. Have also been an exchange student at the Hebrew University, Hadassah Medical School, Jerusalem Israel. Former medical consultant, Swedish National Board of Radiation Protection. Former Police Surgeon and Medical Examiner, Stockholm Police Department. Former Chief Medical Officer, The Royal Guards, The Royal Horse Guards and the Royal Household Brigade, Royal Swedish Army Medical Corps.You can also reach me on: http://www.lifestylerescue.com/expert/health-fitness-advice/dr-claes-gustaf/128 I have no restrictions on the number of questions there.

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