Expert: Claes-Gustaf Nordquist, M.D. - 5/4/2007

Question

I have a somewhat large lump in my right upper breast, have gone to doctor and had mammogram and ultrasound done.  Doctor said it is "Probably a cyst".  I went to another doctor for something unrelated, but during the seemingly routine examine he asked if he could check my breast.  I hadn't told him anything about the lump until after he started the breast exam.  He asked about the results and said he Highly recommended me go to a surgeon, and he would refer me.  I asked him why and he said my lymph nodes are swollen.  He showed me they are coming from the lump going towards my armpit.  My shoulder has been hurting (reason I went to the second doctor) and my chest has been sore.  My question is with the breast lump (even though one doctor felt it was a cyst) accompanied by the now swollen lymph nodes a reason for high concern?? what are the possibilities and what might the surgeon do at the appointment?  

Answer
Without being able to check you myself I can only speculate. He is probably afraid either of 1. an infection/iinflammation or 2. a cancer. In my opinion your pain makes an infection/inflammation somewhat more probable. Yes I think it may be a good idea to let a surgeon check it. My personal thoughts are also that if you had such a prominent lump mammography & ultrasound were not enough on their own here. A breast MRI scan would also have been of value AND a needle biopsy (or if not available or unclear a surgical biopsy) was essential to be on the safe side! Those are things that the surgeon will have to consider too, if necessary. Please do keep me posted!