Expert: Claes-Gustaf Nordquist, M.D. - 11/26/2007

Question
I noticed a lump in my right breast back in May 2007. I've had numerous cysts before and had a fibroadenoma removed (benign) back in 2002 and all remaining mammos/us were ok. This lump didn't feel like a "normal" cyst, was not painful when I palpated it and seemed to be attached instead of free-moving like the other cysts I've had. My last mammo was in Feb 2006, and while I was scheduled for one in Feb 2007, work prevented me from doing it. After discovering the lump, I immed made an appt, but the only appt they had was almost 2 mos later and between that time, I lost my job (and insurance) and had to cancel that appt as well.  Since May, it feels like the lump has grown some and I have continuous shooting, burning pain in the 11 o'clock region of my right breast, the lump located at about 12 0'clock but a little closer to the nipple area.  Just recently, I've begun feeling a burning pain in my nipple area as well.  My right breast has also increased in size so it is approx one size larger than my left breast.  While it has always been bigger, it is now really noticeable.
My personal stats:  45 yr old, tubal ligation in 1999, cancer abundant on my mother's side with aunts, great aunts dying from breast cancer, grandmother dying from stomach cancer, uncles from throat, stomach, intestinal cancers. Mother has had a small patch of cancer detected on her tongue which was removed and no relapse. Father passed a year ago from renal failure as did his mother and father before him.  
I'm on track to be added to my new job's ins on Dec 17th.  I was trying to wait until then to help me pay for costs associated with the mammo/us, but the wait has been nerve-wracking.  This is prob a dumb question, but do you think I should wait for 3 more weeks or is this something where I should look into a low-cost clinic or hospital right now?

Answer
Dear Kat, I'm a Swede living in Sweden and American health insurance policies are a mystery to me! From a purely medical point of view I could argue that you have already waited for such a long time that 3 more weeks probably do not matter. Breast cancer is not usually associated with pain and tenderness. And furthermore a "cheap clinic" - whatever that may be - by being "cheap" probably does not have the resources needed for a full investigation of your case (but I'm prepared to admit that I may be wrong here due to ignorance of what such a clinic is apart from being cheap). On the other hand you have a family history of breast cancer and you are in a risk age. So this is a difficult decision! But if a "cheap" clinic does not do thorough investigations it is probably better to wait, but do it then ASAP! Good luck!