On 06/05/2012 06:44, Peggy Anderson wrote:
> Please help.  I have permission to post.  She is a primip mom who has been exclusively breastfeeding her baby for the past 6 months.  She has been back to work for at least 2 months.  She is a RN and pumps at least twice during her 12 hour shifts.  About 1 month ago she noticed a hard lump, about 1 inch in diameter that extends from her upper outer left breast all the way to her nipple.  When palpated it can be lifted but remains quite hard.  She has no fever, pain, redness, or discharge and the mass is unchanged with breastfeeding or pumping.  She does state that it feels "a little achy" and she seems to notice it more on days she is working and pumping.  She has been pointing baby's nose in the direction of the lump during breastfeeding sessions but without any change.  This seems ductal to me with it extending all the way to her nipple.  I referred her to see her OB doc first and if she would like to try warm compresses and/or cool compresses to see if she has any resolve.  She has been massaging the area but no change.  Any ideas would be very appreciated.
>
Urgent appointment with breast surgeon.  This needs biopsying to exclude 
a malignant cause.  Unlikely at that age, so she shouldn't panic, but 
absolutely NOT impossible.  If I saw this situation in a patient I would 
have a referral to the specialist breast clinic completed and sent off 
before the day was out.


Best wishes,

Dr Sarah Vaughan
MBChB MRCGP

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