What might cause pain in only one breast? Scared of "IBC" - help!
October 5, 2013 12:36 PM   Subscribe

When I google the fact that I have pain in one of my breasts, I get two things. a) Mastitis, a breast infection associated with breastfeeding, or b) inflammatory breast cancer, a rare and aggressive form of breast cancer that is unusual in that it presents with no lump and pain is a symptom. I don't have the visual characteristics of these -- both those conditions have the same symptoms -- but I can't find any other reasons for my pain online. I've never been pregnant, which would implicate mastitis and now I am worried have cancer. What would cause you to feel like you are PMSing in one breast with it's not time for PMS?

I am not looking for a diagnosis. I have seeing a doctor in three days. But I want to stop freaking out and/or have an idea of how pushy I should be when I get to the doctor for additional testing. I am simply wondering what other possibilities there are since mastitis seems very unlikely, and inflammatory breast cancer seems unlikely, but also a super scary possibility. There has to be other explanations, right?

My symptoms: For the past week, my right breast has been tender and sore to the touch -- similar to how both my breasts feel when PMSing. I shouldn't have PMS for another two weeks though and I always PMS in both breasts. My right breast feels a bit fuller and firmer than my left one. It also feels warmer than my left one. I also did a self breast exam and both my breasts feel a bit lumpy, though my right one perhaps a little more so. I have never done a self exam so I'm not familiar with how my breasts should feel. No redness, dimpling, nipple changes, rapid size increase or obvious physical symptoms that indicate it would definitely be either mastitis or inflammatory breast cancer. I also do not have a fever, which seems to be present with mastitis. Overall, it feels like my right breast is PMSing bad.

Here is my question: can a 29-year-old woman who has never been pregnant get mastitis or other benign breast conditions? If so, what other breast conditions COULD cause this? To be honest, I am freaking out and incredibly scared. I didn't sleep at all last night. I've never breastfed, so why would I get something associated with nursing? Is there another possible explanation for these symptoms? It feels like my breast pain is getting worse as time passes. It's been 5 days of this pain. I am seeing a nurse practitioner at my ob/gyn for a clinical breast exam in three days, and that feels too far away. I keep doing all this research online, but it doesn't make any sense that I'd have mastitis. I don't see any other possibilities. And I know inflammatory breast cancer is rare, but I'm really scared.

What else could this be? And do you have any advice for what to do when I see the nurse practitioner to ensure this is investigated fully quickly? If any women out there have experience anything like this and can share their situation, that'd be great. Thanks so much.
posted by AppleTurnover to Health & Fitness (32 answers total) 2 users marked this as a favorite
From WebMD:

There are two different types of mastitis that affect women who are not breastfeeding. These are:

—periductal mastitis, which usually affects women who are in their late 20s and early 30s, and is more common among smokers
—duct ectasia, which tends to affect women in the years before the menopause (when a woman's periods stop), or after the menopause

Both types of mastitis are usually caused by an infection.

The symptoms of mastitis in women who are not breastfeeding include:

redness of the breast
pain in the breast
hard parts (lumps) in the breast
nipple discharge - which may be white or may contain streaks of blood
posted by ocherdraco at 12:46 PM on October 5, 2013

Ask you doctor if you have fibrocystic breasts.

Such as:

If you have fibrocystic breast disease you may experience swelling, tenderness, pain, a thickening of tissue, or lumps in one or both breasts. You may have more swelling or lumps in one breast than the other. Your symptoms probably get worse right before your period due to hormonal changes, but you may have symptoms all month.

Seems to me they used to tell women to cut down on caffeine to alleviate symptoms.
posted by Marie Mon Dieu at 12:49 PM on October 5, 2013 [3 favorites]

That type of pain was one of the indicators that I had a benign thyroid tumor. There are probably 100s of other things that it could be that you've never heard of because people don't bring up boobie problems in everyday conversations.

You are doing everything correctly. You're going to the doctor and you'll get this sorted.
posted by 26.2 at 12:52 PM on October 5, 2013

I know someone who had a mysterious infected cyst appear in her boob. It required antibiotics and eventually surgery. If your breast is warmer then that is an indication of infection. It's time to see a doctor ASAP.
posted by bq at 12:52 PM on October 5, 2013

You could certainly have a cyst - this would affect only one breast and could be painful. You could also have something going on with a lymph node. You could have some kind of infection or irritation of a duct. If you don't regularly do self-exams, you're not going to be able to distinguish your normal breast tissue from any irregularity.

Most of the time it is not cancer.

It's good that you're seeing a doctor - push for something that will rule out IBC, purely for your own peace of mind. Make sure your doctor is familiar with IBC symptoms - not all are. It is very unlikely that you have IBC, though - remember that you are still young for it although it can strike young women and you have no definitive symptom. IBC online material is really scary - rightly so, because so many people ignore real, scary symptoms out of ignorance - but it does give an exaggerated picture.

There are many minor, benign conditions that cause some of the same symptoms as IBC, but they don't get very much coverage even on the internet because they are so minor, rare and benign. Who researches something like "infrequent conditions that cause discomfort but are not actually that serious"?

For years I had a minor infection in one nipple that caused itching, minor discharge and intermittent pain. I was convinced I had IBC at first. The doctors pretty much brushed me off because (honestly) I was too scared to describe the actual symptoms clearly. It finally resolved (hooray!) but it was only on one side and started when I was ~32.
posted by Frowner at 12:54 PM on October 5, 2013

I say ignore the internet and wait until your doctor's appointment. You will drive yourself nuts. Speaking from experience.
posted by thorny at 1:04 PM on October 5, 2013 [9 favorites]

When you see the NP, ask her if she has ever seen a case of IBC. Tell her that you know it is rare but that because you also know that asymmetrical pain is concerning, you would like to rule it out. (Ruling it totally out is, as you know, difficult absent a skin punch, but I believe an ultrasound is helpful to look for thickening of tissue.)

Also, your NP has done a LOT of breast exams. That's the almost the most useful thing about seeing her - something that seems wildly abnormal to you may not be uncommon in her experience. And she has actual physical experience with how normal and abnormal breast tissue feels, so she'll be very well able to tell whether your breast really is lumpier/firmer than the other, or whether this is just your perception. Most women's breasts are slightly/a lot asymmetrical in size, too, and this can affect firmness - something you don't realize until you are freaking out.

Ask your NP in detail - does one breast feel firmer than the other? What could be causing diffuse pain? Can she feel a cyst? (She may actually be able to feel something that is obviously a cyst to her.)

Also if you have a cyst and you're handling it (especially if you're like me and tend to get anxious and be all "ten million self-exams!" about it) you will make it sorer. I speak from experience.

It was in my mid-late twenties that I started to realize how many ills the flesh is heir to - you stop growing/maturing around 25 and little stuff starts to go wrong. The first couple of years of that were a real adjustment for me - I had a lot of trouble distinguishing between things that were just uncomfortable and frustrating but pretty minor and things that needed treatment, and I scared myself a lot more than I should have.
posted by Frowner at 1:04 PM on October 5, 2013 [7 favorites]

can a 29-year-old woman who has never been pregnant get mastitis or other benign breast conditions?

Sure. I have this problem on an ongoing basis and I get it checked out regularly. This is what the deal is with me.

- I have lumpy breasts and a small pituitary tumor (which is no big deal, I know it sounds scary but it's not) which causes some breast discharge/lactation. Sometimes at different times of the month this can cause soreness. If you are on hormonal birth control this could also affect your breasts similarly.
- I am right handed and I mouse with my right arm. Sometimes when I am working a lot or doing a lot of fiddly mouse work I can get pain in my pectoral muscle which feels a lot like breast problems but is not.

My sister has similar problems (the lumpy breast thing is genetic) and for her she has had the occasional small benign cyst. I also sometimes think that if I wear my messenger bag over my shoulder for too long it pinches something in my shoulder which can make my breast area sore.

Frowner is right: most of the time it is not cancer. However that doesn't make it less scary. Wait until you can talk to a doctor, stay off the internet Googling IBC (I have been there, don't do it) and take some Advil or other pain reliever and work on your stress until you can see the doc. If the pain is so bad you can't sleep, take yourself to the emergency room.
posted by jessamyn at 1:06 PM on October 5, 2013 [1 favorite]

Even when it's a tumor, it is often not cancer. I had been feeling pain and tenderness in only my left breast for a few weeks when I finally found a small lump. I went to an urgent care clinic (I had just moved to a new city) and they set me up with an ultrasound that confirmed the lump was solid and therefore needed to be biopsied. The biopsy was a VERY simple procedure -- a topical anesthetic was injected in the area, then a small needle was inserted, guided by ultrasound, so the doctor could biopsy the lump. A week later I found out the lump was a benign tumor and I didn't have to do anything about it.

Over the course of the next year the tenderness in the left breast came and went but seemed to be getting more severe over time, and it was more often "on" than "off". My doctor said the tumor, though still benign, was probably slowly growing, and it would be best to remove it now and have it be over with. I showed up to the hospital early in the morning, I was sedated (no general anesthesia), a very small incision was made, and the entire tumor was removed. It was confirmed to be benign. The area was tender for a few days and I had to wear a bra 24/7 for about a week, I think. It's been a few years and the scar is now so invisible that my new gynecologist said, "It says on your chart that you had breast surgery but I can't tell which side it was on."

I spent so much time during the ~12 months that this was going on absolutely terrified that I had breast cancer, laying awake at night holding my tender boob and thinking I was going to die. Knowing is always better than assuming the worst. You're going to be fine!
posted by telegraph at 1:18 PM on October 5, 2013

Other things it could be:

- your period is going to be early, surprise!
- while sleeping, you pulled a muscle in an awkward place that is aggravated daily by your usual movements
- you are coming down with a cold and one of your lymph nodes is sensitive

Make sure your doctor shows you how to do a self-exam and try to do one every month. Ask your doctor to explain how the normal hormonal differences in everyone's body over the month can make things feel different during a self-exam depending on when in your cycle you do one.

It is almost never cancer. Literally every single time I have googled a series of symptoms I have always been told I might have a cancer. Thus far google has been wrong every time.
posted by elizardbits at 1:21 PM on October 5, 2013 [1 favorite]

I can't find any other reasons for my pain online.

I was in this EXACT same position 10 weeks ago - breast pain, exactly symptomatic of mastitis, but I'm not pregnant or nursing. My doctor sent me to a specialist breast cancer screening clinic for a mammogram to rule out inflammatory breast cancer. My mamogram was clear. The oncologist gave me a six page brochure on breast pain that basically boiled down to "Breast pain: it happens pretty commonly. Try Evening Primrose Oil."

My reaction was "Seriously? This is bullshit, man!" but it did fade away and now I get a very occasional twinge.

And FWIW one of my best friend's has the exact same thing. Neither of us has cancer.
posted by DarlingBri at 1:21 PM on October 5, 2013

OH ALSO the one time I was sure I had A Terrible Death Lump in my breast it was actually inflammation from an incredibly nasty ingrown hair in my armpit that had not yet reached the surface to become a hideous hair-filled zit. That was a horrible adventure.
posted by elizardbits at 1:25 PM on October 5, 2013 [3 favorites]

Oh yeah, DarlingBri reminded me. The lump that was causing the pain that was benign but that I had surgery to remove? Afterwards I still had breast tenderness. The oncologist said exactly the same thing. Try Evening Primrose Oil, it happens to lots of women, there's nothing wrong with you. See ya later.
posted by telegraph at 2:08 PM on October 5, 2013

I have a cyst in my right breast that hurts if I press on it. Cysts are not malignant and do not increase your risk of getting breast cancer.
posted by thank you silence at 2:22 PM on October 5, 2013

Also, do you exercise? After I do certain exercises, like lots of push ups or something else involving my upper body, the muscles near my boob meat can be sore for days.
posted by thank you silence at 2:25 PM on October 5, 2013

a shot in the dark: do you drink much coffee? I get tenderness when I overindulge in the caffeine, on one side more than the other.
posted by seawallrunner at 2:47 PM on October 5, 2013 [1 favorite]

I had this pain, too, and freaked out. My doctor kindly said, "Cancer doesn't hurt," which freaked me out even more!

We figured out it was because I'd recently taken two long-haul plane flights in cattle class and had strained a couple of chest muscles trying to get comfortable in my middle seat while also craning to look out of the window.

A friend of mine had similar pain that was related to bad ergonomic desk setup -- she was reaching too far for her mouse on that side and giving herself soreness in one breast.

I found that Tiger Balm helped relieve the pain, but you're doing the right thing seeing your doc. Good luck.
posted by vickyverky at 2:47 PM on October 5, 2013 [1 favorite]

Were you maybe hit in one breast or something? I was hit kind of hard in one breast as a teen during sports and had some issues from that.
posted by Michele in California at 2:48 PM on October 5, 2013

Over the past 12 months I've had an enormous lump in my boob, very sore, sometimes red and hot. Two breast exams and a bunch of appointments later (fuck yeah Aussie healthcare) the consensus is - benign cyst, lumpy breasts and deal with it. Because of the density changes in breast tissue as we age (and in my case, breastfeed) lumps and cysts can become more obvious. I sometimes still get pain, or it's lumpier than new-normal. Irritating but surgery isn't riskfree or indicated for "man, my boob hurts a lot sometimes". It's worse if I lay on my stomach or compress the breast (say, by resting a book on it) so I try not to do that any more.

As far as mastitis goes, an old friend who had never had children has had mastitis more than once, and her male housemate had also had mastitis.
posted by geek anachronism at 3:36 PM on October 5, 2013

My boob adventure turned out to be an infected milk gland. Primates have nipple/milk glands in a line, just like other animals. It resolved on its own.

Seconding the observation that a lot of upper arm exercises makes the boob meat sore. Ha. Boob meat, I love the expression.
posted by effluvia at 4:07 PM on October 5, 2013

This exact thing happened to me, pain in one breast that scared the shit out of me.

The doctor said, "Cancer rarely hurts. I doubt it's cancer." She was right, it was a cyst. Actually, a painless lump is more worrying. So go see your doctor and investigate your specific situation. I bet it will end well, the way it did with me.
posted by citygirl at 4:09 PM on October 5, 2013

Response by poster: Thank you everyone for the input so far, especially those of you sharing your own personal experience. I really appreciate it.

Poster 26.2, I am wondering how those symptoms would relate to benign thyroid tumors, or how they led you to discovering you had that? I have Grave's Disease and I have a node on my thyroid that I've had for years. My Grave's is under control and it's honestly not something I worry about at all. Not sure if it raises my risk for other thyroid problems.

As for some other comments about possible culprits, I don't drink caffeine, except for very rarely. And after a long period of inactivity I started working out again the day before I noticed my breast pain -- I only did light cardio on an elliptical like I have a million times before and I wear a tight-fitting sports bra that holds me in, so I'm hesitant to think it would affect one breast and not the other. Certainly don't recall taking any hits to my boob or anything. I also haven't had a cold or been sick lately that I know of. Last week the day after I noticed my breast pain, I felt indigestion and nausea, which is very unusual for me, but it went away that day -- I chalked it up to anxiety. I do think I need to talk to someone about anxiety which has been nagging me lately, and I will admit, I have a lot of unwarranted anxiety over my health sometimes (mostly my heart after seeing a young friend have a heart attack and die), but this breast thing came out of the blue and I really thought nothing of it until it didn't go away after a few days and I started googling. I actually thought breast cancer only affects older women (I have since learned that was wrong of me to assume).

I'm not sure if this is relevant, but I have noticed large blood clots with my recent periods (a bit larger than a silver dollar). I did see my gynecologist (not the NP) after it happened for two consecutive cycles because it wasn't normal for me and she said I am probably going through hormonal changes that are natural and I should come back if the duration of my period changes or if I have other symptoms. The next month I had no blood clots. And then the next month after last (this past month), I had another massive blood clot. My next period shouldn't be due for 2-3 more weeks. Not sure if it could be related, but I certainly hope this could be as simple as my hormones changing as I age. I take some relief in knowing my breast doesn't display any telltale dimpling, nipple inversion, leakage, or rash. But I'm still terrified and can't stop worrying about this.

Anyway, I find it really helpful to hear other people's experiences with what symptoms they had and what ended up being the problem. At least it gives me some options over what Google does, which is mostly IBC. Please keep sharing for anyone who has anything to add, and I will make sure to update the thread in case future worriers with breast pain find this thread. Thanks again.
posted by AppleTurnover at 4:55 PM on October 5, 2013

I highly recommend the website of the National Library of Medicine, called Medline Plus for information. They have a very informative site that's reliable and easy to search under different topics.
posted by effluvia at 5:54 PM on October 5, 2013 [1 favorite]

Another possibility is inflammation in your rib cage from exertion or (at least in my case) stress. When I get it, it feels like breast pain.

The way I check to see if it's my rib cartilage (costochondritis) is I poke pretty deep into the breast. If the pain is acute when I reach the rib, it's the ribs, not the boob, and all is well. Well, except for the pain.

Ibuprofen and heat applied to the area work for me, but if you're not sure yet whether it's rib-cartilage inflammation, I'd skip the heat for now and just go with ibuprofen. It also helps for me to notice when I'm holding tension in my rib cage, so I can release it. It can also help to learn how to breathe properly -- there's lots online about that.

The inflammation can be chronic and for me, at least, it can kind of migrate around the rib cage. I might have it on the right for a week and then a couple of weeks later on the left.
posted by ceiba at 5:57 PM on October 5, 2013

Obviously, I'm not saying, "If the pain is acute at the rib, hey, no problem, cancel the doctor appointment." But I'd make sure to point out to the doc whether the pain seems to be worst at the rib.
posted by ceiba at 6:00 PM on October 5, 2013

Oh man, costochondritis, I've had that more than once, was convinced it was a heart attack. Bodies are weird.

Which means the odds are good that you're ok, OP. Breast cancer "awareness" is so effective that it makes a lot of us more spooked than we might be otherwise, but most women still don't get it.
posted by emjaybee at 7:28 PM on October 5, 2013

Response by poster: I've had costochondritis -- it's not that. (Years back, I feared I had angina or coronary heart disease because of it happening while I exercised and stopping when I rested. My primary doctor referred me to a cardiologist to eliminate that possibility, which gave me big ease of mind. It comes back sometimes, even just from twisting to grab my seat belt or something, and now I know what it is -- I can press my chest wall and sternum to see if it's tender to check and ibuprofen makes it go away.)

What I'm experiencing now is definitely breast tenderness and it definitely seems to come from the nipple, as is the case (at least for me) during PMS. I took ibuprofen but my breast and especially the nipple remain tender to the touch. But I do appreciate the suggestions.
posted by AppleTurnover at 8:20 PM on October 5, 2013

Is anxiety a big problem for you? It has been for me and as a result it has been difficult for me to evaluate precisely the kind of symptoms you are experiencing. It has been especially difficult for me to evaluate what I perceive as minor differences in firmness and warmth of breast tissue (and I have discovered that one hand feels that everything is slightly warmer than the other hand does!) I have also found that anxiety really exacerbated the kind of pain you describe. I have never been diagnosed with an actual cyst, despite various painful lumps - it all seemed to be normal cyclic stuff, even though it did not really match up with what I understood to by cyclic.

I add that you could easily have irritated or infected a duct (since you mention that this is nipple-related). It's even possible that this could be the result of exercise - just the whole friction/motion thing facilitating infection. Early on in my own weird itchy infection problem, I had a lot of soreness (and then occasional stabby pains).

If you are an anxious person, your anxiety is magnifying this symptom. Personally, I somatize my anxiety and it absolutely does make my symptoms worse. This isn't conscious on my part and it can happen when I'm not consciously anxious (when I'm stressed, sometimes my anxiety comes out in physical symptoms).

I can't promise that you don't have cancer. However, I struggle with anxiety, had symptoms very much like yours and it was absolutely nothing at all. I remember reading all those IBC pages and how scary they were, and how it seemed like my very minor symptoms must be IBC.

Don't google anything else before your visit. If you are tempted, I have found it helpful to tell myself the very pessimistic "It will still be [TERRIBLE THING] after the appointment even if I don't google; if it's bad, no amount of googling will change that". It probably won't be anything bad.

At the risk of TMI, also, the blood clot thing - all the NIH/CDC advice is "ooooh, blood clots, see your doctor", but as far as I can tell from lived experience and a 400-comment Cleveland Clinic thread, they are incredibly common and not generally a concern except from a oooh-yuck-nuisance standpoint.
posted by Frowner at 12:22 AM on October 6, 2013

Sometimes women mistake pain in their chest as "possible boob cancer" rather than "possible heart failure". My mother's friend died recently from this mistake (a mistake her doctors made as well). If you are going to the doctor to check things out, be sure to have them assess your heart too.

[Not trying to scare you, but the recent event with my mom's friend was a sobering lesson.]
posted by Halo in reverse at 2:37 AM on October 6, 2013

I'm a doctor. I can't comment on what is causing the pain in your case, although I think you've gotten some good suggestions here for possibilities. However, chest wall pain is not a symptom of heart failure, so that is one possibility you do not need to worry about. Heart failure is a failure of the heart to effectively pump blood to the rest of your body and it manifests with shortness of breath and leg swelling. It also is very rare in young, otherwise healthy people (more rare even than cancer in young, otherwise healthy people).

Halo in reverse may have been referring to anginal pain from coronary artery disease, but based on your demographics as a 29 year old woman, that possibility is vanishingly unlikely.
posted by treehorn+bunny at 1:38 PM on October 6, 2013 [1 favorite]

Dr. Google only knows cancer. Every symptom you ever look up on the web is a symptom of cancer. Dr. Google is evil, and wants you to be afraid.

I've been exactly where you are, with an ouchy boob and an internet connection. It's a bad place to be. I was convinced I had IBC, too. I scheduled a superfast appointment with my GYN and then a mammogram (I'm over 40) and you know what I had?

An ouchy boob.

As I recall, my GYN told me that if I had IBC my boob would be MUCH harder than it was, that the size difference would be so significant I wouldn't have to wonder if it was larger than the other, and that there would be a pitting sign on the skin of my breast that would be unmistakable, like the skin of an orange. She also said it would hurt more.

Definitely go see your doctor to put your mind at ease. But I wouldn't put a significant amount of worry into IBC. Infection of some sort sounds far more likely, or just one of those random female things.
posted by kythuen at 1:23 PM on October 7, 2013 [2 favorites]

Response by poster: I went to the GYN and she said my breasts felt normal. After a week of one-sided boob pain, of course on the day of my appointment, my left boob and my pelvis decided to get in on the action for normal PMS symptoms. She said it's better when the pain is happening on both sides and didn't think it was unreasonable for me to have the one-sided pain looked at, but she chalked it up to hormones and said it's pretty common for women to feel benign breast pain. She recommended Motrin or primose oil to relieve the pain. I asked her about the clotting, the one-sided boob pain, the early PMS symptoms and she said it's really nothing to worry about. So there you have it. Googling medical symptoms strikes again!

Thank you everyone for talking me off the ledge. I was worried sick.
posted by AppleTurnover at 9:50 PM on October 8, 2013

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