Concerns About Breast and Nipple Changes: Seeking Guidance from My Doctor
A bit of background about myself: I am a woman in my early twenties, living with polycystic ovary syndrome (PCOS), and I also experience low levels of iron and vitamin D, along with irregular menstrual cycles. Recently, I have noticed several changes: 1. My right breast seems to be slightly sagging. 2. There is a persistent odor emanating from my right underarm. Despite maintaining good hygiene, including regular showers and scrubbing, I find that after about ten minutes, an unpleasant smell returns, even though my activities do not typically induce excessive sweating. 3. Both of my nipples have tiny white dots. I reported this to my physician several times, and while she ordered a blood test to check for nipple discharge, the results were normal. She suggested these could be caused by oil or dirt accumulation from my skin. Though she has performed a manual examination of my breasts and an ultrasound, both of which returned normal results, my concerns persist. A few days ago, I noticed these white dots again and attempted to squeeze them out. Upon further inspection today, I discovered tiny black scabs on my nipples. I squeezed these off as well, revealing very small scab-like spots embedded in the nipple skin. After doing this, I noticed some blood beneath the surface, and when I pressed my nipple, a small amount of oil was released. Additionally, one region of my right nipple appears darker than the surrounding area, although I have had that for several years without significant change. While my nipples are generally darker, some patches are slightly darker than others. I have also occasionally experienced discomfort in my upper body. I am feeling quite anxious as I am uncertain about what I should ask my healthcare provider. The thought of conditions such as Paget’s disease or other forms of cancer is concerning. What specific tests should I discuss with my doctor to ensure a thorough evaluation of these symptoms? I am considering suggesting a patch test for my nipple and possibly an MRI of the area from my shoulders down. Additionally, could you inform me if there are any blood tests that might help in detecting cancer?
Answers (1)
7/27/2025, 8:50:40 AM
OpenHealth AI
It's understandable to be concerned about changes in your breast and nipple area, especially when you've been vigilant about your health amidst your PCOS and other conditions. While your physician has conducted regular assessments and there have been no alarming findings, it's important to ensure you feel supported and well-informed as you proceed.
Main Points:
- Changes in breast and nipple appearance can be due to various benign causes, but it’s wise to discuss your ongoing concerns with your healthcare provider.
- Given your history and symptoms, you can consider advocating for specific tests to ensure a comprehensive evaluation.
Explanation:
- Breast Changes: It's common for breast tissue to change over time—sagging can occur naturally with age or weight changes, even in younger women. The presence of white dots on the nipples may often relate to benign conditions like sebaceous cysts or normal variants.
- Underarm Odor: Persistent odor despite good hygiene might signal a condition like hidradenitis suppurativa or an overgrowth of bacteria, which can be differentiated with proper evaluation.
- Nipple Changes: Darker patches and scabs can be benign but should be monitored, especially with any bleeding or discharges present. It's also worth noting that frequent squeezing can cause irritation and further changes.
Next Steps:
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Request Specific Tests
- Breast Screening: Ask about a mammogram or a more detailed ultrasound specifically focused on the areas of concern in your breasts.
- Nipple Examination: Consider discussing a referral to a dermatologist for a specialized examination of your nipple area, given your unique symptoms.
- Blood Tests: While there are no specific blood tests to diagnose breast cancer directly, tests for hormone levels and inflammatory markers may help evaluate any underlying conditions related to your PCOS. You may also inquire about genetic markers if there’s a family history of breast cancer.
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Document Symptoms: Keep a detailed log of any symptoms you're experiencing, including when they occur, any changes you notice over time, and how long you’ve observed them. This will provide valuable insights to your healthcare provider.
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Communicate Your Feelings: Share your anxiety and concerns with your healthcare provider during your next visit. They can offer reassurance and address specific fears regarding conditions like Paget’s disease.
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Avoid Squeezing or Picking: To prevent additional irritation or potential infections, try to resist the urge to squeeze any lesions or dots.
Your health and peace of mind are vital, so ensure that you adequately express your concerns during your next healthcare visit. This will help you feel more confident in navigating your symptoms and receiving the support you need.
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