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:
-
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.
-
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.
-
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.
-
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.
Related Questions
Could This Be Petechiae? (Child's Case)
My eleven-year-old son approached me this evening to show a rash located on the upper part of his leg, near the groin. This skin issue was not visible just a few nights ago after his bath. He mentioned that it neither hurts nor itches, although he did experience a mild burning sensation earlier, which has since subsided. I initially considered it might be a result of some minor injury, as he seems to be recalling no such incident. Aside from this, his health appears quite robust—he has a hearty appetite, is somewhat stocky, full of energy, and hasn’t experienced any nosebleeds. Recently, he did feel a little under the weather and fatigued, but given the extreme heat and humidity lately, that might be understandable. Is it advisable to visit a physician, or should I let it be and observe if it resolves on its own? I’m trying to remain calm, but upon researching potential causes for a rash of this nature, I stumbled across leukemia, which has understandably raised my anxiety. Thank you for your input. 🤍
Navigating Interactions: Temporarily Halting Plaquenil for Fluconazole
I'm a 24-year-old female currently on a 200mg dosage of Plaquenil, but I need to add in Fluconazole at a dosage of 200mg once a week for a three-week duration. After attempting various less invasive treatments, it became clear that topical applications were not effective. Given Plaquenil’s extended half-life, I recognize that this could complicate things, especially considering I’m using a low dose. To date, I’ve managed to skip taking it for eight days; however, I’m aware that its half-life spans around 40 days. When I inquired with the pharmacist, they were uncertain about how this would affect my situation.
Understanding Scalded Skin Syndrome
Three days ago, my five-year-old daughter was diagnosed with Scalded Skin Syndrome. Initially, she exhibited symptoms such as swelling around her eyes and localized redness in one of her armpits. We assumed these were signs of an allergic reaction since she had inadvertently come into contact with an allergen. To address this, we administered Benadryl and monitored her condition. However, by the following morning, the rash had proliferated, affecting all her skin folds and causing her considerable pain. Therefore, I took her to see our pediatrician, who suspected scarlet fever and prescribed an oral antibiotic, cautioning us to head directly to the emergency room if we noticed any skin peeling. Later that day, we observed that her skin was starting to wrinkle and develop an unusual appearance, prompting us to seek immediate medical attention. After a lengthy wait at the ER, which is not uncommon in our area, we were finally evaluated by a pediatrician who confirmed the diagnosis of Scalded Skin Syndrome. Now I find myself with a pressing question: She has been on antibiotics for 72 hours, and her rash first appeared five days ago, showing stability after the initial flare-up. However, I’ve recently noticed new areas of redness appearing slowly on her arms and legs starting yesterday. While the changes aren't drastic, they seem to be progressing. Does this indicate that the antibiotics may not be effective? I’ve inquired with the medical staff about this, but they haven’t been able to provide guidance.
Assessing the Severity: Understanding the Findings on My Daughter’s Health
I am writing to discuss a critical health concern about my daughter, who is 6 years old and has a specific type of polycystic kidney disease (PKD). We recently visited the Mayo Clinic to identify the precise nature of her condition. During our visit, the medical professionals expressed their concern about her symptoms—namely, severe headaches, vomiting, excessive lethargy, and sweating—which occur when her blood pressure fluctuates sharply. Although they recommended a brain MRI, we were unable to have this done while at the clinic due to scheduling conflicts. Upon returning home, we completed the MRI and, perplexingly, the results were forwarded to the Mayo Clinic with only a vague reference indicating "generic referring" for the physician. This has caused considerable confusion on our part as parents, as effective communication has been lacking. The scans have now reached a neurosurgeon at Mayo, and we have scheduled an angiogram for Wednesday to further investigate. The preliminary findings highlight a “fusiform enlargement of the superior basilar artery,” which raises the concern for a possible fusiform aneurysm. The measurement of the affected area is noted as 4.4mm, compared to the normal size of 2.4mm. Due to her PKD, her blood pressure is highly erratic; she is currently prescribed 7.5mg of amlodipine and has been given hydralazine to use if her systolic pressure exceeds 125. The only physician with whom we have managed to communicate suggested that I reach out to a local doctor within 5 miles and treat this situation as an emergency, emphasizing the importance of limiting her physical exertion. The communication breakdown between the children’s hospital and the specialists at Mayo has left us questioning the severity of this scenario. Is it a benign incidental finding, or should we consider it serious enough to prepare for urgent intervention? I apologize for the disorganized nature of this message, but I am currently functioning on very little sleep and anxiety about her condition is weighing heavily on me.
Seeking Advice on Post-Operative Recovery from a Pilonidal Cyst
I am a 24-year-old male who dealt with a pilonidal cyst that emerged nearly a month ago, around June 23rd. I performed drainage on it myself on June 27th, when it seemed ready, as indicated by the whitish drainage head. I believe I successfully drained it during my last attempt, which took about an hour and a half, leaving only blood without any signs of pus or foul impurities. Following this, I was prescribed antibiotics for four days, taking them twice daily, along with some pain relief medication for a bit longer. Though a month has passed, I still experience some mild discomfort in the area near my tailbone. Sitting or lying down straight causes me a bit of pain or a numb sensation in that region. As a freelancer, my work sometimes requires long hours of sitting, occasionally up to 18 hours in a single stretch, which may be contributing to the discomfort I’m feeling. Previously, I encountered a similar cyst around 4 to 5 months ago, but the numbness and pain didn’t last as long as this time. I'm curious to know if it is common to still experience some pain after a month, and what the typical recovery timeline is for a pilonidal cyst of approximately 4-6 inches in size. Should I be concerned about this ongoing discomfort? Are there any medical professionals who could offer insights or advice?