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Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: OB GYN
Satisfied Customers: 29880
Experience:  MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.
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Numbness and Discomfort in Left underarm and breast

Customer Question

Hello,

I am 50 years old and have, for the last six weeks, been experiencing a combination of numbness tingling itching and a small pain in my left underarm area and my left breast.

I first noticed the problem about six weeks ago, initially I felt a raised numb are under my left arm which was slightly tender. Since then ther numbness has spread to my left breast and included the tingling itching with sensitivity to cold, the sensation is also felt at the top of my left arm at the back. I have tried to go several days without a bra and wear loose clothing but the situation has not improved. I have also noticed tingling in my little finger and the one next to it.

I am on 2mg eostregen HRT after a Hysterectomy over 10 years ago due to abnormal cells in my cervix. Also 4mg of perindripil for raised BP. An Aunt died of breast cancer when she was 49-50.

I would appreciate any advice you could provide.

Kind Regards
Terri Swan
Submitted: 6 years ago.
Category: OB GYN
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Terri Swan,

Greetings.

The spine nerves (neck, upper back, and lower back) supply our upper limbs, thorax/chest, abdomen and lower limbs. The upper limbs, and chest wall including the axilla (underarm) and breast are supplied by the neck nerves. The breast and underarm numbness, discomfort and sensitivity to cold (termed as paresthesia), with little and ring finger tingling is very likely to be associated with the pinched nerves in the neck. This can be due to degenerative disc disease on bone spurs pressing on the nerves (cervical spondylosis). Read about them in these resources;

http://www.mayoclinic.com/health/pinched-nerve/DS00879

http://www.mayoclinic.com/health/cervical-spondylosis/DS00697

With your family history of breast cancer, your apprehension is understandable, but these symptoms are not likely to be indicative of any breast disease.

Confirmation of the pinched nerves is done by MRI of the neck, nerve conduction study and electromyography (NCV and EMG). Your primary care physician will be able to get these investigations. You can get a referral for an orthopedist also.

Please feel free for your follow up questions.

Dr. Arun

 

Dr. Arun Phophalia, Doctor
Category: OB GYN
Satisfied Customers: 29880
Experience: MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.
Dr. Arun Phophalia and other OB GYN Specialists are ready to help you
Customer: replied 6 years ago.
Hello Dr. Arun,

Thank you for your extremely informative and fast response to my question.

Your response has raised further questions regarding my health. Along with the symptoms I provided in my original question, I have also been exeriencing lower back pain and hip pain. I am generally fine during the day but feel the pain after sleeping for a few hours. It makes turning over in bed and getting out of bad uncomfortable for a few minutes. Once I am up though the pain almost disappears and I not usually aware of it during the day.

Is this pain connected to my original symptons or another issue entirely.

Kind Regards
Terri
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Terri,

The pain after lying down needs to looked for the following;

1) This can be again spondylosis of lower back and hip osteoarthritis.

2) Early morning stiffness or stiffness after lying down needs to be looked for a condition called as ankylosing spondylitis.

3) The mattress of your bed also can play a culprit in it. A mattress which sag too much or which is old and bit uneven can cause early morning stiffness.

Again physical therapy has a big role to play. Obviously imaging of these joints would be informative and give clue to the diagnosis.

Kindest regards,

Dr. Arun

Dr. Arun Phophalia, Doctor
Category: OB GYN
Satisfied Customers: 29880
Experience: MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.
Dr. Arun Phophalia and other OB GYN Specialists are ready to help you
Customer: replied 6 years ago.
Relist: I still need help.
The symptons have spread to the underside of my right breast and have slightly worsened
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Terri Swan,

Do you have any breathing difficulty? Do you pain or other symptoms in breast tissue itself? Do you have any tenderness anywhere? Do you know self breast examination technique? Have you examined your breasts? Please let me know, if you have further concerns.

Dr. Arun

Customer: replied 6 years ago.
I examine my breasts on a regular basis so I am instantly aware of any changes, that is why I was immediately aware of the changes as detailed in my original request to you.I sometimes feel short of breath and the areas concerned feel  prickley. when an area feels prickley it also feels numb or a lack of sensitivity. The tenderness remains in the underarm and breast area and has progressed to the areas detailed in my last response. The shortness of breath comes and goes for no particular reason.Many thanks
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hi Terri,

Let me answer you on the basis of the following;

1) Are your symptoms relate to any breast problem? The answer would be NO. Since you examine your breast regularly and there are no nodules felt, the symptoms you feel around the breasts and axilla can be better explained and seems to be more related to musculoskeletal pathology. As we discussed also, the very likelihood is pinched nerves (combination of the degenerative discs and bony spurs).

2) Any pathology related to breast? A very remote association can be of fibrocystic disease of the breast in which pain and nodularity of the breast and axillary region (breast tail) are the main symptoms with tenderness. This is a benign breast condition. Since you have no nodularity felt in the breasts, chances of this is quite less. It does occur in the age group of 30-50 commonly. And there are remission and aggravation of the symptoms. Read about the fibrocystic disease of breast;

http://www.nlm.nih.gov/medlineplus/ency/article/000912.htm

3) What is the reason of your newer symptoms? Can be explained on the same musculoskeletal causative. Still I feel that a physician examination is important as it can decide more objectively the diagnosis and if needed further investigations can be initiated. The treatment and further management can be planned accordingly.

A trial of anti-inflammatory analgesic and a local analgesic spray can be done till you seek an appointment with your physician.

Hope this is helping you.

Please feel free for your queries.

You are welcome.

Thank you.

Dr. Arun

Dr. Arun Phophalia, Doctor
Category: OB GYN
Satisfied Customers: 29880
Experience: MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.
Dr. Arun Phophalia and other OB GYN Specialists are ready to help you
Customer: replied 6 years ago.
Hello Dr ArunI took your advice and consulted a GP at my medical practice.I was advised to wait six weeks to see if the symptoms subside and told that the problem was a tendon under my left armpit and I must have lifted something heavy to cause it. I am sure that I have done nothing to cause such an injury and not confident about the diagnosis.more recent symptoms include further pain on the right side of my back at the top sort of level with my right breast (sorry if that sounds confusing but it is hard to explain in writing) severe headaches where I need to lie down, nausea and 3 episodes of a raised temp. I also have had excessive sweating, only at night, that absolutely drenches me to the point I have to change the bedclothes. The pain at the top of my back, sort of behind my right breast also caused me difficulty breathing but not alarmingly so just to the degree where I have to catch my breath. I think because the symptoms are numerous, it is difficult to convey them to my GP in the allocated 10 minute appointments.

Perhaps I am not asking the right questions or not clearly explaing the symtoms to my GP.

I would appreciate any advice you can provide.

Kind regards

Terri
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hi Terry,

Did you tell your GP about the raised temperature, nausea and drenching night sweats? How much fever do you get? How does fever goes down? Are you stressed?

Dr. Arun

Customer: replied 6 years ago.
Hello Again,

Yes, I told my Gp about the night sweats and raised temps but she did not comment. The headaches nausea and pain in the top of my back have were not present when I saw my GP these are new symptons. I am on Climaval 2mg for HRT so I presume that I need a higher dose to combat the excessive sweating at night. The bouts of fever I have had is 4 bouts over a period of 2 weeks. The fever can last from 12 hours to 36 hours. I don't think I am stressed unduly only regarding my current medical condition.

Terri
Expert:  Dr. Arun Phophalia replied 6 years ago.

Yes, Terri, HRT doses may need to be increased. With your newer symptoms, I would atleast get up initial blood work up. Since your GP examined you, he must have not found any physical examination positive findings. So there might not have been any alarming thing, so called you after six weeks. Nausea, fever headache do warrant investigations. Please seek a fresh appointment with your physician in the light of newer symptoms. I am not sure of the tentative diagnosis at this point of time. But I feel, (whatever I can make out with this modality of information), breast should not be related with this. Axilla needs examination for any lymph node involvement/enlargement and so do the neck.

Please let me know, if you want to discuss it further.

Dr. Arun

Dr. Arun Phophalia, Doctor
Category: OB GYN
Satisfied Customers: 29880
Experience: MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.
Dr. Arun Phophalia and other OB GYN Specialists are ready to help you
Customer: replied 6 years ago.
Dr Arun,

I have consulted my GP again and he gave me a thourough examination and ran a series of blood test and a chest x-ray. The chest x-ray appeared normal and there blood test results were within the normal range. I have been referred to a Consultant this Tuesday. The symptoms have become more aggressive and I am experiencing dizzy spells with a rapid heart beat. These spells happen at any time but mostly when I first lay down at night. The original symptoms remain. I have also noticed that the areas affected by the symptoms, are now permanantly numb or lack of sensation with itchy spells at the site of the symptoms and over most of my body.

could you please give an indication of what is wrong with me and perhaps suggest the right questions to ask the consultant.

Kind Regards

Terri
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Terri,

Good to hear from you. Your initial evaluation of chest x-ray and blood work up is normal, so we need to concentrate on imaging for further evaluating the symptoms. Let me enumerate the things for which we are trying to find the answer; dizziness, which is more on lying down (off and on also), rapid heart beats, numbness underarms and breast area, lack of sensations, and itch spells. Please confirm me this and I will be right back to you.

Which specialist consultant are you contacting next week?

Dr. Arun

 

Customer: replied 6 years ago.
In the areas affected I also experience sharp pin/needle like pain, but not agonising. The right side of my chest breast and back are also affected to the same degree. The area of the back that is affected is in the same place that hurt when I had peumonia in 2003 but I have had the innoculation for that. I am also extremely tired most of the time and total lack of energy.

The consultant I have been referred to is a General Consultant. I can confirm that the symptoms you quoted above are correct.

Terri
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Terri,

Sorry for this delay.

The symptoms you are experiencing may be related to the cervical spine and MRI of the neck is one imaging modality which should be done. Electrophysiological studies like nerve conduction velocity (NCV) and electromyography (EMG) may also be planned later on. The specialist to be consulted would be a neurologist. You can confirm your consultant whether they are neurological origin or vascular origin. Palpating or feeling your pulses would give the idea or any affection of the blood vessels. Although, I feel arteries should not be responsible for your symptoms. Dizziness can be explained on the basis of cervical spine affection and this is termed as cervicogenic dizziness or vertigo. Read the resource related to this;

http://www.chiroweb.com/archives/13/02/03.html

I would also consider chronic fatigue syndrome or fibromyalgia for your symptoms, which are common in your age group. So you can discuss about them with your consultant.

Please feel free for your queries.

Sincere regards.

Dr. Arun

 

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Dr. Arun Phophalia
Dr. Arun Phophalia
OB GYN Doctor
29880 Satisfied Customers
MBBS, MS. Deal with women related all surgical problems including genito-urinary and breast surgery.