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Ask Dr. Arun Phophalia Your Own Question

Dr. Arun Phophalia
Dr. Arun Phophalia, Doctor
Category: Pediatrics
Satisfied Customers: 29711
Experience:  MBBS, MS, Fellowship in sports medicine. Deals with general pediatric surgical disorders.
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My 5 year old daughter has a hard knot in her right breast

Customer Question

My 5 year old daughter has a hard knot in her right breast we had a chest and soft tissue x-ray, hormone labs all turned out normal just had an ultrasound that showed it was not the result of an accident like we originally thought it might have been, was told to get referred to a specialist in Little Rock but haven't been as of yet. The Dr didn't think it was cancer said it may be her breast bud but with quote signs he said it's "probably a benign cyst, growth or something like that" What do you think it might be?
Submitted: 6 years ago.
Category: Pediatrics
Expert:  Dr. Arun Phophalia replied 6 years ago.

Greetings.

 

Since how long is the lump? Is it painful and / or tender? Is it mobile all around? Is the skin adherent (stuck) or free from the lump?

 

Dr. Arun

Customer: replied 6 years ago.
We noticed it almost 6 weeks ago, she and her brother were wrestling around she fell and later that night she was noticibly swollen, we've kept an eye on it since then without it going away.

She says that if she bumps it on something it hurts but it does not hurt to examine the lump.

It is somewhat movable, I can cup it in my fingers and move it in a circular motion a tiny bit.

I tried to "lift the skin" on and around the lump, around an inch above the lump I can lift the skin but can not on the lump but of course I dont want to hurt her.

Other info: On the US photo's I have the measurement of the lump it is 1.13cm x .0905 cm. My husband wants me to also mention that the lump is directly behind the nipple. To me feels like a 1/2 of a walnut shell.

Thank you, XXXXX XXXXX forward to hearing from you.
Andrea Lewallen

Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello Andrea Lewallen,

 

The modern medicine sometimes gives lot of weight and is too much dependent on investigations. Ultrasonography, mammography, and even MRI of the breast may not be able to discern the difference or diagnose the breast lumps, but old medical teachings are always reliable. The history of trauma is important here and finding of observed swelling after the injury is very important feature in the history and diagnosis. I would keep it traumatic fat necrosis, as the first possibility . The trauma causes fat necrosis, or breakdown of the adipose tissue. The second possibility would be lipid cysts. Mammary duct ectasia would be third consideration which can occur in prepubertal boys and girls.

 

All of them are benign but biopsy is usually essential to relieve the anxiety.

 

Please feel free for your follow up questions.

 

Dr. Arun

Customer: replied 6 years ago.
I looked up the things you said it may be to better understand the meanings I wanted to follow up with this...

She has yet to have any discharge from the nipple.

The nipple is somewhat a darker shade than the other one with prominate visiable vein's inside compared to the other one.

The US showed the mass to be "a big black ball" with blood flow not just a difference in texture, So you think that could be fluid?

And I'm hoping I will leave you alone after this but do you think in your professional opinion that we should press the fact of being referred to a specialist since this has been evedent for at least 6 weeks?

Thanks
Andrea Lewallen
Expert:  Dr. Arun Phophalia replied 6 years ago.

Hello,

 

Oh yes, it should be seen by a specialist, a pediatric surgeon or a general surgeon. Any mass will change the nipple color because of the pressure and affecting the blood supply. Ultrasound are usually very good modality to tell the difference between a fluid or cystic swelling and a solid swelling. Since it pointed out for cyst, a low grade abscess may also be in the consideration (abscess usually are tender and painful).

 

It is pleasure assisting you.

 

You are welcome.

 

Dr. Arun

Expert:  Dr. Arun Phophalia replied 6 years ago.

Hi Andrea,

 

I would like to mention one thing. Usually websites and books will mention only the classical features of the diseases. So people may be many times misguided reading them or don't get the correct perspective. Diseases very uncommonly come in copy book styles.

 

Hope this helps.

 

Best.

 

Kindest regards.

 

Dr. Arun

Dr. Arun Phophalia, Doctor
Category: Pediatrics
Satisfied Customers: 29711
Experience: MBBS, MS, Fellowship in sports medicine. Deals with general pediatric surgical disorders.
Dr. Arun Phophalia and other Pediatrics Specialists are ready to help you
Customer: replied 6 years ago.
Dr. Arun,

Before I let you go I wanted to say thank you for your time and thank you for being a part of such a neat internet find, in times of "not knowing what to do next" it's good to have an outlet.

Thanks again!
Andrea Lewallen
Expert:  Dr. Arun Phophalia replied 6 years ago.

You are always welcome.

 

I wish a very fast recovery for your daughter.

 

Let me know the follow up, if possible.

 

Dr. Arun

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