Lump

[BillyP123]

I have a lump under my right nipple that hurts. I am going to the doctors today. If it ends up being gynecomastia what happens if I do nothing about it. Also if it needs to be removed can I have whatever surgeon they send me to do it or should it be done by a plastic sureon or someone that specializes in it? I don't think my health insurance covers plastic surgery.

[Dr. Elliot Jacobs]

If you have a new and tender lump, then it should first  be evaluated by your primary care doctor.  He/she may then recommend a mammogram or sonogram or an endocrinologist.  Once a workup has been done and a reasonable diagnosis made, then they may recommend watchful waiting (if its gyne, it may disappear by itself) or perhaps an excisional biopsy by a plastic surgeon or general surgeon. 

You would have to check with your insurance company re possible coverage.

Dr Jacobs

[BillyP123]

Thanks for answering my question. I have to get an ultrasound and mamogram tomorrow.   He thinks it might be a cyst.   Who knows he might have just told me that because he knows I'm worried about it.

[BillyP123]

I went to get a mammogram and ultrasound today. They don't know what the lump is and I need to see another doctor. I asked if it was gynecomastia and he said that it would have shown up on the mammogram and that everything looked normal on it.  He was looking at the ultrasound and trying to show me that the skin goes under the lump. I couldn't really tell what I was looking at.  They kept asking me if I noticed anything on the skin that looked like a pimple or a bug bite but I haven't. He said it's not a mass or a cyst. What could it be? When I touch it it feels like it goes down pretty deep. Could he have made a mistake and I find out later that it's Gynecomastia? I am relieved but at the same time I am afraid he might be wrong.  Also forgot to mention I am 31 and this is a new problem. It just appeared out of nowhere on Friday.

[Litlriki]

At 31 in the absence of inciting medications or some other causative factor suggesting gynecomastia, a solitary breast mass should be evaluated in the manner you've described so far.  If diagnostic tests don't tell you what is going on, then a biopsy will be required.  A breast biopsy is certainly covered by your insurance.  If it's gynecomastia, again, at 31, possible causes need to be explored to be sure it's not a sign of some other health problem.  It could very well be a simple cyst, and in fact, that may be quite likely, so no need to get overly anxious.

Rick Silverman

[BillyP123]

Thank you very much to both of you for answering my questions. I have been losing sleep over this and it really helps ease my mind. I have an appointment with another doctor tomorrow to see if he knows what it is.  Thanks again.