Breast Redness and Areola Weirdness

[bluephoenixx]

I'm a 59-year-old woman, post-menopausal and have never taken HRT.  Last month (while on vacation) I noticed that my left breast areola appeared to be a different color than the right; more gold/yellowish instead of the usual pink.  It gets more pronounced if I lift my left arm overhead for several seconds.  I also noticed some faint redness on the left breast, on the underneath side and to the left and looks like it might be behind the nipple as well and tissue feels a little thick and uncomfortable to press on.  The skin's texture looks the same and there are no open sores, no nipple discharge or crusting, no itching, no visible orange peel texture.  Just redness and sensitivity, especially to pressure/compression, and an areola color change under certain conditions.  

Some background:  I've had fibrocystic breasts since my 20s and had to have a cyst aspirated years ago in the right breast.  Medications for allergies & asthma resulted in some weight gain these past few years and last year I needed a new bra size but didn't have much luck finding one to fit with stores or fitting rooms closed!  (Internet purchases resulted in getting the wrong size and several returns.)  Fitness bras didn't fare any better.  Due to some asymmetry, it's difficult to find one that's not too big for the right breast, so I stuck with what I had, and I don't like going braless.  Well, THAT bra was too tight and eventually my breast started complaining, so took it off and just wore a larger one with cup wrinkles for the right breast since it just didn't fit right.  That was a month ago.

I don't know whether wearing a tight bra for too long did some damage or if there's something else going on.  I will see my doctor soon for an exam and ultrasound at least (maybe a mammo as well but I think that would hurt like hell right now), but meanwhile I'm worried and can't find much info about tight bras and breast changes.  I've read about IBC and it scares the heck out of me.  Ideas? ...help?  (TIA.)

[Sara_MHModerator]

Hello and welcome to the forum.  Thanks for the question. Have you seen your doctor yet?  Even women post menopausal can get mastitis. This is a possibility for you.  Breast changes also can occur.  Another possibility is mammary duct ectasia.
https://www.mayoclinic.org/diseases-conditions/mammary-duct-ectasia/symptoms-causes/syc-20374801 However, that often comes with nipple discharge which you don't have.   IBC would be a concern because of the breast swelling and redness but it most often has the changes in skin that you say you don't have or nipple changes such as inversion.   https://www.mayoclinic.org/diseases-conditions/inflammatory-breast-cancer/symptoms-causes/syc-20355413  Please let me know what your doctor says.

[bluephoenixx]

Hello, Sara.  Yes, I saw my doctor.  He did a physical exam and a breast ultrasound.  After I told him the history of the tight bra (during hot summer weather), he prescribed an antifungal cream, Terazol for use for two weeks and I have an order for a mammogram. (I thought he might prescribe oral antibiotics, but no.)  I mentioned Googling the symptoms and that IBC came up several times and his response was, "well, you don't have that" and that I don't show any signs of peau d'orange or nipple discharge.  We have a TeleHealth appointment next Wednesday.  My breast is a little tender, maybe from not wearing a bra for two weeks or from all the rubbing and checking.  I was wondering, with my history of fibrocystic breasts and two previous cysts that required aspiration, if maybe a cyst had been squeezed too much and burst?   I still can't figure out the areola color change when I lift my left arm; it doesn't really happen with the right breast, but that one is a little smaller (well, by about half a cup size!).  No nipple inversion.  This has all been seven weeks now and nothing's really changed, but it's too soon to tell whether the cream will help.  I will ask about mastitis/antibiotics at our phone appt.   Oh, and an interesting aside, whether it's at all relevant:  I had my second COVID vax in the left arm (at the end of May) and after that my left armpit was itching for weeks.  It seems to have stopped now.   I have no idea if there's any connection, but I did read that some women were experiencing swollen lymph nodes on the side of their vaccination that were concerning for breast cancer but after being checked they were alright.  I realize that may not mean anything in terms of my symptoms, but it's curious.   I've read many scary articles on IBC.   Thank you for the link on periductal mastitis.  This is all quite confusing.  I'm afraid maybe only a biopsy would be conclusive but I'm a couple of steps away from that.  

[Sara_MHModerator]

I think your mammogram will be quite helpful.  When is that scheduled?  Did your doctor see you in person?  This seems like a good situation in which that would make sense.

[bluephoenixx]

I'm calling next week to schedule the mammo, which could possibly be done next week if I use the local breast center -- unless they want me to wait until I'm done with the terazol cream but that won't be 'til the 16th.  I saw the gyne in person; the second appt next week will be a phone call since I don't have Facetime.  What could a mammogram possibly show (and, er, not show)?  Could it detect mastitis or a cyst, or a ruptured cyst?  

[Sara_MHModerator]

Mammography can show many things. Radiologists are great at looking for something that would be regarded as suspicious. They may then follow up with other testing. Has the mammography been scheduled yet or better, completed?

[bluephoenixx]

TeleHealth appt with the gyne:  I said I didn't think the Terazol cream was doing much although I'd already mentioned that there was no itching.  He prescribed a steroid cream instead and failing that, he said I could be referred to a dermatologist.  Also, he said the breast ultrasound showed "no abnormalities" but I forgot to ask about mastitis.   There still wasn't any comment as to why my areola changes to a golden color if I lift up my left arm for long enough.  He recommended I make some strict dietary changes (restrict caffeine especially), wear a looser bra, and then give it about three weeks before getting a mammo "until after things calm down" (also, I think maybe if my breast is still red, that's going to freak them out).   It'll be a 3-D mammo, too.   The other thing is, this local center I went to before has a strong reputation for being paranoid, even by some doctors, so they call anything "suspicious" unless they're 99.9% sure there's nothing that indicates further testing, and I DO NOT LIKE overdiagnosis or overtreatment!  And, uh, they squeezed those plates WAY too tightly last time... very painful.  I would have to make sure the doctor makes a notation for them to take it easy on the compression.   So, for now, I either try his recommendations and wait a bit, see someone else for a second opinion, or just wash off the cream and do the painful mammo ASAP anyway, red breast and all (and I hope I don't get hit with a $1200 bill)!    (Thanks again.  :))

[Sara_MHModerator]

It sounds like you have a plan even though not completely satisfied with the answers.  So, when is the 3 D imaging?  I hope you let us know the findings and give me an update on how things are going,  And agree, hope you don't suffer an outrageous bill or this.