Nipple eczema, inversion, discharge, blood...What should I expect?

Hello there,

Feeling rather in limbo as I saw my GP on Monday regarding my left nipple, which has suffered from eczema for the past year. I thought I’d managed to cope with it my switching to organic cotton bras with no seam across the cup last year, but it came back red raw last week. Healed again by Sunday. It had been producing abnormal amounts of yellowy discharge for a couple of weeks and then I noticed clear liquid pouring out of the very middle and then a bloody discharge. The nipple also tends to be inverted most of the time (not the right, only the left).
I’m 31 and haven’t had any kids.
I had a lump in my right breast 5 years ago which had to be re-aspirated 3 times because it kept filling. (I’d had mastitis in the run up to it). The ultrasound report said it was probably malignant and an atypical fibroadenoma, but the consultant said it was infected and treated it with antibiotics and drained it.

I was told I was being referred within 2 weeks for this left nipple due to the eczema.

I don’t have an appointment yet (was told I should hear by tomorrow).
What should I be asking, and what to expect?

Dear Puddleduck

Welcome to the Breast Cancer Care forums where I am sure you will receive valuable support and information from your fellow forum users. In addition, you may find our booklet called ‘Referral to a breast clinic’ helpful as it contains information about what to expect from your appointment , you can read it via the following link:

breastcancercare.org.uk/docs/referral_07_0.pdf

Our helpline is open Monday to Friday 9am-5pm and Saturdays 9am-2pm, please feel free to ring if you need further information or support on 0808 800 6000.

Kind regards
Sam
Moderator
Breast Cancer Care

Hi Puddleduck

I am sorry I can’t offer any comments on what you have experienced, but just wanted to say I hope you have an appointment soon. I think the waiting part is just terrible, so I hope you can distract yourself with whatever suits best - shopping, walking, talking - for me it was playing the piano!!

Everyone on here is so supportive and kind - it is a great resource.

Love Tinkers

Thanks for your messages.
I tried to read the “Referral to a breast clinic” link given in the first reply, but it wouldn’t open.

I’m mainly keeping busy through work, but it’s hard to stop my mind from going places other than where I want it to go. It seems never-ending. Within the last year I’ve had two operations for endometriosis (including two lots of surgery to remove multiple ovarian cysts with 3 months of each other) plus a horrible 6 months with a Mirena.
I wonder when I’ll see the light again.

Hi Puddleduck

If you don’t hear anything tomorrow then get on that phone first thing Monday morning, better still why don’t you do it this afternoon, at least then you will have the weekend to get your mind around it rather than worrying about it until Monday. Just keep pushing, the sooner things are sorted the sooner you can relax.

Love K

Thanks, Lucy!

I managed to see online booklet this time.
I have an appointment for next Friday.

Hi Puddleduck

That is good news that your appointment is for next Friday … lets hope that everything comes back OK for you.

Good luck and take care. Let us know how you are though.

Love
Dawn
x

great puddle, i,m sure you will find out why all this on fri i have my appt on fri too
love and support
cee

Thanks for your messages of support.

I had the appointment this morning.
Was examined by the consultant (who is from the Middle East and whose comprehension of English is patchy…I had to speak very slowly and repeat everything 4 or 5 times).
He can’t feel a lump, the skin has cleared from the steroidal cream and there was no discharge coming out today. He didn’t send me for an ultrasound, either.
It made the appointment seem a bit pointless, to be honest.
I’m too young for a mammogram (under 35).
I said I didn’t feel reassured without some sort of evidence there was nothing underlying this…so he went to get the breast care nurse, who examined me.

Then he started giving me statistics about why this is unlikely to be cancer because I have no relatives with breast cancer and I’m 31 and there’s no lump.

Truth is they need the actual discharge to see under a microscope…without it I won’t know either way. I still feel they ought to check what’s going on directly under the nipple, but I imagine the only way the can do that is via MRI or needle biopsy/something equally unpleasant.

He said I was “highly intelligent” and gave an "excellent history"and overall picture of the condition and seemed pleased. He’s also impressed I’m on natural progesterone…

The nurse spent a great deal of time trying to calm me down because I was anxious and apparently trembling. They’ve asked to see me in 6 weeks, but I’ve to go back immediately I have any blood/discharge from the nipple.
Apparently it’s not in the protocol for management of bloody nipple discharge/eczema to do an ultrasound or any other scan.

Is all this cricket?

It seems quite normal, but if you feel they are wrong, then you can seek a second opinion from another consultant.

If you haven’t already found this site, it is worth you having a look at it: breastspecialist.co.uk/nippledischarge.htm

With reference to your problem with the consultant, I have found that, however good their written English, non-native speaking consultants can come across more abrasively even than native English-speaking ones.

Thanks for your advice, Phoebe.
I took a look at the link you gave me in your message.

The picture of the yellow gunk looks surprisingly like what came out of my left nipple for 2 weeks last month before the bloody discharge began.

Hi Puddleduck

I had meant to post to you yesterday but had a day out with OH and time sort of rushed by in the evening.

I would like to back up what phoebe says, if you want a second opinion go for it. I was dx with an aggressive grade 3 tumour last August when I was 41, I had a mammo and USS and was duly diagnosed after many core biopsies.

What I wanted to say was that I was seen by the same surgeon in July 05 with a bi-lat nipple discharge, I was 40 at that time and I was sent across for a mammo which came back clear. Yet by the December of 05 I could feel a pea sized lump, I eventually saw my GP when the lump was cup’able’ in my hand that was in the April 06 and still obviously less than a year after my initial consultation, it was then at the end of August 06 I found out I had BC.

So you must follow your instincts, if you are not happy ask for a second opinion or ask to speak to the BCN again.

Good luck.

Lynn

Hello there,

Just to update you on this topic:
I had my follow-up appointment today.
The discharge hasn’t oozed for a few weeks. I’ve had a lot of itching of the left breast around the nipple but no eczema there at the moment. There has been pain, too (quite bad and using codeine at times 2-3 weeks ago) but nothing to feel or see.
I’m less worried about it now. Consultant suggested a referral back to dermatology, possibly to check whether there is Paget’s disease of breast, but I don’t see the need to see the skin specialist, since I can control my eczema reasonably well with prescribed steroidal creams and emollients, as well as other measures.

Thanks for your support.