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Q. Though I got BIRADS-1 on the breast ultrasound, I have pain in the breast with blisters. Why?

Answered by
Dr. Shama Naaz
and medically reviewed by Dr. K Shobana
This is a premium question & answer published on Nov 14, 2021

Hi doctor,

I am a 38-year-old female. I got an all-clear BIRADS-1 on the breast ultrasound taken before 40 days. I got a pain in the outer bottom edge of my right breast before seven days. It became a burning pain that remained focused on that area. I thought that it was related to my cycles which were also seven days away. Three days back, I found a red spot on that area and also on my torso below the breast. I thought that it was due to some allergic reaction to the pain gel applied to it. Yesterday, when I wore my bra, I got severe painful itching. When I saw that area, there was a line of four more red blisters. The itching got subsided but that area was burning with slight pain. My gynecologist says that it is herpes zoster. Does this look like herpes zoster or something like inflammatory breast cancer?

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#

Hi,

Welcome to icliniq.com.

Please answer the following questions, which will give an idea regarding the nature of the illness. Please mention whether the skin lesions look like fluid-filled blisters. Please mention whether the burning pain radiates towards the back. Please mention whether you took any new medications before the onset of burning pain. If possible, please send a focused picture preferably with flash.


The Probable causes:

You seem to have herpes or any allergic reaction.

Thank you doctor,

I am not sure whether they are fluid-filled. But they look like red dots. I also have pain in my ribs, back and do not feel much in the breast tissue. I did not take any new medication except Avomine medicine a day and Melatonin for two days. I have attached a close-up.

#

Hi,

Welcome back to icliniq.com.

You should worry about inflammatory breast cancer because it usually remains associated with stage 3 or 4 breast cancer with swelling and redness of the breast. Your breast ultrasound shows BIRADS-1. The likelihood of malignancy with a BIRADS-1 classification is essentially zero percent and the recommended management for the patient is to continue with routine mammography screening. According to your history and clinical photographs, it looks like miliaria rubra (heat rash). It is caused due to blocked sweat duct. It also occurs due to heat and sweat. If you have already started taking Acyclovir, you can continue it, though the lesions are not classical herpes zoster and the chances of postherpetic neuralgia without acyclovir is high. You can apply cold compresses, avoid tight-fitting clothing, keep the area dry, use a soft towel or cloth, do not rub the area, and apply Allsuth or Acnid lotion (Calamine) twice daily.


The Probable causes:

It occurs due to heat.

Investigations to be done:

It needs investigation by doing dermoscopy.

Differential diagnosis:

You may have herpes zoster.

Regarding follow up:

Have a follow-up after a week.


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