Nipple pain, doctor dismissive

When I talk to doctors, I try to use words that are meaningful to them. I think doctors may often experience interactions with patients - that if they just reassure them that nothing is wrong, the patient goes away happy, and it’s taken care of. And sometimes that is true. Sometimes.

If a doctor has been dismissive about a problem, they might revisit the concern if they are helped to understand how the lack of a diagnosis, or no improvement in the problem, is affecting life.

If it were me, and my understanding of your situation, this is what I’d say to the doctor:

The nipple pain and transient heat and pain in my breast has not gone away
We tried ______ topical meds, and there were no changes.
What is causing this? Is there a diagnosis?
If it were hormonal, wouldn’t it affect both breasts?
Did the mammogram show fibrocystic disease?
Are my inflammatory markers high, meaning it might be an infection?
Are my breasts dense, can this be masking another issue?
I’m worried that this may affect my life . . .
(are there ways that this is affecting you, even in small ways?)
Example:
I’ve adjusted some of my exercise, I do less
I worry about this, and it keeps my stomach churning
I feel anxious about this every day
I haven’t been getting as many tasks completed because of worry
(A doctor should be concerned if an issue is negatively affecting other parts of your health. They should want to prevent new problems that arise from the first issue.)

I’d again ask for the diagnosis, and what is the next step since the topical meds didn’t work.
Ask “would you expect the nipple pain, breast heat, to still be present in 6 months? 1 year? 3 years?”
Would I different type of scan show more detail? What about an ultrasound of the nipple area? What about a MRI?

Note to you: I would also be careful what you ask for. I’ve realized if I ask too much I might end up on a less preferred med to the statin I was on, be prescribed an anti-depressive, or suggested anxiety or sleep med. If you’re not comfortable with a MRI or engaging in further tests, then don’t bring them up.

Hello @rjl1955 I would add another thought to all the ideas that Ruby slippers gave.
If this were me, I would ask for a referral to an OB/GYN, preferably a female one. If it is something minor, this would ease my mind. These doctors deal with breasts all day long.
Hoping for some answers for you tomorrow.

Just to add to what others have commented, if your current doctor is not responsive to the aforementioned questions and discussion, I would quickly get a second opinion, including from an OBGYN. Also, anyone over the age of 45 is no longer being scheduled 2 years out from mammograms, some depending on whether they have dense breast tissue or not, are being scheduled every 6 months. If you don't have DBT, your normal mammogram frequency should probably be 12 months to 24 until you are 75. However based on what you said I would worry a good deal more about infection because heat and pain generally indicate there is an infection present and I would expect any doctor to put me on antibiotics immediately if heat and pain are present in tissue. Best wishes!

I'm no expert by any means; I'm only going from my experiences but the redness and heat suggest an infection to me. If that is the case, the least you would need is antibiotics. If what they are telling you doesn't feel right, keep pursuing it. You are your own best patient advocate. Best wishes.🦋

Try to find a breast surgeon that specializes in breast cancer. My BC presented as cellulitis of the breast. Had pain in my right breast and 2 days later I had a very swollen breast, red, hot, underneath look bruised blue and purple. It was treated by infectious disease and my breast surgeon (I had already had benign tumors removed) and she kept me in her office for about 4 hours because mammo and ultra didn't show anything. She called in another doctor. Nothing. A year to almost the day, cellulitis was back. I knew what it was, went to infectious disease and she said I would be fine I caught the cellulitis early. But she also sent the report to my breast surgeon. The office called the next morning, told me I needed to come in immediately. I didn't want to go because it was an infection and it wasn't as bad as the prior year. She insisted. I went and that day and was diagnosed. If she wasn't so vigilant, I wouldn't have gone back for 6 months or more for my next mammo. So she caught it early stage and good thing because it was a very aggressive cancer. That's was 10 years ago. Research your drs. And find a breast surgeon. Hope this helps.