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Dr. Phil, MD
Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 54833
Experience:  GP in the United States
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Hello Six years ago I had a partial vulvectomy due to vulval

Resolved Question:

Hello
Six years ago I had a partial vulvectomy due to vulval cancer, I have been fine until recently. I do not know if it is my imagination but I have been very itchy in that area ( I cannot bear to look, but don't think there is any kind of sore). Now my left nipple is incredibly painful and there is a little area that is kind of 'sunken' and flatish ( not the whole nipple inverted) . I do not know what is just being overreactive and what is worth concern. I have not visited a doctor in ages, so I know I am not a panicker! Would appreciate some advice and possible answers.

Many thanks Nikki
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Phil, MD replied 3 years ago.

Dr. Phil, MD :

Hello. I'm Dr. Phil, licensed and practicing internist. Excellent service is my goal.

Dr. Phil, MD :

please enter chat

Dr. Phil, MD :

Hi I'm Dr. Phil

Dr. Phil, MD :

Nice to meet you Nikki

Customer:

Hello Dr. Phil

Dr. Phil, MD :

Did you have an chemo or radiation?

Customer:

Did you get my message about what is concerning me?

Dr. Phil, MD :

Yes, I did

Dr. Phil, MD :

Did you have any chemo or radiation with your cancer?

Customer:

No , I just had the partial vulvectomy and they removed the whole lump and I cannot remember how many lymph nodes, but they were negative.

Dr. Phil, MD :

when was the last time you had an exam?

Dr. Phil, MD :

Are you sexually active?

Customer:

Just over a year ago

Dr. Phil, MD :

sexually active?

Customer:

Yes, I am married

Dr. Phil, MD :

mammogtam?

Dr. Phil, MD :

gram

Customer:

Sorry to add to the last bit, sex is painful despite using lubricant ( but I think I may have reached menopause, I had a hysterectomy 22 years ago because of numerous CIN 111's and bad endometriosis so `I do not know whether I am fully menopausal Sorry, a bit involved

Dr. Phil, MD :

no problem

Dr. Phil, MD :

mammogram?

Customer:

last mammogram was 18months to 2 years ago and was fine

Dr. Phil, MD :

okay

Dr. Phil, MD :

I really think this is nothing

Dr. Phil, MD :

of course you need an exam but the itching is likely atrophic vaginitis or lack of estrogen as you said associated with menopause

Dr. Phil, MD :

you need a pelvic exam with your history and a mammogram but I think you are okay

Customer:

that would be good, but could you give me some idea of what the nipple pain is as it is really sore and as I said a flat in the middle of the nipple, a little fluid came out today

Dr. Phil, MD :

that is more concerning

Dr. Phil, MD :

it could be something like a cyst or blocked duct

Dr. Phil, MD :

but you need a mammogram to be sure

Dr. Phil, MD :

nipple changes can be the first sign of cancer.

Customer:

that of course is my worry, as I said I am not a person who panics easily but I read about a benign infection is there something I can do to see if a self administered treatment will help before I visit the doc ( I am a bit doctor phobic) sorry, nothing personal

Dr. Phil, MD :

no problem :)

Dr. Phil, MD :

Get in though

Dr. Phil, MD :

you need it checked Nikki

Customer:

Thank you, XXXXX XXXXX know of a site where I can view pictures of things to worry about so I can compare my nipple to what is considered normal?

Dr. Phil, MD :

http://www.breastcancer.org/pictures

Dr. Phil, MD :

please don't forget an excellent rating for me.

Dr. Phil, MD :

I appreciate it and good luck to you Nikki :)

Dr. Phil, MD :

you all set Nikki?

Dr. Phil, MD :

Need any more help?

Customer:

No, thanks for that, will leave an excellent rating!

Dr. Phil, MD, Board Certified Physician
Category: Medical
Satisfied Customers: 54833
Experience: GP in the United States
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