DD14 with non-blanching breast rash and swollen lymph node, would you seek review?

[RashyRashRash]

My DD14 has a non blanching rash on her breast. It’s developed over a few days. I initially thought heat rash but as it’s spread I’ve realised it wasn’t and was non blanching.

In addition to this she’s had fluid filled lumps under her arm pit on and off for the last 18 months or so. Ultra sound last year said they were nothing to worry about.

In addition to the rash that arm pit is very swollen. The rash itself is not sore or itchy. The arm pit is very tender to touch.

We went to the GP this morning who referred her down to a&e.

A&E doc requested bloods and also said she wanted to surgical team to look at the fluid under her arm pit as it was a lump of around 4cm long. Surgeon came and said that’s not a lump that’s a swollen lymph node, I don’t know why she’s asked for me.

Bloods all came back fine, so we’ve been told an infected lymph node and given 10 days antibiotics and sent on our way.

I just can’t shake the feeling that the rash isn’t consistent with that and does the lymph node actually get infected or does it fight infection?

Yes. I would absolutely go back either to the GP and ask for an urgent referral for ultrasound or back to A&E to ask for the same. Hope she’s ok xx

I don't have any medical knowledge so have no idea if that sounds like a vakid reason for your dd's symptoms but I too would feel really worried. Ten days feels a long time to wait for antibiotics to work. I know nothing medical but does she have any sign of infection e.g. temperature or blood results?

Did you see a paediatric consultant? I would push the gp to get an urgent referral to paeds for your dd. A surgeon dismissively isn't good enough.

No standard signs of infection ie no temp or blood markers.

She has said she has a headache and chest pain, they said the chest pain was because the whole area was inflamed.

Rash on breast can be inflammatory breast cancer. Though BC in such young girks seems like its 1 in millions so.dont know.

Antibiotics generally start working pretty quickly

I don’t know specifically who we saw, there was an a&e doctor we saw first and then the general surgeon.

They obviously had different opinions on the lump.

I would think this would be super rare but I had read this too.

Anyone with a medical background got an opinion?

How is she? Is there a temperature? Is the rash improving? I'd monitor and go back to a and if she doesn't improve.

No temp yesterday (she’s still in bed today), the rash had spread more last night but as she had only just started the antibiotics I would expect that until they kick in. I think we will monitor until she’s had a day or two of antibiotics and see how she is.

In the photo it looks like her nipple is also inverted, that’s another symptom of inflammatory breast cancer. I’d would be going to A&E every day demanding an oncologist. I’d even book a private MRI. Yes it is ultra rare in girls that young, but it does happen.

And yes the inflammatory breast cancer does cause a rash and a swollen lymph node in the armpit on the same side as the breast with the rash.

If she had some bacterial infection, there would be more lymph nodes swollen around her body because it’s impossible for this to be mastitis which is infection of 1 breast due to breast feeding complications.

I would be referring you to the breast clinic urgently. It's really unusual to get this in a 14 year old. I'd get back to your GP today and get the referral on the way. If it were to get completely better with antibiotics that would be good but I'd still want an opinion.

Apologies if you've done this already OP but I'd be looking for the hospital's Martha's Rule number and pressing for an urgent review. https://www.england.nhs.uk/patient-safety/marthas-rule/

Looks like the rash my mum gets when it’s been hot and she chafes

That was my original thought when she first showed me a few days ago but it’s non blanching, spreading and not itchy or sore, and only on one breast so feels much less likely now.

Check your hospital trust's website to see if you can self-refer to the breast clinic.

Thank you

I can’t see any changes to her nipple. I think on the photo it’s a shadow from the glass (I purposely avoided including the nipple so I could share the photo).

No I haven’t, I will look at this thanks.

Hopefully it is nothing serious, but with those symptoms I would want the possibility of inflammatory breast cancer to be investigated. Don't take no for an answer. Some doctors think that teenagers can't possibly have cancer because they are so young. The fact is, it is highly unlikely but not impossible and it is the 'not impossible' part that should be focused on in this situation.