I'm a 23 year-old female with a painful hard vein in my armpit. why could this be and what can i do about it? could this have to do with breastfeeding even though the painful vein is a good distance from the breasts?

Clots : Clots in the veins of the arms can be seen in a variety of circumstances, but in an otherwise healthy young person with no history of having central vein catheter placement of other procedures, the fist diagnosis to consider is paget-schroetter syndrome. This is a condition in which there is a blockage of the central veins by an extra rib, a band of muscle, or other anatomic structure that causes the blood to flow so slowly that it clots. Initial treatment for paget-schroetter is with blood thinners or a procedure called thrombolysis. If you are breastfeeding now, that may impact your treatment options. Your doctor will probably also check your blood clotting function to make sure you are not prone to clot formation. If you are taking birth control pills, this will increase your likelihood of getting clots.

In : In a patient who is actively breast feading a palpable lump or cord can be indicative of a clogged duct. This condition is treatable by your physician or lactation consultant. However, if there is an identifiable "vein", your assessment may be correct. Regardless, you should report this to your primary doctor or your ob/gyn physician. Depending on their assessment, an ultrasound can be very helpful to futher evaluate whether it is a vascular issue or breast duct issue.

As : As mentioned above Paget schroeder's disease, often called "effort vein thrombosis" is often found in people with a lot of overhead arm exercise such as baseball pitchers but this effects the deep vein called the axillary vein. Pregnancy itself is linked to a normal increase in clotting factors and this helps to normally control post partum bleeding after delivery. Mondors disease may be a more likely diagnosis in your case. First described in detail by henri mondor in 1939, this condition is a rare entity characterized by a sclerosing thrombophlebitis of the subcutaneous veins of the anterior chest wall (superior epigastric vein) and also effect the veins in the axilla and lateral chest wall (lateral throacic and thoracoepigastric veins). It is characterized by the sudden appearance of a subcutaneous cord, which is initially red and tender and subsequently becomes a painless, tough, fibrous band that is accompanied by tension and skin retraction. The condition is usually benign and self-limited and will resolve with anti inflammatory medicines. Your ob-gyn should be familiar with this condition and of course any medicine you take may effect your breast milk and your infant, so please consult with your doctor and do not take medicines on your own while you are actively breast feeding. It is important to realize that the resulting inflammatory condition may effect the future interpretation of your mammograms and this history should be told to the radiologist when they are interpreting your films. As mentioned above, a coagulation profile (thrombophilia panel) is indicated to see if you have an known condition which predisposes you to clotting disorders. Recent advances in superficial thrombophlebitis (svt) have shown that abnormalities such as lp(a) and , methylenetetrahydrofolate reductase (mthfr) polymorphisms at c677t and a1298c genetically predisposes its carriers to svt which may contribute to hypercoagulation in pre-existing varicose vein disease.