TMI Friday: Discount Silicon Implants

This weeks unfortunate tale revolves around a 26 year old woman who turned up to Addenbrookes hospital, Cambridge in 1975 with a peculiar condition. The woman reported that for around 6 months , she had been bleeding out of her left nipple. To quote the doctors :

On examination she looked extremely pale and was breathless on exertion. The left side of her brassiere was full of clotted blood. The right breast was normal, but on the left side the nipple was excoriated and was oozing bright blood from several areas.

The woman needed to be transfused with 4 units (~2 litres-ish) of blood to keep her conscious. The doctors then looked for cancerous lumps. When they couldn't feel lumps, they cut out the whole damaged left nipple. This allowed them to sow up the wound, and stop the bleeding. But the question remained, what was causing the bleeding ?

So they analysed the nipple under a microscope, and find out what was making it bleed so much. The doctors found that the nipple had been subjected to a lot of trauma, over s long period of time.

 The patient may have been suffering from "Dermatitis artefacta". This is a disorder that occurs when patients excessively scratch or irritate their skin. Sufferers of this disorder seek out medical attention out of some subconscious need. But that isn't the weirdest part of the story. 

The story gets weird one month later when the patient returned, complaining of a painful lump in her left breast. Maybe the physicians were wrong. Perhaps they had misdiagnosed this patient, and she had cancer after all. The wound from the nipple excision had not fully healed and was spewing a disgusting yellow pus. 

The left breast had become heavier than the right one. 

They took an X-ray,  revealing a large calcified mass (shown above). Calcified masses can develop in the breast as a result of cancer. Irritated tissues accumulate calcium to create hard lumps which show up in white on X-rays. But usually, these lumps are very small. The calcified lumps on this woman's X-ray were massive in comparison.

So the decision was made. They needed to operate. The surgeons cut open the breast at the position just above the lumps, and found something very odd. These lumps were not what the surgeons thought they were.

One by one, the surgeons pulled out approximately fifty stones, mixed together with sand and gravel, which had apparently been inserted into the initial biopsy wound.

Upon being confronted with this incongruity, the patient did what I imagine many patients featuring in TMI Friday would do if they had the chance. She discharged herself from the hospital, offering no explanation as to what occurred and why.

Sampson D. (1975). An unusual self-inflicted injury of the breast, Postgraduate Medical Journal, 51 (592) 116-118. DOI: 10.1136/pgmj.51.592.116