My boob exploded on the morning of April 23. I was engaged in light aerobic exercise. I raised my arms above my head, and my husband said, “You have a big wet spot on your shirt, right over your left boob. Something’s wrong.”
I remembered my attitude adjustment and said, “I want to finish what I’m doing. I’ll look at it later. The abscess probably exploded. It won’t kill me, and it doesn’t really hurt much.” I’d been expecting this, so I was calm. The new abscess on the lower part of my boob had been growing, and the skin was weak at the biopsy incision site. It had started hurting and feeling tight. I took five minutes to finish before I took off my t-shirt and sports bra to check.
Yup. It exploded all right. Just like a volcano. Popped, burst, erupted. The incision site opened up and a thick gob of greenish-yellowish-beige pus made its way down my lower boob over my ribs. I should have filmed it and put it on YouTube. It would have gone viral! Gross. I grabbed some tissue to catch the flow, and ended up filling four tissues with freely flowing goop. When the flow slowed down, I decided that if my body didn’t want that gunk, I should help it out. Better out than in. I pulled and pushed at different angles and squeezed gently around the hard lump. This filled two more tissues. Then I figured it was best to let it all out, so I pushed a little harder until only a clear, serous fluid came out (and filled another tissue). When that stopped, there was only a clear drop left in this new opening on my boob. I took a shower, disinfected the area, and applied some heavy-duty band-aids. Dear hubby suggested I buy nursing pads.
This kind of pus is called aseptic pus. It is not the result of infection. It does not even smell bad. I’ve been taking doxycycline for over a month, so I am not particularly concerned about infection. I read the results of my latest four-tissue-sample biopsy. There is necrotic tissue in the hard lump in my boob. Necrotic, as in dead. I assume that this pus build-up is the result of white blood cells doing their job. Macrophages, to be more precise.
“Macrophages (and their precursors, monocytes) are the ‘big eaters’ of the immune system. These cells reside in every tissue of the body, albeit in different guises — such as microglia, Kupffer cells and osteoclasts — where they engulf apoptotic cells and pathogens and produce immune effector molecules. Upon tissue damage or infection, monocytes are rapidly recruited to the tissue, where they differentiate into tissue macrophages. Macrophages are remarkably plastic and can change their functional phenotype depending on the environmental cues they receive. Through their ability to clear pathogens and instruct other immune cells, these cells have a central role in protecting the host but also contribute to the pathogenesis of inflammatory and degenerative diseases.” (http://www.nature.com/nri/focus/macrophages/index.html)
Apoptosis is programmed cell death, so apoptotic cells are dead cells. They have to be cleaned up, and macrophages are the cellular cleaning crew. Now, if I have necrotic tissue in my breast, it means I have a whole bunch of dead cells, although they probably did not die their programmed death, but an untimely and sinister death. Incidentally, cancer occurs when apoptosis fails. (This is the super simple explanation.) Autoimmunity can be seen as the opposite of cancer. In cancer, the immune system slacks off and doesn’t kill cells that go rogue. In autoimmunity, the immune system goes rogue and kills perfectly innocent cells.
So, all this pus is most likely the result of macrophages gobbling up and liquefying the necrotic tissue. It could also be the result of macrophages destroying healthy breast tissue, but I’d like to think that my immune system would at least have the decency to try to get rid of the dead cells. Considering this build-up started when I reduced the prednisone dose, it could go either way. The word ‘macrophage’ kept running through the mind to the tune of ‘Jingle Bells’ while I dealt with this. Macrophage, macrophage, macro, macrophage… Why, oh why, did I pay attention in biology class? Why?
The most important thing about The Morning My Boob Exploded is that I did not let myself freak out. I chose to see the humor in the situation. I mean, when you think about it, it’s kind of funny. My hubby suggested I call the doctor, but I didn’t. I had just seen my GP the day before, and I was going to see the boob doc the following day. This could wait one day. Besides, I had to work at the hospital, and going to the doctor would leave me too wiped out to do my job calmly. I embrace my New Normal, and if this involves intermittent miniature volcanic eruptions from my boob, I will find a way to laugh about it.