Based on your history and ultrasound findings, your symptoms are most suggestive of fibroadenosis (fibrocystic breast changes). This is a benign (non-cancerous) condition and is a common cause of breast pain in young women. A reactive axillary lymph node on ultrasound is usually seen in response to inflammation and is generally not a cause for concern if the ultrasound features are benign. Breast pain can sometimes be significant in fibroadenosis and may worsen around the menstrual cycle. Wearing a well-fitted, supportive bra usually helps reduce discomfort. Vitamin E and other supplements may provide relief in some patients, although the benefit varies. Simple analgesics such as paracetamol or NSAIDs (if not contraindicated) may be used for pain relief as advised by your treating doctor.

Based on your description and ultrasound findings, a painful, movable breast lump with a reactive axillary lymph node is more suggestive of a benign breast condition such as fibroadenosis/fibrocystic changes rather than cancer. Reactive lymph nodes are commonly seen with inflammation and are usually not worrisome. Pain can be significant in fibroadenosis, especially around the menstrual cycle. Continue the prescribed medications and wear a well-fitting supportive bra to reduce discomfort. If the pain is severe, your doctor may prescribe an anti-inflammatory pain reliever after assessing you.

You would require re-evaluation of the condition. Please consult a general surgeon, or if possible an onco-surgeon. Detailed examination and specific investigations are required to diagnose and treat your condition.

Your ultrasound findings of a reactive axillary lymph node are generally reassuring and are commonly seen with inflammation or infection rather than cancer. At your age, fibroadenosis (fibrocystic breast changes) is also a common cause of breast pain and tenderness. However, severe pain that is affecting your daily activities is not normal and deserves re-evaluation. I recommend consulting a surgeon for a detailed breast examination and review of your ultrasound. Occasionally, additional imaging or further evaluation may be required if symptoms persist or worsen. In the meantime, wearing a well-fitting, supportive bra may help reduce discomfort. Seek prompt medical attention if you notice a rapidly enlarging lump, skin changes, nipple discharge (especially bloody), fever, or redness of the breast. This evaluation will help determine the exact cause of your pain and the most appropriate treatment.