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- $Unique_ID{BRK01139}
- $Pretitle{}
- $Title{How Can Doctors Tell What's Wrong Without an Accurate Test?}
- $Subject{special procedure procedures breast breasts mammography mammographies
- lump lumps benign cancerous cancer cancers diaphanogrophy diaphanographies
- cyst cysts biopsy biopsies laboratory lab test tests}
- $Volume{P-19}
- $Log{
- Excisional and Endoscopic Biopsy*0001902.scf
- Aspiration Biopsy*0001905.scf}
-
- Copyright (c) 1991-92,1993 Tribune Media Services, Inc.
-
-
- How Can Doctors Tell What's Wrong Without an Accurate Test?
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-
- QUESTION: I am a 29 year old woman. I recently found a lump in my breast and
- visited my doctor, who said it could be a cyst. However, he refused to do a
- mammogram. Another doctor who I visited for a second opinion also refused to
- do a mammogram, saying I was too young and that it was probably a cyst. My
- question is this--how can doctors tell you what's wrong without an accurate
- test? I am concerned because my mother had breast cancer and died.
-
- ------------------------------------------------------------------------------
-
- ANSWER: While I understand your anxiety and can sense your frustration, I can
- only hope that the information I will provide you here will help you
- understand what is going on. To start with, most breast lumps are benign;
- that is, they are not cancerous. In addition, cancer of the breast in a woman
- under the age of thirty is rare. You were certainly correct in consulting
- your doctor when you discovered your lump, but his examination, including an
- inspection and palpation, provided him with a great deal of information about
- your lump, its size and texture, and whether or not it was freely movable
- under the skin. By shining a bright light through the breast
- (diaphanogrophy), it is possible to tell whether the lump is filled with a
- clear fluid, as in the case of a cyst. And a fluid filled cyst is not a
- cancer. While the combination of a physical examination and mammography can
- detect the presence of a cancer in about 97% of the cases, only a biopsy can
- really tell if the tissue is cancerous or not. A biopsy is the surgical
- removal of the lump, followed by a careful microscopic examination of the
- tissue. Your statement that two physicians have examined this lump and not
- permitted a mammography leads me to the conclusion that the lump was small and
- freely movable, probably had the consistency of a cyst, and was filled with
- fluid when examined with a light. That's very good evidence that it is not
- cancer, and that the mammography would show little other evidence that could
- either help make or change the diagnosis. Since your family history tells of
- your mother and her disease, it is clear that you will have to continue to be
- checked on a regular basis for any changes, but for now I think you safe
- enough without the unneeded mammography. All that said, and being perfectly
- correct from a strict medical perspective, if I felt your anxiety was
- affecting you too intensely, I would probably order the test for you.
-
- ----------------
-
- The material contained here is "FOR INFORMATION ONLY" and should not replace
- the counsel and advice of your personal physician. Promptly consulting your
- doctor is the best path to a quick and successful resolution of any medical
- problem.
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