$Unique_ID{BRK01139}
$Pretitle{Skin and Subcutaneous Tissue}
$Title{How Can Doctors Tell What's Wrong Without an Accurate Test?}
$Subject{breast mammography}
$Volume{L-19}
$Log{}

Copyright (c) 1991   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.

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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 with out
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.
ÿ
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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.
