Daily Column

DEAR DR. GOTT:
Your practical approach to treatment has been very attractive and helpful. Keep up the good work.

I’ve worked as a mammography technician since before it became a specialty, so I’ve had numerous opportunities to address issues and concerns. Recently a reader wrote concerning pain behind the breast. This is a common complaint, so common we no longer discuss it at conferences. One theory is that arthritis develops in the intercostal spaces and the pain radiates into the breast.

Many women seem to take comfort in this possibility and enjoy the peace of mind the knowledge brings when other possibilities have been ruled out.

DEAR READER:
Breast pain is common and affects as many as seven in ten women at some point in their lives. Symptoms are most common in pre-menopausal rather than in post-menopausal women. [Read more...]

Daily Column

DEAR DR. GOTT:
My wife has had breast cancer for two years. She had a lumpectomy on her right breast, followed by chemotherapy and radiation.

The only problem she has had since her treatment is burning and numbness in her feet and legs. I might add she is on her feet eight hours a day as a cashier. She never had these problems prior to her cancer. Her doctors don’t think it is neuropathy. We do have a couple of nerve centers in our area, but would like your recommendation as to the right physician to see for pain relief.

DEAR READER:
Unfortunately, breast cancer is the most common form of cancer among women. The good news is that it can be curable if discovered in its early stages.

Warning signs include breast lumps, thickening or swelling, skin dimpling, nipple retraction, or discharge. [Read more...]

Daily Column

DEAR DR. GOTT:
I would like for you to tell me what to do for this annoying problem I have with my right nipple.

I am a 75-year-old male in fairly good health. For the last three months, my right nipple has been very sore. Some days are worse than others. When I told my doctor about it, he said it is from the beer I drink. When I asked about the possibility of cancer, he said I didn’t have cancer because I didn’t have a lump.

Dr. Gott, I don’t think this is caused by beer. I drink about three days a week when I go to the local VFW and I only consume light beer. I don’t drink alcohol at home. My doctor claims it’s only caused by the beer and hasn’t given me any other possible cause.

I’m worried about this since it is only on one side and (to me) doesn’t appear to be related to alcohol.

DEAR READER:
As I have written before, men can develop breast cancer, especially if there is a strong family history of breast cancer, such as in your mother, sister, grandmother or aunt. It is especially worrisome if you have another male relative who was diagnosed with breast cancer. Because you do not give a family history, I do not know if there may be a genetic relation. Symptoms can include nipple discharge, a lump, swelling, tenderness and pain. Just because you do not have a palpable lump does not rule out cancer. I urge you to make an appointment with an internist (a diagnostic specialist) who can perform a breast exam and order appropriate testing such as a chest X-ray, mammogram or breast ultrasound. He or she may choose to order a CT scan or MRI which can provide more detailed images.

If your doctor is dismissing your fears without proper testing and examination, you should find another physician. I hope, for both your and your doctor’s sakes, that the cause of your breast pain is benign. The time wasted by your current physician in getting you proper testing could make the difference in detecting disease in its early stages and necessitating minor treatment and finding advanced disease that needs extensive and powerful medications and possibly surgery.

It is ALWAYS important to follow-up on a patient’s health concerns, even if they are something the doctor feels are minor. It is the doctor’s job to make the patient feel comfortable and that includes answering any questions. Your doctor has completely failed you in this respect. You need to find a physician who is kind, respectful and willing to sit down to discuss health concerns with you. Good luck. Don’t delay any longer in getting the testing you need.

To give you related information, I am sending you copies of my Health Reports “Breast Cancer and Disorders” and “Choosing a Physician”. Other readers who would like copies should send a self-addressed, stamped number 10 envelope and $2 per report to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title(s).

Daily Column

DEAR DR. GOTT:
I am an 82-year-old woman. I have a very puzzling problem.
Since June 2007, I have had a small amount of drainage from my right breast. I saw a breast surgeon who took a sample and ordered a blood analysis. I was told unless there was blood in the fluid, there was only about a ten percent chance that the drainage was caused by cancer.

I have a strong family history of cancer so the specialist suggested I have a biopsy. He said it would be a painful process. He also gave me the option of wait-and-see.

I have not done anything yet but wonder if I should. The surgeon told me he thought the drainage was from a milk duct abnormality. What is your opinion?

DEAR READER:
Any breast drainage is a red flag warning of possible cancer. Your breast surgeon is, in my view, somewhat correct that a biopsy is an appropriate step, however I suggest you first explore non-invasive techniques, such as mammogram and breast ultrasound. In this way, the surgeon would be able to visualize the mammary glands (milk ducts) as well as the rest of the breast. These procedures should show any abnormalities.

I would just like to mention that I am unsure how your breast surgeon would know where to do a biopsy unless he has already done imaging studies. This would be like throwing a dart at a target but only knowing what wall the target is on. Chances are, if something is present, it would be missed.

Because you have a strong family history of cancer, the drainage is persistent and you have delayed for nearly a year, I urge you to have the imaging studies. Further testing and possible treatment can then be based on those findings. Don’t delay any longer. Breast cancer can be cured if caught in the early stages. There is always a likely chance that the drainage is benign but without evaluation, there is no way to tell.

To give you related information, I am sending you a copy of my Health Report “Breast Cancer and Disorders”. Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Daily Column

DEAR DR. GOTT:
I am a 28-year-old woman in good health. In a recent column you addressed changes of the breast. This really hit home for me. For the last few years my nipples emit a clear to cloudy discharged when gently squeezed. Is this normal? Should I be concerned about cancer?

DEAR READER:
As I have repeatedly emphasized in the past, any breast abnormality, including nipple discharge, should be evaluated. Your physician or gynecologist should perform a careful examination along with a mammogram or ultrasound and other tests such as a microscopic examination of the breast fluid. I cannot predict the findings but this approach is appropriate.

To give you related information, I am sending you a copy of my Health Report “Breast Cancer and Disorders”. Other readers who would like a copy should send a self-addressed, stamped number 10 envelope and $2 to Newsletter, PO Box 167, Wickliffe, OH 44092. Be sure to mention the title.