Is Tamoxifen linked with memory loss?

DEAR DR. GOTT: I am hoping that since there seems to be almost an epidemic of breast cancer diagnoses and now plenty of women are taking the drug Tamoxifen, that you can address an issue. I browsed your topics online and didn’t find anything about it.

I was diagnosed and treated for invasive breast cancer (small and no lymph node involvement) late 2010. I am 52 years old and at the time wasn’t experiencing menopause. After a lumpectomy and approximately seven weeks of radiation, I am hoping this is all behind me. In March 2011, I started taking Tamoxifen, which I understand is protocol for non-menopausal women and I will continue to take it daily for five years. I have read and talked to my doctors about some of the side effects, such as hot flashes and leg cramps. The hot flashes have come, as has (it seems) menopause. [Read more...]

Should oncologist continue monitoring?

DEAR DR. GOTT: I was diagnosed with early breast cancer in 2004. I was treated as if it was non-invasive since the cancer in my lymph nodes was detected by the “new testing method”. The oncologist said that under the prior testing method it would not have been detected. It was a small tumor that was hormone-receptor positive. After chemo and radiation I took tamoxifen for two and a half years, then arimidex for two and a half years.

After those five years I was “released” from the hematology oncologist. Since then I see my radiation oncologist once a year. Several friends, treated by different hematology oncologists, are still seen by their oncologist and have never returned to the radiation oncologist. I have been questioned by two different PCPs, a bone specialist, and my gynecologist as to why I don’t return to the [Read more...]

Are breast thermograms better?

DEAR DR. GOTT: I would like to know if breast thermograms are as reliable as mammograms in detecting cancer.

DEAR READER: Thermography utilizes an infrared camera to produce images that reveal a pattern of heat and blood flow on or near the surfaces of the body. The process is painless, non-invasive and relatively inexpensive. Although the FDA gave safety approval in 2004, in June 2011 it issued a safety communication notifying consumers that thermography is not a replacement for screening mammography and that on its own is not an effective screening tool. Proponents feel the procedure can detect precancerous inflammatory changes and cancerous tumors up to 10 years earlier than routine mammography. Despite the accolades of some and the fact that the process has been used for almost 50 years, it has never been accepted as clinically useful by many medical professionals, [Read more...]

Gott article saved life

DEAR DR. GOTT: In 2005 I read one of your articles about a woman who had an indentation in one of her breasts and her doctor told her it was okay and no to worry about it. You told her to go immediately to another doctor as an indentation in a breast could be an indication of a problem.

On that day I really looked at my breasts in the mirror and saw an indentation in the left one. To make a long story short, I was diagnosed with stage 1 invasive ductal carcinoma. I had surgery, radiation and chemotherapy. I am now cancer free six years later.
[Read more...]

If concerns remain, get a second opinion

DEAR DR. GOTT: I had a mammogram and they said they saw a nodule and called me back in to do more views. They said without doing an ultrasound, it was a lymph node and that I don’t have to go back for a year. Does this sound normal?

DEAR READER: Unfortunately, you failed to tell me your age because the guidelines for mammography have changed, depending on the source you rely upon. Other important issues include your family history, breast density, use of birth control pills, and more. I will generalize and hopefully will answer your question.
[Read more...]

Conflicting advice over treating tumor

DEAR DR. GOTT: I’m 88 years old and have developed a breast tumor. One doctor wants to do a mastectomy, but another who knows I have carotid-artery disease and is treating me for it advises not to have the surgery but to take Arimidex to try to shrink the tumor.

I value your answer because I read your articles constantly. I feel confused but am an active person who still drives, cooks, and takes care of myself. I’ll wait for a reply in the paper. Thank you.

DEAR READER: I completely understand where each physician is coming from and why you have received two conflicting recommendations. Let’s address the issue of your breast tumor first. Because your doctor (I am assuming an oncologist) wants to perform a mastectomy, he has apparently determined that you have a malignant tumor. [Read more...]

Fibrocystic breast pain can be treated

DEAR DR. GOTT: I am a 37-year-old female. I have been told that I have fibrocystic breast tissue (in both breasts). This is an extremely painful condition, but I was told that nothing could be done for it. The pain has gotten so bad that there are days I can hardly stand it. It has become a problem between my husband and me. Is there anything you can tell me about this condition? Is there anything I can do about the pain? I have had mammograms, and nothing was found. I can’t stand it anymore!

DEAR READER: Fibrocystic breasts are fairly common, with more than half of all women experiencing fibrocystic changes within their lifetimes. These changes involve the development of cysts, the overgrowth of cells lining the milk ducts (hyperplasia) or the milk-producing tissues (lobules), scar-like tissue (fibrosis) and enlarged breast lobules.
[Read more...]

Daily Column

DEAR DR. GOTT:
I had a mastectomy at the end of 2005. The drain was removed 30 days later. Following that, I developed a seroma. Subsequently, I had to have it drained about every three weeks. Then in March 2006 I had a pulmonary embolism and was put on warfarin. I was advised at that time I had to continue it indefinitely because of a personal history of superficial phlebitis and family history of related conditions.

To date I still have a seroma which must be drained once a month and now my surgeon wants to do another surgery to see what is wrong. Have you ever heard of this problem?

DEAR READER:
A seroma is simply a build-up of fluid that usually follows surgery, especially mastectomy (breast removal). In most cases it disappears on its own. Some seromas may need to be drained, occasionally more than once. [Read more...]

Sunday Column

DEAR DR. GOTT:
I read your column faithfully and find it very helpful and interesting is so many ways for both my family and me. I am an 84-year-old female in very good health. I had stage II breast cancer followed by breast removal 16 years ago. I was on tamoxifen for five years but never had chemotherapy or radiation. I continue to have yearly mammograms and so far, everything has been good.

I used to be a competitive racewalker, competing locally and nationally with the Senior Olympics. I received numerous medals in both levels but had to give it up to take care of my husband about 10 years ago. I continue to racewalk on my own. I was treated for leg and back pain while doing this competitively.

I am writing for you opinion on two issues. The first is treatment of meralgia paresthetica. [Read more...]

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...]