DEAR DR. DONOHUE: I am 20 and need your help. I felt a lump in my right breast. I told a friend about this, and she said breast cancer never happens to anyone my age. If that’s the case, I am relieved. If it’s not the case, what should I do? How can you tell a cancer lump from one that isn’t cancer? This is on my mind all the time. — L.G.
ANSWER: Breast cancer does happen to young women. It’s often said that it does not, but that’s misinformation. It’s true that breast cancer is more prevalent at older ages and that the risk for it increases the longer a woman lives. So someone your age is less likely to have it, but youth doesn’t make you immune to it.
Size, how the lump feels and whether it is tightly fixed in place are some of the qualities that sway a doctor into judging a lump as being cancerous. Cancer lumps are hard. They’re firmly anchored to the tissue beneath them; you can’t move the lump. Cancer lumps have irregular borders. Frequently, the overlying skin of a cancer lump is drawn down toward it to form a little dimple.
This sounds like it’s easy to tell if a lump is or isn’t cancer. It’s not. If a doctor, after examining the breast, cannot be sure, then he or she usually has the patient come back in a month or two to see if the lump has changed in size. If doubt still exists, an ultrasound in a woman less than 35 and a mammogram in an older woman usually can settle the matter.
Should either of these tests not provide a definite answer, the next step is to obtain material for microscopic examination. That might be done with a very thin needle, with a larger bore needle or with a scalpel. Self-examination is good for discovering a lump. Self-diagnosis is foolish for proclaiming the lump benign or cancerous. You have to let the doctor do that; see yours today.
Incidentally, it is better to have a breast exam one week after a period. At the time of a menstrual period, many breast lumps enlarge and become tender, and this can make a difficult diagnosis more difficult.
The booklet on breast cancer explains the details of this illness and its treatments. Readers can obtain a copy by writing: Dr. Donohue — No. 1101W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: I am a 41-year-old woman, very petite, 5 feet 1 inch tall, and weigh 95 to 105 pounds. I am being bullied about this by my doctors. Have they supersized the height-weight tables to accommodate our increasingly obese population? I am lightweight but have no health problems. Your thoughts are welcome. — L.N.
ANSWER: Your body mass index is 18.9, which puts you in the normal weight category but at its lower end. If you feel healthy and eat a balanced diet, bully those doctors back.
DEAR DR. DONOHUE: My son is almost 3. He reaches for everything with his left hand. I want to train him to use his right hand. Being left-handed is such a drag. What are your thoughts? — G.S.
ANSWER: Who says being left-handed is a drag? The 10 percent to 15 percent of the population who happen to be left-handed adjust to it without any great physical or psychological trauma. Leonardo da Vinci, Pablo Picasso, J.S. Bach and Sandy Koufax were lefties. They did all right for themselves.
I'd let your son accept what nature has dealt him.
Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.
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