My wife, a 25 y.o. woman {generally very healthy and in extremely good shape) did a self examination the other day and felt something a little strange. She thinks it may be a lump but is not sure. There is difinetly a small something there (not just smooth tissue underneath, feels kinda like a cyst, maybe from my estimate 1/8-1/4 of an inch in size). Her mother and close family has no history of cancer, but she thinks a great aunt (or someone about that distant) did. She is not overly alarmed, but she doesn’t think she has felt it before so we feel it should get checked out.
The problem is, our family doctor is on holidays right now… and will be for the next 2 weeks. No other doctor we have tried has time to see her. So, in order to see a Doctor we would have to go the the hospital emergency room and wait.
What do others think here? Wait until the 24th or so or go to the emerg?
The objective answer: A two week wait to find out will in no way endanger your wife, even if the lump is cancerous (highly unlikely in a 25 year old without risk factors).
The subjective (and probably more important) answer: Waiting in uncertainty is very stressful. Is there no urgent care type facility, or planned parenthood office nearby? They could do an exam, and make recommendations and plans with you.
mm… does she have the option of visiting a women’s health clinic? Is the “family doctor” you refer to her gynocologist? Can she see an ob/gyn – or even a Ob/Gyn Nurse Practioner* from her regular doc’s practice? My first instinct is that it is not an emergency-room type situation. But peace of mind is worth a lot.
*Are you British? If so, do you have the concept of NPs there? In the US, a Nurse Practioner is more highly qualified than a regular nurse (Registered Nurse or RN) and can write prescriptions.
Thanks Qadgop, that is re-assuring. We are not really panicing or too scared right now as we (even though I have no medical training) know the odds are very, very stacked in our favor… so a 2 week wait won’t make us loose any sleep. We live in a small city (Approx 40K people) and since it is public healthcare we don’t have too many (actually, zero here) walk in clinics. Our only real options are our MD and the hospital emerg. Actually, I used to go to a Doctor here years ago and had a pretty good rapport with him… I think I am going to just drop by and see if I can get a bit of quick advice and/or see if he will agree to do a quick exam on the wife. Is this something they can tell just by a quick exam or is an X-Ray going to be necessary for sure, Qadgop?
rmariamp, we are Canadian. Basically where I live there is our Dr and the hospital… thats about it.
if the doc’s conservative, he’ll probably say it feels completely benign, if it gets bigger, or otherwise changes, let him know and he’ll order a mammogram.
If the doc’s really conservative, he might order a mammogram anyway.
For a 25-yr-old, they probably won’t do a mammogram (or at least they refused to when I was that age with the same problem), but will instead do an ultrasound. This will take a little time to schedule anyway. Actually, my memory is that they made me wait until the lump had persisted through a full menstrual cycle before they would even schedule the ultrasound, which took another month to actually get done. I eventually had it aspirated and it went away.
If it grows and shrinks over the course of her cycle, and especially if it aches just before or during her period, that’s further evidence that it’s just a cyst.
Two years ago(at age 21), I had a lump taken off my breast. I found it at the end of March '99 and it wasnt evaulated til at least the middle of April '99 (my doctor had to keep rescheduling my appts for some reason…)Had it surgically removed May '99. Turned out to be a fibroadenoma, which is benign. I did have two ultrasounds and a mammogram, and was evaulated by many people (college nurse, surgeon, radiologist, etc.). It should be nothing worry about (but I’ll readily admit I was convinced I was dying for those few weeks between finding it and getting it evaluated).
I went to my old Doctor after lunch and he agreed to see her under the circumstances. He sounded re-assuring but said better to be safe than sorry. So, tommorow at 9AM the wife pays him a visit.
A recent report from Nancy Baxter, with the Canadian Task Force on Preventive Health Care, “Preventive health care 2001 update: Should women be routinely taught breast self-examination to screen for breast cancer?” may be of interest to the OP and others (although it does not answer the OP).
Dr. Baxter evaluated the evidence relating to the effectiveness of breast self-examination (BSE) to screen for breast cancer. She searched the electronic databases MEDLINE, PreMEDLINE, CINAHL, Health-STAR, Current Contents and the Cochrane Library were searched for abstracts and full reports of studies published from 1966 to October 2000 that evaluated the effectiveness of BSE in reducing breast cancer mortality. In addition, references of key papers were searched and experts consulted to ensure that all relevant articles had been identified. Prevention of death from breast cancer was viewed as the most important outcome; other outcomes examined included the stage of cancer detected, the rate of benign biopsy results, the number of patient visits for breast complaints, and psychological benefits and harms. Dr. Baxter found that 2 large randomized controlled trials, a quasi-randomized trial, a large cohort study and several case–control studies have failed to show a benefit for regular performance of BSE or BSE education, compared with no BSE. In contrast, there is good evidence of harm from BSE instruction, including significant increases in the number of physician visits for the evaluation of benign breast lesions and significantly higher rates of benign biopsy results. (The full text in PDF format can be found by a search for breast self-examination starting at http://www.ctfphc.org/)
The conclusions of Dr. Baxter and the Canadian Task Force on Preventive Health Care is based on the evaluation of all available evidence by scientists trained to analyze and synthesis data from clinical trials who strive to be objective. Their conclusions may differ from the opinions of other respected physicians and scientists who screen for/treat/study/lobby for breast cancer/breast cancer research and from the opinions of breast cancer patients.
Couple of quick things, though I am glad you were able to secure a doctor’s appointment!
Planned Parenthood will do breast exams on even on non-patients. It’s worth keeping them in mind if you need an appointment quickly.
Others have pointed out that most lumps are benign, but here’s another thing: women should only perform self-exams in the first week after their period. Breast tissue is affected by hormones, and so its texture will only reliably reveal lumps in that first week. If you feel something at another time, it’s certainly worth investigating, but only get worried when there’s something un usual in the first week after a period.