BENIGN CHANGES IN THE BREAST
Question: Six months ago 1 had a breast biopsy that showed benign changes—fibrocystic disease and intraductal hyperplasia. Is either of these linked to an increased risk of breast cancer in the absence of a family history?
Answer: Your risk of breast cancer is no greater than average. The conditions you mention are natural changes that occur over time. Fibrocystic “disease,” a term that implies an abnormality or disorder, is a misnomer, since about half of all premenopausal women have it. It’s really a catchall term for painful, lumpy breasts. Such lumps were once thought to be associated with increased cancer risk, but several studies have since dispelled that notion. Intraductal hyperplasia is a benign overgrowth of cells in the breast ducts, the tubes that carry milk to the nipple. Only when those cells start to appear abnormal on a biopsy does the risk of cancer increase.
Question: At the time of my last routine physical, my doctor diagnosed a fibrocystic lump in my breast. I was told to avoid anything containing caffeine, including chocolate. But I love chocolate. Would eating chocolate really affect the growth of any lumps?
Answer: Probably not. The theory that caffeine causes non-cancerous breast lumps has never been proved. Besides, chocolate contains relatively small amounts of caffeine.
FIBROID TUMORS AND ESTROGEN
Question: For years my doctor told me that I could never go on estrogen replacement therapy because I have a fibroid tumor on my uterus (roughly the size of a 14-week fetus). I’ve just reached menopause, and now he’s changed his mind; he wants me to start hormone therapy. He says it would be okay—that the tumor would even shrink. Please advise.
Answer: Estrogen can stimulate the growth of uterine fibroids, which are benign tumors of muscle and connective tissue that originate within the uterine wall. Now that you have reached menopause, your body’s own supply of the hormone has begun to dwindle. Ordinarily, that would make the tumor shrink. The tumor might continue to shrink even with estro-gen replacement therapy, if the dose of estrogen was relatively low. Higher doses might maintain the tumor or even make it grow.
If you decide to go on estrogen replacement therapy— because of severe menopausal symptoms, for example, or a high risk of osteoporosis—your fibroid tumor should be monitored closely. If it continues to grow, your physician may reduce your estrogen dosage or suggest that you stop taking the hormone entirely.
Question: I have several egg-shaped growths on my body. Please tin whether these bumps, diagnosed as lipomas, are dangerous and how the condition can be treated. I would have quite a few scars if the lumps were all surgically removed.
Answer: Lipomas are benign, fatty tumors that are fairly common, typically appearing on the trunk, neck, and forearms. Usually they cause no discomfort and are best left alone. If you prefer to have them removed for cosmetic reasons, you can choose either conventional surgery or liposuction, in which a small tube inserted under the skin sucks out the fatty tissue, resulting in less scar formation. The rare lipoma that enlarges rapidly may harbor a cancerous growth, known as a liposarcoma, and should be removed surgically.
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