detected microcalcifications that should be removed and analyzed. My
surgeon disagrees with this, saying that further surgery would have to be
a mastectomy. What do you suggest I do?——Mrs. J.M.

I am a childless 32-year-old woman. While going for a routine examination,
I was found to have some lumps in my breasts. I immediately made an
appointment with a specialist, and this doctor diagnosed my condition as
fibrocystic disease. He ordered mammograms, which I took (by the way, the
x—rays took two hours-—it seems they weren't dark enough so they had to
keep retaking them).

Doctor, what is fibrocystic disease? What can be done for it? Can
it become cancerous, and does it ever go away? I'm really worried about
this.-—J.U.

Way back when I was a medical student, my pathology professor taught that
the two most difficult areas in which to distinguish the normal from the
abnormal are the female breast and the thyroid gland. As far as the
breast is concerned, these words are as true today as they were a quarter
Fibrocystic of a century ago.

d$9flw So—called fibrocystic disease (alias chronic cystic mastitis, alias
breast dysplasia) remains as enigmatic as ever, and a look at a medical
textbook reveals the confusion that exists about the relationship between
this condition and cancer. The lack of scientific knowledge surrounding
this condition is matched only by the urgency for elucidation, since the
condition is now clinically recognizable in one—fourth to one—third of all
women.

To show you how complicated this relationship is, the 1976 issue of
"Current Therapy" states, "If fibrosing adenosis, hyperplasia or meta-
plasia, and/or intraductal papilloma is present, the incidence of breast
cancer is increased three— to four—fold. Mamography plus repeated care-
ful physical examination is the procedure required to properly protect
the woman with cystic mastitis."

Such subtle pathologic distinctions require the closest attention of
a skilled, experienced pathologist to reach a proper diagnosis. Even then,
the options are controversial.

I wish I could recommend mammography with more enthusiasm, but recent
findings about its dangers coupled with the all too frequent retaking of
x—rays, such as J.U. reports, does little to reassure me that the proced-
ure is safe.

Furthermore, I am afraid that I foresee an increase in the incidence
of fibrocystic disease. The use of female sex hormones in The Pill and
other forms of medications, the continued infrequency of breastfeeding,
and the smaller number of children per family seem to me to point in the
direction of more and more breast abnormality.

 

My mother had a mastectomy seven years ago. Ever since that time, her arm
has had this awful swelling. I have heard and read a lot about the surgery,
but I've never heard about this type of swelling. She exercises her arm
often, but nothing seems to help.

Her arm is so big that it weighs her down on one side, and she has to
buy her clothes about four sizes larger so that the sleeves will be large
enough. Is it possible that this surgery was done wrong? My mother
objects to my insistence that we bawl out the doctor who did the surgery,
but I think we have a good malpractice suit. This has bothered me all
these years, and I can't stand it any longer. Please tell me what to
do.--J.J.