In response to Becky Saentz' lump posting:

I was struck by one comment you made in relation to a mom who was told by a
doc that "all breast lumps must come out." It was something like that,
wasn't it? I think you mentioned as an aside that this mom had no risk
factors for breast cancer. It seems to me that I read in a brochure (in the
waiting room of the Lahey Clinic while I waited for my friend to come out
from her radiation treatments for breast cancer) that only some relatively
small percent of the premenopausal breast cancer patients actually fall
into the risk groups. I want to say something like 16%. Maybe it was more,
but I am quite sure that it wasn't anywhere near 50%. I found that scary.

I guess I'm a little over sensitive about this subject since the only
maternal patient I ever "lost" was a 35 year old primip who had not pursued
a suspicious lump, only to die when her baby was 9 months old. The labor
and delivery nurses were the first ones to document the tumor. By that time
you could guess by looking at the breast that this was a malignant tumor.
She gave a couple of reasons for not having mentioned it to her health care
providers but the one that surprised me was that she had been told by
somebody not to worry since she didn't fall into any of the risk groups.

Now I encourage my clients to have any suspicious lumps examined. What
constitutes a non-suspicious lump? I usually say that if the lump is new
since starting to lactate, seems to wax and wane in size up to and then
after a feeding, doesn't seem to be "anchored" to muscle tissue behind
breast, and can seemingly be emptied by applying heat, massage, and
pumping, then these characteristics seem to make the lump sound more like a
plugged duct or even just a palpable little collection of milk producing
tissue. Do those seem to everyone like reasonable guidelines? Should I add
something, subtract something?

I certainly wouldn't want to line moms up for needless fine needle
aspirations (even though I've never had one, the idea is not appealing) but
I could not forgive myself if I reassured a mom, only to find that my
glibness had cost her valuable time in seeking treatment.

Bonny Nothern, IBCLC