placidfox55 said:Thanks for the advice. I don't want to get too bogged down in hair treatments... but please look over what I wrote... and let me know if I used the medical terms correctly.
It’s sad that American doctors have to earn respect through aggression. Maybe in a few more years, people will learn how to maintain a professional relationship. I’m not saying you haven't been attacked without cause multiple times—in those cases, you truly have to fight for your dignity. However, the less you fight back, the less likely you are to sink into the quicksand. Save your energy for your demanding profession.
And to add to that, let me pose a question: ... once you've had a needle biopsy and a mammogram, how can you be 100% certain that an open biopsy wouldn't show malignancy? Essentially, the clinical exam and the mammogram are the basis upon which the decision for a needle biopsy or an open biopsy is made. Naturally, a mastectomy only happens after the histological results come in. However, mastectomies are performed (globally) even without proven histological malignancy in cases where there is a strong genetic component.
I’m intentionally going to leave that first part without comment...
Clinically speaking, an exam, ultrasound, and mammogram indicate a cytological needle biopsy... which allows us to obtain and analyze specific cells. If the cells show abnormalities in the sense of malignant alterations or even just metaplasia—meaning, if the finding isn't positive but merely suspicious—then we move to a biopsy. If the biopsy comes back negative, there isn't much else to do because the biopsy removes the entire growth. Women are then monitored at regular, shorter intervals with follow-up ultrasounds and mammograms.
Besides, every woman, regardless of whether she has experienced a breast change before, should have an exam and an ultrasound every year, and for anyone over 40, a mammogram every one to two years...
Certain histological tumor types, which are more aggressive than others, appear bilaterally and multifocally; this usually refers to invasive lobular carcinoma. These tend to occur more frequently in familial lineages following invasive ductal carcinomas, though both are hereditary, as I've mentioned before.
Ideally, for every female relative of a patient, it would be best to check if they are carriers of specific oncogenes, BRCA 1 and BRCA 2. It turns out there is a significantly higher incidence of disease among relatives who carry one, or even worse, both of those genes, whereas for those who don't carry them, the risk is equal to the rest of the population of the same age.
When a woman is a carrier of both genes, it would be advisable to undergo a preventative bilateral mastectomy, which is very commonly done in places like the US and Sweden.
Here, unfortunately, Medicare doesn't cover BRCA 1 and 2 testing, which can be done at the Lawrence Berkeley National Laboratory, and the procedure costs about $1,000. Furthermore, the surgery itself isn't covered by a standard referral...
But I'm not to blame for this; it's the system...
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