Be cautious with breast abnormality

Dear Dr. Gott: I have had a lipoma below my left breast for about five years. It is the size of a small lemon, and there is no pain or discomfort. It is firm and on my bra line.

My primary-care physician said nothing need be done; some people have many.

Should I be concerned? If it is removed, how is that done? Where? By what kind of physician? I’m 67 and have always enjoyed good health.

Dear Reader: How do you know that this lump is a lipoma (a benign fatty tumor)? Have you had a mammogram or an ultrasound? What does your gynecologist say? Upon what data had your primary-care physician concluded that the lump is benign?

Before charging ahead for further (invasive) testing or treatment, such as a biopsy, you should be examined and tested by a surgical specialist.

I am being ultraconservative here because, over the 40 years of my medical practice, I’ve been impressed by how often breast cancer can present itself in weird ways, even as a firm, painless lesion that hasn’t changed in five years.

Get to a specialist, and, if he or she finds nothing, great. I’m just doing my job. To give you related information, I am sending you a copy of my health report “Breast Cancer and Disorders.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092. Be sure to mention the title.

Dear Dr. Gott: Could you please comment on the good/bad long-term use of Coumadin for keeping the blood in balance to prevent blood clots?

I have had clots in my right leg and also in one lung. A few years ago, prior to major surgery, my doctor had a Greenfield filter implanted to catch any clots that may have floated around during surgery.

I have been on Coumadin now for three years, and my surgeon, not the doctor who is monitoring my blood weekly, doesn’t think that I should be on the drug, as he feels it is dangerous, and, because I have the filter, there is no need for the Coumadin.

Dear Reader: I cannot advise you about stopping Coumadin because I am not familiar with your health problems. Many patients who have a tendency to form blood clots take Coumadin for years.

However, for obvious reasons, stopping the medication could be in your best interests. I suggest that you discuss this problem with your internist and follow his instructions. To give you related information, I am sending you a copy of my health report “Consumer Tips on Medicines.” Other readers who would like a copy should send a long, self-addressed, stamped envelope and $2 to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title.