Cysts are not al­ways bad news

The Weekend Australian - Travel - - Health - THE DOC­TOR LINDA CAL­ABRESI

I am45 years old, fe­male and healthy. Re­cently I dis­cov­ered a lump in my right breast. The doc­tor sent me for a mam­mo­gram and ul­tra­sound, where the lump was di­ag­nosed as a cyst. The fluid was drained and an­a­lysed; no can­cer was found. I was told fur­ther harm­less cysts could de­velop. AmI at in­creased risk of breast can­cer be­cause of th­ese cysts?

The con­sen­sus among Aus­tralian breast can­cer ex­perts is that sim­ple breast cysts do not be­come can­cer­ous and do not in­crease your risk of de­vel­op­ing breast can­cer in the fu­ture. In fact breast cysts are very com­mon in women aged 35 to 50, with most go­ing un­no­ticed be­cause they are small. It is not known why some women are more sus­cep­ti­ble to cysts than oth­ers, but hor­mones are be­lieved to play a part. Cysts also com­monly oc­cur in older women tak­ing hor­mone re­place­ment ther­apy. Usu­ally the cysts dis­ap­pear af­ter menopause, but in some women they per­sist through­out their lives. There is a rare con­di­tion known as in­tra­cys­tic can­cer where a can­cer de­vel­ops inside a cyst, but this will look dif­fer­ent on ul­tra­sound. While it is prob­a­bly re­as­sur­ing for you to know that if you get an­other breast lump it is more likely to a be­nign cyst, do not de­lay get­ting the lump in­ves­ti­gated — just in case it’s not. My new lit­tle grand-daugh­ter has just been di­ag­nosed with con­gen­i­tal dis­lo­ca­tion of the hip at her six-week check-up. She now has to wear a splint to keep the hip in place. Will she have any long-term con­se­quences be­cause of this hip prob­lem? And how likely is it that any fu­ture brothers or sis­ters will also be af­fected? Con­gen­i­tal dis­lo­ca­tion of the hip — or de­vel­op­men­tal dys­pla­sia of the hip, as it now called) — can al­most al­ways be suc­cess­fully treated, es­pe­cially when the con­di­tion is de­tected at such an early age. It is caused by the socket part of the ball-and-socket hip joint be­ing ab­nor­mally shal­low. This al­lows the ball part of the hip (at the top of the fe­mur) to slip out of joint. The har­ness your grand-daugh­ter is re­quired to wear will en­sure the joint stays in po­si­tion un­til her bones ma­ture and the hip sta­bilises. This will usu­ally take be­tween six and 12 weeks. For the vast ma­jor­ity of chil­dren this will be all the treat­ment they re­quire and they will go on to have nor­mal, ac­tive lives with­out any de­tectable dis­abil­ity. Very rarely, some chil­dren will de­velop arthri­tis in that hip as adults. Fu­ture sib­lings will be at in­creased risk as the con­di­tion does tend to run in fam­i­lies, and girls are much more likely to be af­fected than boys. You will prob­a­bly find all fu­ture chil­dren in that fam­ily will un­dergo an ul­tra­sound of their hips at six weeks of age. I ama 20-year-old, pre­vi­ously healthy male. Two years ago I de­vel­oped an itchy skin rash all over my body, which the spe­cial­ist said was der­matographism. I take an an­ti­his­tamine ev­ery day to keep it un­der con­trol. Will I have to do this the rest of my life? You are un­lucky, as most peo­ple with this con­di­tion are far less af­fected than you ap­pear to be. Der­matographism, the con­di­tion where stroking or slight scratch­ing of the skin causes itchy weals to de­velop, usu­ally at the site of con­tact, is gen­er­ally con­sid­ered a vari­a­tion of hives. It is very pos­si­ble that the con­di­tion will be­come less se­vere with time, but you will prob­a­bly al­ways have the ten­dency to have a skin re­ac­tion of some sort to cer­tain trig­gers. It might be worth­while get­ting checked to de­ter­mine which stim­uli cause the great­est re­ac­tion so you can try and avoid them. Linda Cal­abresi is a Syd­ney GP and ex­ec­u­tive ed­i­tor of www.6min­, a news ser­vice for Aus­tralian doc­tors. Send your queries to lin­da­cal­

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