Women's Health
My breasts are of unequal size. Is that normal?
Its not unusual to have breasts of a different size, provided the breasts are absolutely normal in appearance - no nodules and no other feature of concern, such as discharge from the nipples, etc. Unequal breasts are absolutely normal and not pathological.
I have found a lump on my breast. What should I do?
All lumps on the breasts need to be looked at. Having said that, 80% or 90% of breast lumps are totally benign. Although they need to be checked, they only need to be checked because of the potential seriousness of it. The vast majority of breast lumps are not serious. Furthermore, a number of lumps in the breasts can be normal. The woman suffers a cyclical variation in her hormone levels every month. This change in the oestrogen levels can produce certain nodules or cysts in the breasts, particularly during the latter half of the cycle. It's always best to check breasts immediately after a period or during a period, but not during the latter half of the cycle. That's when you're going to notice your lumps least. If a breast lump is persistent, it needs to be checked by a doctor. He will assess whether it has any malignant features; the benign features of a lump are that it's rounded, mobile and often tender. He will usually request a mammogram or an ultrasound scan, or both. He may often request a biopsy. This is absolutely normal and should not concern the patient unduly, because very often we just need to make certain that the lump is not malignant. Patients have to understand that sometimes we do these things to reassure the patient that a breast lump is not malignant rather than because we suspect that it is malignant. Sometimes, I'm afraid patients just have to go through the process, get the lump looked at, get it sorted out, so that they can then forget about it.
When do women ovulate?
Ovulation in women occurs fourteen days before the next period. It is difficult to predict. In cycles of twenty eight days, ovulation will happen on the fourteenth day. In shorter cycles of twenty one days, ovulation in women might happen on the seventh day.
Is ultrasound a safe procedure?
We've now been using ultrasound for the better part of thirty years. So far, we haven't found ultrasound to cause, or to be a risk for, any future disease. At present, we consider it to be safe.
Why should I have a smear test and what can I expect?
The reason why patients have smear tests is because we can detect cells around the cervix which are potentially malignant, but are not yet. We can find the type of cell that, if left alone, will eventually change to become malignant. The reason for having cervical smear tests is to prevent cervical cancer. We look for these cells and, if they are present, we will treat the patient and by so doing, we prevent cervical cancer. What to expect for a cervical smear test is that the patient, the woman, will have a vaginal examination. She will usually obviously lie flat and the doctor will have to insert a vaginal speculum. He will have to look inside the vagina under a good light and he will take a sample from the cervix, which lies at the top of the vagina. The sample will usually be taken either with a brush or with a little spatula. A smear test is not painful. They will just feel a knot sensation of being touched. That sample will then be analysed on a slide.
My nipples are inverted. Should I be worried?
Provided the patient is not concerned about the appearance, the doctors are not going to be too worried by inverted nipples. However, it is important for the patient to remember that if their nipple was normal and then becomes inverted, that is potentially a serious sign and always needs consultation with a doctor. However, given the question of an inverted nipple from puberty, it's a different matter and is purely an aesthetic problem.
Can an inverted nipple be treated?
Inverted nipples can easily be treated. It is a surgical procedure. Inverted nipples are simply caused by a short duct that leads out to the nipple and, hence, it needs a small surgical procedure to allow it to extend to be a normal nipple. There are a couple of considerations that women would need to know about before going through with the surgical procedure. That is, mainly, that if it's done before they've had any children and they are considering breast feeding, the operation could interfere with breast feeding in the future. The inverted nipple operation could also reduce nipple sensitivity and that might be an important issue for some women.
