Recently I suffered from an irritating itch in the center of my left breast. I checked for lumps but found nothing unusual other than a white spot on the nipple. Should I see my GP? I am 72 years old and on low dose HRT.
Changes in the breast of a woman over 70 should always be checked by a general practitioner. It is unlikely to be anything cancerous, but there is always a chance that it is.
Typical symptoms include itching and a lump or changes in the size and shape of the breast. A difference in the appearance of the skin is also cause for concern, such as a rash or dimpling of the skin.
Nipple changes are very important – check for discoloration, discharge or when it turns inward.
A rare type of breast cancer is called Paget’s disease, which specifically affects the nipple, causing skin changes that can look a bit like eczema.
Other cancers can also cause symptoms that affect the nipple. This is why these changes in older women are always taken seriously and usually result in a referral to a breast clinic.
Assessing potential problems in the breast involves more than a mammogram. An examination at a breast clinic will also include an ultrasound and possibly a biopsy. Opting for a mammogram alone risks missing something.
All women are entitled to a breast screening every three years between the ages of 50 and 70. People over 70 can request a mammogram by contacting local breast screening services, but the GP is the first point of contact.
Of course, the breast and the nipple can be affected by slight skin problems, just like any other part of the body. Itching can be caused by dry skin, dermatitis, or irritation.
I have terrible asthma and seem to keep getting chest infections making it difficult to breathe. About a week ago I also started having back problems, so much so that I have to lie down. Could the two things be related?
It is not uncommon for people with severe asthma to suffer from back pain, especially if they are prone to lung infections, which can themselves cause pain. This may be due to a complication of the infection itself. An example is pleurisy – when the layers that cover the lungs become inflamed.
Anyone with severe asthma should get a thorough medical check-up, especially if they frequently suffer from chest infections. Pulmonary function tests or examination by a specialist may be necessary.
Asthma can cause bouts of coughing which can often lead to pulled muscles, aches and pains. It is also possible to develop back pain from lack of exercise and movement due to shortness of breath.
However, lower back pain is very common, often triggered by awkward movement or straining, and therefore might not be asthma related. Doctors call it “simple” back pain, to reassure patients that it’s not serious.
Back pain usually lasts about six weeks per episode and it is common for patients to want to lie down, but doctors do not recommend bed rest – gentle exercise is the key to recovery. Useful movements are listed on the NHS website. Taking painkillers regularly is helpful because it helps you move around more comfortably. Non-medical pain relievers, such as heating pads or acupuncture, may also help.
Try seeing an osteopath or physical therapist for more support.
My 30 year old daughter developed polycystic ovary syndrome in her late teens and has suffered from terrible facial hair ever since. I was wondering if there are any new treatments for these symptoms? The GP prescribed a cream and the pill but neither worked. Would it help if she had her ovaries removed?
Polycystic ovary syndrome, often referred to as PCOS, is a very common condition involving multiple cysts that develop on the ovaries. But cysts alone don’t mean you have the condition.
Many women have cysts on their ovaries and experience no symptoms. A diagnosis is only made if blood test results are abnormal and the patient suffers from irregular periods, excessive hair growth and fertility problems. The condition is also linked to weight gain.
Treatment very much depends on what the patient wants, as symptoms vary greatly from individual to individual.
Do you have a question for Dr. Ellie?
Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr. Ellie can only answer in a general context and cannot answer individual cases, nor give personal answers. If you have a medical condition, always consult your own GP.
Removal of the ovaries would not be an option. It would throw someone into sudden and extreme menopause, which is not appropriate for young women who want to start a family.
PCOS is associated with problems with insulin – the hormone that helps our cells use glucose. A special type of diet, called a low GI diet, can help women with PCOS. It focuses on lowering blood sugar levels and hormonal balance.
Metformin, a diabetes medicine, is licensed for use in PCOS and can be prescribed by a GP. Other options focus on specific symptoms. For hair growth, a dermatologist might offer hair removal treatments, but this is not always available on the NHS.
Different types of hormonal pills can be used to stabilize the menstrual cycle. These can help relieve skin and menstrual symptoms. An endocrinologist, who specializes in female hormonal conditions, will advise you on the right type of pill to use.
Are you left in the mouth, without a dentist?
It seems to me that NHS dentistry is no longer accessible since the end of the closures.
My clinic is inundated with patients with dental issues who have turned to their GP for help because they cannot get an appointment with their dentist. And I keep coming across horrible stories, like patients sticking their teeth back together with superglue or putting gum in a cavity.
Unfortunately, in most cases there is not much that GPs can do, especially in emergency situations. We lack expertise and it is very possible that we are wrong.
We’re often asked for antibiotics to help with mouth infections, but it’s not always the right treatment, not to mention the well-known dangers of unnecessary antibiotic prescribing.
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Relax, Zoom therapy works!
I was delighted to see that health chiefs gave the green light to digital psychological therapies.
Although therapists have been seeing patients on Zoom for some time, digital apps and other online platforms are now officially recommended when prescribing the NICE watchdog for depression and anxiety. Many of my patients are skeptical when I suggest using an app to improve their mental health.
In fact, a fair amount of high-quality evidence suggests that this method – which typically includes online exercises and remote appointments with therapists – can be as effective as face-to-face therapy. Some patients, such as those with disabilities and social anxiety, often feel more comfortable when they are not seeing anyone in person.
Personal consultations would be ideal, but we simply don’t have enough psychologists – NHS or private – to meet the growing demand.