Worried, 18 year old daughter with lump

It is very clear from your post that you are a highly resoponsible, knowledgeable and caring parent. It is inevitable that you will be extremely anxious, as any illness occurring in one's child leads to a range of emotions, including feelings of guilt.

I am not an expert, but I anaesthetised patients undergoing surgery for breast cancer and for primary or secondary reconstruction for many years.  Two years ago, I was diagnosed with breast cancer myself, at the age of 52. I seem to be OK now, although I retired from medicine early for other health reasons, primarily osteoporosis.

The combination of professional and personal experience may perhaps give me some insight into the disease.

All the information that you have quoted appears entirely correct.  Particularly the very low incidence of cancer in a woman aged under 20 - in the graphical presentation of age related incidence of breast cancer, published by Cancer Research UK, the incidence occuring per 100,000 of girls in this age group is unrecordably low.

Fibroadenomas, however, are quite common at her age.  It is likely that if your daughter had one of these detected, if not formally diagnosed by biopsy a year ago, that the only change in it would be a slight increase in size - it would be unlikely to just go away.

Weight loss in teenaged girls is not uncommon, and can result, as you know, from many causes.  It could well be the result of her Crohn's disease, or just be a part of her maturing into a woman, with the self-image issues that arise.  

Where weight loss is the consequence of malignant disease, which appears to be your main concern,  it is usually a late manifestation, and I would think it almost implausibly rare for this, secondary to breast cancer, to be the cause of her weight loss.  Although 10 lbs seems a lot to lose over a period of six weeks, especially at relatively low starting weight, it isn't difficult to achieve that level of weight loss by dieting alone, without the existence of Crohn's diease, and its proclivity towards weight loss.

I am pleased to hear that her white cell count is now normal, although I suspect its reduced level in the past may well be a red herring, as far as her breast lump is concerned.

I am able to empathise with your concern that if this lump (and as you say, god forbid) turned out to be malignant, that delay in diagnosis by a year might have put her in more danger.  I am afraid the answer is probably, yes, it would have done. 

All medical and surgical procedures come with their own risks, and since the liklihood of your daughter's lump being malignant is so very small, it may well have been akin to gilding the lily to have had the lump biopsied a year ago.

Having said that, I am sure that it was the right thing to do at this stage, if only to allay anxiety for both of you.  It seems very probable, that within a few days, when you have the results of the biopsy, that you will be able to draw a huge sigh of relief, and relax again.

Having thought about what you wrote for some time, since I read you post last night, it occurs to me that you may need, or have been asking for some reassurance that you have done everything that you can to help her.  That reassurance, for what it is worth, I am able to give. 

It sounds to me as if you have done everything that you possibly can to protect and to nurture her.  Do not forget that, in terms of what is done medically to or for you, your child, or to anyone that is within your family, once you have drawn attention to the problem to a doctor, they then bear a large part of the responsiblity for how aggressively the problem is addressed. 

I hope my words have given you some help and encouragement. 

There is a wonderful charity - breast cancer care (easy to find on line) - who offer enormous support, and a care line manned by quite highly trained people who have either had breast cancer, or close contact with it. I found their help invaluable, while going through the worst stages of coming to terms with my breast cancer, and really recommend them. 

I am also acutely reminded that the time between my biopsies, and the results of them, was perhaps the most difficult of all.  It was far easier to cope with once I knew what I was dealing with, than all the unknowns.  I do feel for you.

I wish you and your daughter happiness and health, and hope that you will let me know how she gets on.

With my very best wishes

M

i know that finding a lump in your breast is worrying for both you and your daughter, as I have been, and still am in the same position. I suffer from fibroadenoma too which is a lot more common than people think, so it is more than likely this is the case with your daughter. Please try not to worry, as this will make her worry more, and it won't help her chrones and is probably why she is losing weight.

hope all goes well for you and your family.

Thank you again

SM

Thank goodness!  I have been thinking about the pair of you, and what you will have had to endure since the biopsy.  This is fabulous news!

Thank you for your lovely words. 

Since retiring from medicine, I very much miss the opportunity to offer care, and sometimes I am able to find that outlet on this site.  I am hoping to become a volunteer for Breast Cancer Care UK, as they were so helpful to me, and although the training process is quite onerous, I think it would be worth it.  It is too early in my own healing process as yet - BCCUK tend not to offer training to those so recently affected by the disease - but it is not so long now, before I might apply.

It is clear from your post that you are highly educated, so in all probability you know how to encourage someone to gain weight.

During my radiotherapy I lost a huge amount - partly because I was really quite unwell - severe second degree burns and vomiting - all quite unusual, (in case anyone about to undergo radiotherapy reads this and is worried by it) but my oncologist told me that it was largely due to my Celtic genes (my father was of Irish descent), and because I am very fair skinned.  I lived on tiny slices of steak, liver and home made mashed potato!  When I was feeling better, I ate tiddly little danish pastries, because I love them, and they are highly calorific.

So, maybe the answer to weight gain for your daughter is for her to write a list of all the things that she most enjoys to eat, and, assuming it isn't just smoked salmon and lobster thermidor, washed down with champagne, then add them to her normal diet. It worked for me!

Thanks so much for letting me, and other people that responded to your message know that your daughter is going to be fine.  Breast cancer is a horrible disease that unfortunately so many mature women have to deal with, but to have it at such a young age would have been utterly dreadful.

I hope you can now relax, and enjoy a beautiful and restful Easter weekend.

Very best wishes

M x