Worried, 18 year old daughter with lump

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Hello.

I'm worried sick. My 18 year old daughter was diagnosed with Crohn's Disease in 2012. It's been managable and without significant complications although uncomfortable during flare ups. She also has a low white blood cell count that was determined by a hematologist to not be caused by any underlying disease. It's just her count.

About a year ago she developed a lump in her right bust. Her PCP said that it was HIGHLY unlikely that it was anything to be concerned about and to keep an eye on it.  After a year, it's still present.  She had a biopsy done today to determine what it is. The doctors examined her and did an ultrasound a week ago and seem to believe that it is, more likely than not,  fibroadenoma and said we should have nothing to worry about. We should know in a few days. I'm really concerned because she's lost 10 pounds in a month and a half. On January 23rd she was 121 lbs. As of last week she's 111 lbs. I know that patients with Crohn's are susceptible to weight loss and poor apetite but with this breast lump being presesnt I'm extremely concerned.

We have NO history of breast cancer in our family and at the age of 18, I understand it to be EXTREMELY rare for someone to develop breast cancer, but I'm still really worried.

God forbid, if it were something, would having waited a year to get this checked out possibly have been something that put her in more danger. She's had check ups and blood tests done during that year, all of which came back fine. Her white blood cell count was even normal recently.

Any words of advice, encouragement, expertise would be greatly appreciated.

SM

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  • Posted

    Hello SM

    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 smile

     

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    • Posted

      There aren't words to adequately how appreciative I am that you took the time to respond to my concerns as thoroughly and heartfelt as you did. THANK YOU!  It means much and certainly helps to ease some of the anxiety associated with this ordeal including and especially now, awaiting her biopsy results.  

      I've taken some comfort in knowing that over the past three years since her Crohn's diagnosis, she's been in and out of procedures and doctors appointments so much so that I'm hoping that if something serious was going on that it would have been detected.  Her white blood cell count was low even as a toddler, I'm told that in African Americans this is common.  The hematologist determined in 2012 that it wasn't low because of any existing condition.  So, I'm hoping that that's still the case.

      I've certainly considered that the weight loss could be a result of the Crohn's although she's never lost weight since the diagnosis. It's been challenging for her to gain, we're just small folks so I'm sure it's hereditary, but this is the first time she's actually lost what I thought was a significant amount of weight. However, she isn't ILL. No vomiting or diarrehea or nasuea. Just the weight loss and this lump.

      I will certainly update you when we hear the good news! smile

      Thank you again for taking the time and I'm very happy to hear that you're okay. I'm sure this is a scary and difficult journey for anyone who receives a diagnosis of Breast Cancer.  Hearing the stories of those who survived and thrived is so important!

      SM

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    • Posted

      Thank you all for your kind words. Thankfully, my daughters lump is benign. She was diagnosed with having fibroadenoma. To say we're relieved is an understatement. I'm still concerned about what appears to be rapid weight loss. She went from 121 to 115 to 111 and now 109 today. We have to find out why she's losing weight. All of her blood work came back normal on Jan 23rd and her biopsy results were benign so I'm not sure what's going on but I'm very happy we have one of the biggest concerns out of the way.

      Thank you again

      SM

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  • Posted

    Hi Muhammad,

    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.

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    • Posted

      Thank you all for your kind words. Thankfully, my daughters lump is benign. She was diagnosed with having fibroadenoma. To say we're relieved is an understatement. I'm still concerned about what appears to be rapid weight loss. She went from 121 to 115 to 111 and now 109 today. We have to find out why she's losing weight. All of her blood work came back normal on Jan 23rd and her biopsy results were benign so I'm not sure what's going on but I'm very happy we have one of the biggest concerns out of the way.

      Thank you again

      SM

      Report
  • Posted

    Thank you all for your kind words. Thankfully, my daughters lump is benign. She was diagnosed with having fibroadenoma. To say we're relieved is an understatement. I'm still concerned about what appears to be rapid weight loss. She went from 121 to 115 to 111 and now 109 today. We have to find out why she's losing weight. All of her blood work came back normal on Jan 23rd and her biopsy results were benign so I'm not sure what's going on but I'm very happy we have one of the biggest concerns out of the way.

    Thank you again

    SM

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  • Posted

    Dear 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

     

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