Recently I have been suffering from an annoying itch in the middle of my left breast. I’ve checked for lumps but can’t find anything unusual other than a white spot on the nipple. Should I see my GP? I am 72 and on low dose HRT.
Changes to the breasts of a woman over 70 should always be clarified by a general practitioner. It’s unlikely to be something cancerous, but there’s always a chance it could be.
Typical symptoms are itching and a lump or changes in the size and shape of the breast. A difference in skin appearance is also a problem, such as a rash or dimpled skin.
Nipple changes are very important – check for color changes, discharge or when it turns inwards.
A rare type of breast cancer called Paget’s disease that specifically affects the nipple and causes skin changes that can look a bit like eczema.
Breast changes in a woman over 70 should always be checked out by a GP (stock photo)
Other types of cancer can also cause symptoms that affect the nipple. Therefore, these changes in older women are always taken seriously and usually lead to referral to a breast clinic.
Assessing potential breast problems involves more than a mammogram. An exam at a breast clinic will also include an ultrasound and possibly a biopsy. If you only decide to have a mammogram, you risk missing out.
All women between the ages of 50 and 70 are entitled to a breast exam every three years. Women over 70 can request a mammogram by contacting local breast screening services, but the GP is the first port of call.
Of course, like any other part of the body, the breast and nipple can be affected by minor skin problems. Itching can be caused by dry skin, dermatitis, or irritation.
I suffer from terrible asthma and seem to keep getting chest infections making it difficult to breathe. About a week ago I also started having problems with my back – so much so that I have to lie down. Could the two things be related?
It’s not uncommon for people with severe asthma to struggle with back pain, especially if they’re prone to chest infections, which in themselves can cause pain. This may be due to a complication of the infection itself. An example is pleurisy – when the layers covering the lungs become inflamed.
More from dr Ellie Cannon for The Mail on Sunday…
Anyone suffering from severe asthma should be closely monitored medically, especially if they have frequent respiratory infections. Lung function tests or a specialist review may be required.
Asthma can cause coughing fits, which can often lead to muscle strain and pain. It’s also possible to develop bad back from lack of exercise and exercise due to shortness of breath.
However, lower back pain is very common and is often triggered by an uncomfortable movement or strain, so it may not be related to asthma. Doctors refer to this as “simple” back pain to reassure patients that the pain is not serious.
Back pain typically lasts about six weeks per episode and it’s common for patients to want to lie down, but doctors don’t recommend bed rest – gentle exercise is key to recovery. Helpful movements are listed on the NHS website. Taking painkillers regularly is a good idea because it allows you to move more comfortably. Non-medical pain relievers such as heat pads or acupuncture can also help.
Try seeing an osteopath or physical therapist for more support.
My 30 year old daughter developed Polycystic Ovarian Syndrome in her late teens and has had horrible facial hair growth ever since. I wondered if there are new treatments for these symptoms? The family doctor prescribed a cream and the pill, but neither helped. Would it help if her ovaries were removed?
Polycystic ovary syndrome, often known 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 have no symptoms. A diagnosis is made only when blood counts are abnormal and the patient suffers from irregular periods, excessive hair growth, and fertility problems. The condition is also associated with weight gain.
Treatment is highly dependent on what a patient wants, as symptoms vary greatly from person to person.
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dr Ellie can only respond in general terms and cannot address individual cases or provide personal answers. If you have any health concerns, always consult your GP.
Removal of the ovaries would not be an option. This would plunge one into a sudden and extreme menopause, which is inappropriate for young women desiring a family.
PCOS is linked to problems with insulin – the hormone that helps our cells use glucose. A special type of eating plan called a low-GI diet can help women with PCOS. It focuses on lowering blood sugar levels and balancing hormones.
The diabetes drug metformin is approved for PCOS and can be prescribed by your family doctor. Other options focus on specific symptoms. For hair growth, a dermatologist could offer removal treatments but this is not always available on the NHS.
Various types of hormone tablets can be used to stabilize the menstrual cycle. These can help with skin and period symptoms. An endocrinologist who specializes in female hormone imbalances would 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 has been inaccessible since lockdown ended (stock photo)
It seems to me that NHS dentistry has not become more accessible since lockdown ended.
My clinic is inundated with patients with dental problems who turn to their GP for help because they can’t get an appointment with their dentist. And I keep coming across horrifying stories, like patients gluing their teeth back together with superglue or stuffing gum into a cavity.
Unfortunately, in most cases GPs can do very little – especially in emergency situations. We lack the expertise and there’s a very good chance we’re doing something wrong.
We are often asked for antibiotics to help with infections in the mouth, but this is not always the right treatment, not to mention the well-known dangers of unnecessarily prescribing antibiotics.
If you are affected by this issue, I want to know about it. Please write to me at the address below.
Relax, the therapy via zoom works!
Health chiefs have given the green light to digital psychological therapies (stock photo)
I was pleased to see health chiefs give 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 endorsed by prescribing the depression and anxiety watchdog NICE. 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 involves online practice and remote appointments with therapists — can be as good as in-person therapy. Some patients, such as those with disabilities and social anxiety, often feel more comfortable not seeing someone in person.
Face-to-face consultations would be ideal, but we simply don’t have enough psychologists – NHS or private – to meet the growing demand.