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So it happens one fine day, when my relative (I shall address her as M in this entry) has to go for a general medical check-up.....which is the norm for someone who has applied for a student visa.
She went to a private medical centre. It went pretty smoothly at the beginning - blood and urine samples were taken promptly, her chest X-ray done within 10-15 minutes.
Even the initial consultation was fine (remember the general screening "questionaire" we all got to fill? XD)......right until it was time for a quick physical examination.
Like all general check-ups for females, a breast examination is to be done to complete the physical. Well that is acceptable, considering the need to screen child-bearing women for any breast disease. What was unacceptable, however, was THE WAY a certain female doctor (let her be Dr. S) handled the examination:
After informing M that she'd have to check her breasts, she got M to undress and promptly proceeded to examine her. At the end of the procedure, Dr. S remarked (albeit as a matter-of-factly) that she noted a "LUMP" on M's right breast.....and promptly left the matter just like that.
My female relative was obviously shocked by the sudden news that she subsequently broke down. It was only when the tears started flowing did Dr. S panic, and tried (in vain) to console M.
I found this appalling, for:
1. There was no explaination done regarding the significance of the "lump" found on examination.
M is in her early twenties, is not in the medical field, does not realize that a "lump" could also mean anything other than breast cancer, and on top of that, both her grandmother and aunt had breast cancer....so I'm not surprised if she concluded, "OMG, does that mean I have breast cancer too?"
Can't one see how distressing it might be for her?
What irked me most was the fact that M was almost at the end of her menstrual cycle, so wouldn't that mean her breasts might be physiologically "lumpier" than usual?
[NOTE: M did tell Dr. S prior to the examination that her last menstrual period was almost a month ago]
At times, I still wonder if the doctor actually took that into consideration before telling M she has a "lump" in her right breast.
2. Dr. S never bothered to explain if this matter should be followed-up or not.
3. The aforementioned doctor clearly doesn't know how to break "bad" news properly....and she has been practising medicine for a few years!
If the doctor were to be given another chance to break the news, I would very much like to see her explain clearly what she has found on the breast examination, what she thinks the "lump" could be (eg: physiological lumpy breasts, cyst, fibroadenoma, breast Ca etc), taking into consideration M's menstrual, systems review, past medical, family and social history, how the lump feels like on palpation, whether or not there is axillary/supraclavicular lymph node enlargement and/or constitutional symptoms, and the epidemiology of breast diseases within the younger population. I would also like Dr. S to explain if M needed a follow-up within a period of time (eg: after her menses arrive perhaps), just to see if the "lump" is still there....and if it IS present, whether or not she would consider a breast ultrasound/ mammogram, with or without a fine-needle aspirate/tissue biopsy to rule out anything sinister.
Dr. S, at the end of the consultation, finally conceded that it could be just normal breast tissue (and that was only when she realized M hasn't had her periods yet).
M sought a second opinion, one week after her menses came.....and no lump(s) could be felt on examination.
How would you respond, if you were Dr S'?
Labels: Medicine/Hospitals/Medics
