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`I've never had a mammogram because I fear the pain of a breast biopsy.'

THE FEAR OF BREAST BIOPSIES

Q I'm a 42-year-old mother of two boys and I'm in pretty good shape. I had a physical examination about five years ago, but I have never had a mammogram because I fear the pain that would come with a breast biopsy if the test detected something. I want to take the test, but I can't face the potential for pain. Is there any way I can avoid the pain that comes with a breast biopsy (if it's necessary)? S.C., Los Angeles

A Since you have surpassed the age of 40, most doctors say it is a good idea for women who have reached that milestone to get regular mammograms, an X-ray of the breast tissue that can detect breast cancer in its early stages. You are like thousands of other women who are apprehensive about getting a mammogram because of what it could reveal and the procedures that follow. If the test reveals some suspicious-looking tissue, many women don't want to have to endure the pain associated with a needle biopsy.

Fortunately, the Food and Drug Administration has approved a new breast imaging device (T-Scan 2000), which is used as a follow-up step to a mammogram and, using electricity instead of needles, distinguishes malignant tumor tissue from surrounding normal tissue.

Of the 25 million women who get mammograms annually, doctors say nearly I million require further testing to determine whether cancerous tissue is present. Medical experts continue to stress the importance of regular mammograms because the majority of women who develop breast cancer do not have a family history of the disease, nor do they fall into any other special high-risk category.

DANGERS OF A CRASH DIET

Q Please help! I have a friend who wants to lose about 20 pounds in a hurry, and she is considering going on a crash diet to do it. I've told her that's not a good idea. What can I tell her that may convince her to forget about this plan and lose the weight sensibly? T.M., Detroit

A Tell her that, from a health standpoint, there's nothing good about a crash diet. In fact, doctors say such a diet could cause your friend some serious and, possibly, permanent physiological problems. The healthiest and longest-lasting weight loss occurs when you take it slowly, losing 1/2 pound to 1 pound a week.

Nuritionists say most quick-fix or crash diets, especially those based on eating only from one food group (for example, foods high in protein), aren't nutritionally balanced and may eventually harm the body. Such diets, specialists say, can put tremendous stress on the body and seriously affect a number of organs.

Because a crash diet isn't a healthy idea, tell your friend she should follow the simple and straightforward advice from the Dietetic Association, the U.S. Department of Agriculture and the National Institutes of Health: Eat less and exercise more. Nutritionists say the most successful weight-loss programs are those that combine diet and physical activity. A low-fat, low-calorie diet, combined with increased physical activity, can help your friend lose more weight and keep it off longer than either way can achieve alone.

CHOOSING A DOCTOR

Q At the beginning of the new year, I decided to get a new lease on life and take better care of myself. The first thing I want to do is get a physical exam, but I've never had one and don't have a doctor. What are some of the things I need to consider when choosing a doctor? N.P., Denver

A There are several important things to consider when choosing a doctor, but first and foremost among them is to find someone with whom you can be comfortable and open. Internists and family physicians are the two largest groups of primary care doctors for adults. Look for a doctor who has the training and background that meets your needs; has privileges at the hospital of your choice; is part of your health plan, unless you can afford to pay extra; listens to you; encourages you to ask questions; explains things clearly; and treats you and your concerns with respect.

Friends and family members can help you in your search or you can contact doctor-locator services that will match you with a doctor who meets your needs and desires.

# posted by Medical Information : 3:03 AM