Breast calcifications do not always indicate cancer

DEAR DR. DONOHUE: In the past six months, I have had three mammograms. The findings are always the same - microcalcifications in the upper outer quadrant of the left breast.
No one has told me what microcalcifications in the breast are. I had a biopsy years ago, and it was revealed that the calcifications were benign. I have occasional sharp pains in that breast. I would appreciate your help.
J.C.
ANSWER: Microcalcifications are tiny specks of calcium. Calcifications don't always sound the cancer alarm. The body patches up many things by plastering calcium over them.
Past breast trauma - a bump that didn't even register on your consciousness - might have led to calcifications in your breast. Calcium in minute breast blood vessels is another possibility. Benign breast growths can become calcified.
On the other hand, microcalcifications can be a warning sign of cancer. The doctors who interpret mammograms evaluate such calcium specks by their size, the pattern of their arrangement, their shape and their location in order to distinguish harmless calcifications from the harmful ones.
Sometimes the call is difficult and no clearly positive statement can be made. In order not to make a tragic mistake, follow-up evaluations are needed to spot any changes. If doubt still exists, a biopsy might be able to resolve the question.
Did you have a mammogram at the time your biopsy was taken in the past? If you did, that mammogram would be most informative in interpreting your current mammograms.
Stick with the program. It's better to err on the side of caution than to miss a serious condition.
Breast pain is not a common indication of cancer. I don't know what your occasional sharp pain is, but it's not likely to be a cancer sign.
The booklet on breast cancer goes into the diagnosis and treatment of this common cancer. Readers can obtain a copy by writing: Dr. Donohue - No. 1101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $6 Can. with the recipient's printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I get a pain at the bottom of my rear end that lasts from 30 minutes to an hour. It happens about two or three times a month. It can come on in the middle of the night or in the day.
I have been examined by two doctors without a diagnosis. This has been going on for 15 years. I am 58 and in good physical condition. What do you suggest?
C.G.
ANSWER: Proctalgia fugax (prock-TALE-juh FEW-jacks) is sudden, severe anal pain that lasts for only a short while - 15 minutes or less. Its cause and treatment are unclear. Firm upward pressure on the painful site can sometimes stop it.
Sitting in a tub of warm water is another remedy. Nitroglycerin, the same under-the-tongue medicine used for angina, has put an end to it for some.
Levator ani syndrome is another possibility. The levator ani is a muscle that forms a sling to support the rectum and anus. Spasms of that muscle provoke recurring anal-rectal pain that lasts longer than proctalgia fugax. The upper-hand pressure can work for levator ani syndrome too. So can muscle relaxants. Flexeril is an example.
Something that has been going on for 15 years without change is unlikely to constitute a serious health threat.

DEAR DR. DONOHUE: Will you explain arthroscopic knee surgery? Much pain? How long is one laid up?
K.M.
ANSWER: An arthroscope is a pencil-thick scope through which the surgeon gets a good view of the knee joint. It's inserted through a small incision. Two other small incisions are made - one for instruments and another for an irrigation device.
The doctor can perform corrective surgery without making a large cut into the knee. Pain is much less than the pain of traditional surgery. A person can return to work in a week or less and is doing everything he or she ever did within six weeks of the procedure.