Biopsy

Q: My doctor has made a tentative diagnosis of temporal arteritis and has referred me to a surgeon for a biopsy of an artery on the side of my face. I am reluctant to follow his advice because my only health problems at age 75 are some headaches and increased tiredness. Why would I need a biopsy?A: Temporal arteritis, also known as giant cell arteritis, is a disorder caused by an unexplained inflammation of the arteries, most often those supplying the scalp and eyes. Narrowing of the arteries by the inflammation can decrease the blood supply to tissues and cause headaches, pain and tenderness in the scalp, pain when chewing and recurrent, but transient, blurring or loss of vision.

Loyola women's lacrosse coach Diane Aikens moved out of intensive care yesterday, one day after surgery to remove a brain tumor. The results of a biopsy are expected this weekend.A fund has been started for Aikens that will pay medical expenses not covered by insurance. Contributions can be mailed to Loyola College Athletic Department/Diane Aikens Fund, 4501 N. Charles St., Baltimore, Md., 21210.For questions relating to the fund, contact Dave Gerrity at (410) 617-2547.

A new study has raised serious questions about radiologists' reliability in reading mammograms and making recommendations about what to do when a suspicious lesion is found in the breast.The study, by researchers at the Yale University School of Medicine and published yesterday in the New England Journal of Medicine, found that radiologists who read mammograms can vary considerably in their interpretations of the X-ray films and in the advice they would give to women.Where one radiologist might recommend an immediate biopsy, another looking at the same mammogram might suggest a repeat X-ray in three months, and still another might suggest waiting a year to do another mammogram.

She is 54, not young, not old. Her yearly mammogram showed a small lump. "Highly suspicious," said the radiologist. The doctor recommended a biopsy. She knew then her life could change forever.I'll call her Ella. She is one of my closest and dearest friends. She lives in the nation's capital.The part of her tedious journey from breast cancer discovery to recovery over a three-year period that most frightened me and frustrated her were the terrible decisions she had to make on her own and the controversy surrounding various procedures.

Washington.--In December the National Cancer Institute revised its guidelines on mammogram screening for breast cancer. Previously, it had recommended regular mammograms for all women over age 40. Now it makes no recommendation for those between 40 and 50. Its position is that the evidence is not clear. Women, it says, should study the data and decide for themselves.This is a deeply unsatisfying recommendation, for two reasons. First, if the experts at the National Cancer Institute can't decide whether mammograms are worth while for women in their 40s, how on earth is a non-expert supposed to decide for herself?

Many women are expected to use the National Cancer Institute's change of heart as an excuse to avoid an examination they were never really comfortable with in the first place.Having a mammogram is inconvenient, possibly expensive (even with mandated insurance coverage, there is usually a co-payment), uncomfortable and frightening."They might find something" is probably the leading reason why two-thirds of women have so far avoided this examination. Another common excuse is a fear that the X-ray examination itself might be harmful.

The Rev. Bert Benz's condition continues to improve and has been upgraded from critical to serious.Doctors are pleased with his progress, said Kay Yeltin, spokeswoman for the Markey Cancer Center, University of Kentucky, in Lexington, where the Hampstead minister has been a patient for nearly a month.Benz, pastor of Faith Baptist Church, has chronic myelogenic leukemia. The 47-year-old received a bone marrow transplant from his daughter, Lauren, 12."The reverend has been moved from the intensive care unit," Yeltin said Friday.

Q: During a check-up last week, my doctor discovered a small lump in my thyroid gland. The possibility of thyroid cancer was suggested, and I made an appointment to see a specialist. What is the chance that a thyroid lump is cancerous and how is the diagnosis made?A: Thyroid lumps (nodules) are quite common. In adults they are present in about 6 percent of women and 2 percent of men; they are more frequent in elderly individuals. Approximately one thyroid nodule in 20 is malignant.A thyroid nodule is more likely to be malignant in men, in younger people, in those with a family history of thyroid cancer, and especially in people who had irradiation treatment to the head and neck during childhood or adolescence.