I saw a patient this week that really drove home the importance of diagnosis before treatment. In plastic surgery, diagnosis is usually very straight forward and can be made from across the exam room or sometimes even from across the street. Common diagnoses in my practice include large breasts, saggy breasts, small breasts, asymmetrical breasts, saggy abdomen, big saddlebags, jowls, saggy eyelids …… you get the idea. But sometimes I will see a patient whose diagnosis requires something more than a history and physical examination.
This particular patient was a lady in her early 60’s who had a breast lift some 15 years previously. She presented with an ulcerated area on her right nipple that had been present for over 6 months. She was convinced it had something to do with her breast lift surgery although the ulcerated area was well away from any of her well healed and almost invisible breast lift scars. I am convinced that her ulceration is a rare and treatable form of breast cancer called Paget’s disease.
She had seen a half dozen alternative provides who all offered some sort of treatment be it supplements, special salt baths or special ointments. Guess what? Nothing worked and none of these providers had a diagnosis. They were treating an unknown problem with ineffective therapy. If you know me well, you know that this sort of thing makes me really, really cranky. This lady had spent a lot of money and delayed a definitive diagnosis by 6 months.
I referred this patient to a breast cancer surgeon for a biopsy which will reveal her diagnosis and allow her to get proper treatment. I never cease to be amazed by the hubris of some members of the “alternative” medical community. They don’t know what they don’t know.
Thanks for reading. Dr. Lisa Lynn Sowder
@lisalynnsowder
