At age 30, I noticed a lump in my left breast. My doctor told me that it was probably fibrous and to keep monitoring it and not to worry. He also did not recommend a mammogram because of my age. I think I should look into it further and would like a mammogram. Why are breast exams promoted at such an early age if, when we find something, the recommendation is to monitor it for several more years?

Kim

Mammograms can be very difficult to interpret in younger women -- dense breast tissue obscures many abnormalities. Clinical examination is very important. A smooth, mobile, rubbery or cystic (fluid-filled) lump in a 30-year-old is most likely benign. If there is a strong family history of breast, ovarian or colon cancers, however, that lump should be biopsied, regardless of what a mammogram shows. If it is unclear whether a lump is cystic or not, an ultrasound can help. Cysts, especially if they wax and wane with one's period, are most often benign.

Many women have fibrocystic breasts -- lumpy, bumpy breasts, especially pronounced right before the menstrual period. Caffeine can exacerbate these fibrocystic changes, and vitamin E (400-800 IU daily, taken orally) may help minimize them.

If your lump does not change with your cycle, if it grows over the next couple of months, if it is associated with any puckering of the overlying skin or nipple, it should be investigated. If you continue to notice it and are worried, then by all means seek a second opinion.