Dr Tom Smith 

Doctor, doctor: Routine breast checks and a Lyme disease scare

Is it pointless to examine my breasts? Plus my son was bitten by a tick – will he be OK? Dr Tom Smith has the answers
  
  

Doctor, doctor: breast checks
Photograph: Aaron Tilley for the Guardian Photograph: Aaron Tilley for the Guardian

I've been told by a medical friend that research shows it's pointless for women routinely to examine their breasts for lumps, and that it will only cause increased levels of anxiety – is this really the case?
This is a misunderstanding of reports a few years ago, which said that rigidly sticking to such a routine did not, in fact, detect breast cancers earlier. The emphasis these days, however, is on being "breast aware", so that by regularly feeling your breasts at any time, you get to know them so well that any new "feel" is instantly recognised as different. Our local Breast Cancer Care team were a little upset to hear that someone had suggested examining one's breasts was pointless. They organise our screening service and told me that very many of their women had found early cancers themselves – probably at least as many as had been found by routine mammography. They say the "breast aware" system has saved many lives. So keep up the examinations; just don't do them according to a once-a-month schedule.

Six weeks ago, after a walk in the local park, I discovered a small tick on my eight-year-old son's leg. I removed it, and over the following fortnight a red, blister-like lesion slowly appeared. He's had antibiotics, and also a blood test, to see whether or not he has contracted Lyme disease. I'm worried if it is Lyme, because it sounds very serious indeed. Is there anything else I should do?
No. Lyme disease is passed on to humans from the mouth parts of ticks, which are infected by the bacterium that causes it. Without the antibiotics, your son might have gone on to develop fever, joint swellings and pains, and perhaps other symptoms as well. With the appropriate antibiotics, however, the infection is stopped before it causes any problems. So, you can be confident that your son won't develop the illness. Without treatment, the usual course of Lyme disease is for symptoms to start from several weeks to a few months after the tick bite. I'm sure your son won't be affected by then, so you can stop worrying.

• Got a medical question for Doctor Tom? Email Doctordoctor@theguardian.com

 

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