Letter: A doctor's vigilance

Sir: I read with interest Annabel Ferriman's piece "Hands off my chest, doctor" (13 October) and cannot agree with the conclusion that manual examination of the breast serves no purpose. The writer asserts that if she were subjected to such an examination she would change her doctor.

Some years ago when I was in general practice I was consulted by a lady who had a chest infection and in the course of an examination I carried out a manual palpation of her breasts. I discovered a lump in one breast which she had not noticed herself and this turned out to be malignant. Prompt action was taken and, although she was unfortunate to lose the breast, she is alive and well more than 10 years later and clearly cured of her cancer. This would probably not have been the case had the lump not been discovered until it had grown large enough for the patient to find it herself. It is hardly necessary to say that she is eternally grateful.

I hope that Annabel Ferriman will never find herself in a situation where she discovers such a breast lump, but if she did I suspect that she would follow the pattern of this litigious age and sue a doctor for being insufficiently vigilant.

Dr H SILVER

Downholland,

Lancashire