DEAR DR. ROACH: I had my first mammogram and was found to have a lesion. The mammographer said that I should follow up in six months with another mammogram and sonogram, but I have a grandmother who died of breast cancer. So, instead of waiting, I underwent a biopsy that showed a fibroadenoma.

What is it? Does it ever become cancerous? I also read that they are associated with being overweight. I did have bariatric surgery in the past. — V.P.

ANSWER: A fibroadenoma is a benign breast mass. Most fibroadenomas are “simple” and do not increase the risk of developing breast cancer. They do not need to be removed since they won’t become cancer, but some women choose to remove them so that they won’t have to worry about them, although this can cause a scar and some dimpling.

Complex fibroadenomas slightly increase the risk of breast cancer. Some experts believe they should be removed so that the whole tumor can be evaluated, while others do not feel that a complete removal is necessary.

Fibroadenomas do seem to be related to estrogen levels as they tend to occur during a woman’s reproductive years and may increase in size when taking estrogen or during pregnancy (since estrogen levels are high). They also tend to shrink after menopause.

Women who are overweight enough to be considered for bariatric surgery tend to have higher levels of estrogen as fat cells can make a type of estrogen called estrone, which is not very potent but lasts for a long time. If you lost weight as most do with bariatric surgery, your estrogen levels are likely to go down.

DEAR DR. ROACH: I am a 78-year-old woman. I have been prescribed lisinopril and metoprolol for a long time. This past year, my physician discontinued lisinopril and prescribed amlodipine instead.

I have been under a great deal of stress during these past few months. I take my blood pressure on a regular basis and find that it is good when I am relaxed, which isn’t very often. I am feeling this overwhelming panic and fear more than ever. (I have been diagnosed with post-traumatic stress disorder, PTSD, which was caused by losing a daughter to murder years ago.)

I see a therapist regularly. I am wondering if my anxiety could be exacerbated by my medications. I worry constantly, and I don’t feel like I am being supported. — Anon.

ANSWER: I am very sorry about your loss. People with PTSD are more likely to develop high blood pressure. The fact that your blood pressure is under control when you’re relaxed is a good sign, but the important goal now is to treat your PTSD more effectively.

Anxiety is an emotion, not a psychiatric diagnosis. Anxiety can be a helpful way of motivating people to do things, but too much anxiety often has the opposite effect.

Some people with excess anxiety have generalized anxiety disorder (GAD), which is a mood disorder and a specific psychiatric diagnosis. Anxiety is a core symptom of PTSD, and although it is possible to have both PTSD and GAD, often the anxiety that a person feels can all be explained by PTSD.

The medications you are on are very unlikely to be causing or exacerbating anxiety. Metoprolol in particular is often used to help treat the physical symptoms of anxiety, and doing so can help the suffering caused by excess anxiety.

In addition to therapy (a key portion in the treatment of PTSD), medication treatment may be helpful for you if you aren’t taking it already. Your regular doctor or a psychiatrist can prescribe a treatment for your PTSD that can help your mental symptoms (like panic and fear) and also help control your blood pressure.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu. (c) 2025 North America Syndicate Inc. All Rights Reserved