Breast Cancer

By Lewis, Carol | FDA Consumer, July 1999 | Go to article overview

Breast Cancer


Lewis, Carol, FDA Consumer


Better Treatments Save More Lives

Two different women. The same deadly disease. One thought she couldn't get it. The other was told she didn't have it. Both opinions were wrong.

In 1994, one week before turning 35, Cathy Young received the devastating news. "I thought people had to be in their 50s to get cancer," the Oak Grove, Mo., resident says. "And then it happened to me."

Linda Hunter, 42, recalls that in January 1995, her mammogram results came back normal. But skin changes on one of her breasts compelled her to seek a second, third and fourth opinion--all of which supported the initial mammogram findings. Her tenacity finally paid off when a fifth doctor she visited detected a rare form of the disease.

Every three minutes a woman in the United States learns she has breast cancer. It is the most common cancer among women, next to skin cancers, and is second only to lung cancer in cancer deaths in women. Only 5 to 10 percent of breast cancers occur in women with a clearly defined genetic predisposition for the disease. The overall risk for developing breast cancer increases as a woman gets older.

Although treatment is initially successful for many women, the American Cancer Society (ACS) says that breast cancer will return in about 50 percent of these cases.

"It's hard to say that things are back to normal when one survives breast cancer," says Young, "because a survivor always has a fear that one day the cancer may return."

New drugs, treatment regimens, and better diagnostic techniques have improved the outlook for many, and are responsible, according to ACS, for breast cancer death rates going down.

"Women have greater options in breast cancer treatment compared to a decade ago," says Harman Eyre, M.D., chief medical officer for ACS. "New drugs and procedures open up a whole new era of effective treatment."

Breast Cancer Treatments

Breast cancer can be treated with surgery, radiation and drugs (chemotherapy and hormonal therapy). Doctors may use one of these or a combination, depending on factors such as the type and location of the cancer, whether the disease has spread, and the patient's overall health.

Most women with breast cancer will have some type of surgery, depending on the stage of the breast cancer. (See "Stages of Breast Cancer.") The least invasive, lumpectomy (breast-conserving surgery), removes only the cancerous tissue and a surrounding margin of normal tissue. Removal of the entire breast is a mastectomy. A modified radical mastectomy includes the entire breast and some of the underarm lymph nodes. The very disfiguring radical mastectomy, in which the breast, lymph nodes, and chest wall muscles under the breast are removed, is rarely performed today because doctors believe that a modified radical mastectomy is just as effective.

While removing underarm lymph nodes after surgery is important in order to determine if the cancer has spread, this procedure may add chronic arm swelling and restricted shoulder motion to the discomforts of the overall treatment. But a new method, sentinel node biopsy, still under investigation, allows physicians to pinpoint the first lymph node into which a tumor drains (the sentinel node), and remove only the nodes most likely to contain cancer cells.

To locate the sentinel node, the physician injects a radioactive tracer in the area around the tumor before the mastectomy. The tracer travels the same path to the lymph nodes that cancer cells would take, making it possible for the surgeon to determine the one or two nodes most likely to test positive. The surgeon will then remove the nodes most likely to be cancerous.

Radiation therapy is treatment with high-energy rays or particles given to destroy cancer. In almost all cases, lumpectomy is followed by six to seven weeks of radiation, an integral part of breast-conserving treatment. Although radiation therapy damages both normal cells and cancerous cells, most of the normal cells are able to repair themselves and function properly. …

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