Surviving Breast Cancer: Better Early Detection and New Treatment Methods Are Helping to Lower the Mortality Rate from the Second Most Deadly Cancer Killer of Women

By Hughes, Carolyn | The Saturday Evening Post, January-February 2002 | Go to article overview

Surviving Breast Cancer: Better Early Detection and New Treatment Methods Are Helping to Lower the Mortality Rate from the Second Most Deadly Cancer Killer of Women


Hughes, Carolyn, The Saturday Evening Post


Part I Lisa Schmidt had been tempted to skip the mammogram appointment. But there it was on her calendar, and she already had postponed it once. The summer had been hectic for the 45-year-old nurse and mother of two teenage girls who was trying to work full-time despite a nagging disc problem in her neck. Resigned, she went to the mammography center, hoping to get in and out and get to work.

After her x-rays were taken, she waited for what seemed like a long time. When they did call her name, they explained that more x-rays and an ultrasound scan were needed. Her pulse quickened. Feeling the breast herself a few minutes later, she really began to worry. There was a lump, small but rock hard. How had she missed it in her regular breast self-exam?

The new scans were "suspicious" in the area of the lump, so the doctor inserted a needle to remove a small amount of tissue to look at under the microscope. The news came to her the following morning: as she feared, it was breast cancer. As the reality started to sink in, sobs poured out of her from deep inside that she couldn't control.

Strengthened by the love and support of her family, she would now begin a long journey of appointments, treatments, and surgery. A whirlwind of facts and statistics would be presented; she would try hard to take it all in. There would be decisions to make, and the clock was ticking. She would now have to walk an unfamiliar path--that of a patient.

In 2001, over 190,000 women faced a new diagnosis of breast cancer in the United States. With a one in eight lifetime risk of breast cancer, women around the nation fear that they are in the midst of an epidemic. Breast cancer ranks second only to lung cancer as a cancer killer of women. It crosses lines of all economic classes and racial groups. Relentlessly, the numbers had risen every year until 1989, when the number of new cases each year began to level off.

Amid the bad news about breast cancer, there is one bright spot. The number of people dying of breast cancer has fallen nearly 2 percent every year since 1989. Why? More than anything else, breast cancer screening gets the credit, by finding cancers early.

Mammogram Is Still the Best

We screen for breast cancer in three ways: with breast x-rays (mammograms, also called mammography), clinical breast exams by healthcare providers, and breast self-exams, which women should perform monthly. It's proven that mammograms save lives, cutting mortality from breast cancer by up to 25-30 percent.

"With all of its limitations, film mammography remains the gold standard against which new imaging technologies will be measured," said University of California, Berkeley, professor Joyce C. Lashof, M.D., author of a recent report from the Institute of Medicine.

And the word has been getting out. In 1998 over 68 percent of women aged 50 and older had a mammogram in the past two years, compared to 27 percent a decade earlier, according to the National Health Interview Survey.

But mammograms aren't perfect. About one in five breast cancers can be missed, and mammograms can't tell for sure whether a suspicious mass is benign or malignant (cancer). A tissue biopsy is then needed; which turns out to be negative for cancer 75 percent of the time. Often, a biopsy can be avoided if an ultrasound scan, which uses sound waves, detects that the mass is filled with fluid, like a benign cyst.

Other types of scans, such as an MRI (magnetic resonance imaging), can show a high-resolution image of a breast mass. MRIs help doctors see areas where the breast has been altered by breast implants or previous radiation. Techniques like these can be used to get more information about a breast mass once it has been found. But they can't compete with the mammogram as a screening test.

What else might the future hold? Cancer causes the breast to change its metabolic activity, which is picked up by positron-emission tomography (PET scan), or its temperature, detected by an infrared scan. …

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