Word: breast
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Dates: during 1980-1989
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...some point in her life, one out of eleven American women will be told she has breast cancer. The dread of this moment is perhaps the single biggest fear that women have about their health. For Nina Miller, 42, of Santa Cruz, Calif., it happened two years ago. Her reaction was typical: "Total hysteria. My only thought was, they're going to mutilate my body, and then I'm going to die." But Miller has lost neither her life nor her breast. Like a small but growing number of breast-cancer patients in the U.S., she avoided...
Until recently, such breast-sparing techniques were universally considered to be inadequate and dangerous. Today, the evidence is to the contrary. Last month, at a meeting at the National Cancer Institute in Bethesda, Md., noted Italian Oncologist Umberto Veronesi presented the results of a landmark ten-year study comparing survival after a mastectomy with survival following a less disfiguring operation called quadrectomy (see diagram). His conclusion: "There is absolutely no difference...
...bases his conclusion on the treatment and follow-up of 700 Italian patients. Half were treated with a mastectomy and half with a quadrectomy, plus radiation if the malignancy extended to lymph nodes under the arm. All of the women in the study had a very early stage of breast cancer, with tumors measuring less than three-quarters of an inch in diameter. A decade after treatment, 96% of the women in both groups were alive and apparently healthy. Significantly, the study defied the longstanding dictum that anything short of a mastectomy increases the risk that cancer will recur...
Fisher is one of a small number of American medical dissidents who have long opposed the indiscriminate use of mastectomies for breast-cancer patients. At a recent conference in Venice, Italy, sponsored by Bristol-Myers, he and a number of other U.S. doctors reported on their successes with more limited treatment. According to Dr. Samuel Hellman, physician in chief of New York's Memorial Sloan-Kettering Cancer Center, even patients with tumors as large as two inches in diameter may require nothing more than a lumpectomy followed by radiation. Though this approach involves removing even less tissue than Veronesi...
Despite the persuasive force of these studies, Hellman admits, "the consensus among U.S. physicians is still in favor of mastectomy." Indeed, his own institution, Sloan-Kettering, has long been a bastion of radical surgery. A survey conducted in 1980-81 by the National Cancer Institute found that 80% of breast cancer patients in Atlanta and Detroit were being treated with a modified radical mastectomy, an operation in which the breast and some chest muscle are removed. Up to 5% were still being treated with the old-style radical mastectomy, in which so much pectoral muscle is removed that arm motion...