Word: breast
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...nearly four decades, some women with a family history of breast cancer have been so fearful of possibly having inherited a strong predisposition to the disease that they opted--even though they showed no signs of cancer--to have their breasts surgically removed. But it's impossible to extract every last piece of breast tissue from the upper body; so they were never sure that the procedure, called a bilateral prophylactic mastectomy, would truly help protect them...
Until now. Last week physicians from the Mayo Clinic reported that 639 women, all facing a moderate to high risk of developing breast cancer, underwent prophylactic mastectomies from 1960 to 1993 and reduced their chances of dying from the malignancy at least 90%. The study, published in the New England Journal of Medicine, has received so much attention that it could spark an increase in the number of preventive mastectomies. Currently, according to Dr. Kenneth Kern, a surgical oncologist at the University of Connecticut Health Center and Hartford Hospital, perhaps a few hundred such operations are performed nationwide each year...
...Mayo investigators derived the figure from statistical models and from the death rate of the patients' sisters, who did not undergo the operation but presumably faced the same cancer risk. The deaths among the untreated sisters led doctors to predict that there should have been 20 deaths from breast cancer in the research subjects. In fact, after the mastectomies, there were only two deaths...
Most women and even many physicians overestimate a woman's risk of developing breast cancer, says Dr. Barbara Weber, professor of medicine and genetics at the University of Pennsylvania Cancer Center in Philadelphia. For example, everyone has heard that 1 in 9 women develop breast cancer. "That doesn't mean you have a 1 in 9 chance of getting sick tomorrow," she notes. It means that over a lifetime of 85 years, 1 out of 9 women will develop breast cancer. But two-thirds of breast-cancer patients die of something else. In fact, heart disease...
...important to remember," Horowitz emphasizes, "that this radical procedure should be viewed as something to be considered only by women at the highest risk" This is not for any woman who simply had a relative with breast cancer. "This is for women who had a close relative with breast cancer, like a mother or a sister," says Horowitz, "and most importantly, a close relative who developed the disease at an early age." Obviously, a double mastectomy is a tough decision that should be made in close consultation with a physician. Women should remember that there are other preventive alternatives such...