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...took great risks in attacking on a Sunday during the day. He remained coolly in control, deliberating and improvising as he went along. In short, the killer was young, highly intelligent, probably with a high school education, and possessed of a confident manner. The police eventually arrested a 175-cm, 7.3-kg (5-ft. 9-in., 160-lb.) black male who was physically strong, very bright and macho, worked in a fast-food restaurant and had been staying with his sister one building away from the victim. He was 15 years...
Consider these facts. By the time a breast tumor is large enough to be felt as a lump, it is generally more than 1 cm (0.4 in.) in diameter and contains several billion cancer cells, some of which may have broken loose, circulated through the bloodstream and begun to infiltrate other organs. A mammogram can detect pinpoint tumors that are less than 0.5 cm (0.2 in.) across, often well before the process of metastasis has started. This is not to say that a manual exam by a doctor or the woman herself is a waste of time. Such exams...
Colleen Fallscheer, a cheerful 40-year-old mother of two from Waterford, Mich., is living proof that breast-cancer therapy is not the horror show it used to be. A little over a year ago, a mammogram revealed a bright malignant spot, no more than 1.5 cm (about 0.6 in.) across, imbedded in the translucent tissue of her left breast. A surgeon recommended a mastectomy, to be followed by chemotherapy. Fallscheer was appalled. She sought a second opinion from David August, a surgical oncologist at the University of Michigan Medical Center, who told her that her tiny malignancy made...
Last November, in a two-hour operation, Dr. August's team removed the cancer plus a margin of surrounding tissue, leaving Fallscheer with a 5-cm (about 2- in.) scar in an otherwise normal-looking breast. To catch any residual cancer cells, she received six weeks of daily radiation therapy, which produced a light suntan but left no permanent trace. "A lumpectomy plus radiation does not cure more women than mastectomy," says radiation oncologist Allen Lichter of the University of Michigan, "but it creates fewer physical and emotional scars." Fallscheer concurs: "It was only after I saw Dr. August that...
Frequently, doctors use a variety of factors to determine which patients are at highest risk. One major consideration: tumor size. "One centimeter ((0.4 in.)) is considered the major turning point," says Dr. Larry Norton at Memorial Sloan-Kettering in New York City. "Over 1 cm, and I lean very strongly toward additional treatment." A close look at the tumor cells will provide other clues, says Dr. William McGuire, chief of medical oncology at the University of Texas Health Science Center at San Antonio. Misshapen cell nuclei, abnormal amounts of DNA or an accelerated rate of cell division...