Word: lumping
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...talk about it. Breast cancer struck the most evident of a woman's assets, where the motherly and the erotic are joined. And treatment of the disease was a nightmare of pain, disfigurement and uncertainty too terrifying to contemplate. A seemingly healthy woman with nothing more than a tiny lump in her breast (and a larger one forming in her throat) could agree to have a biopsy performed and not know whether she would awake from surgery with a small bandage on her breast -- or no breast...
...surgical options have multiplied. Chastened by better educated and more demanding patients, doctors now wait after a positive biopsy to discuss these options before moving in to amputate. Just last year a consensus meeting convened by the National Institutes of Health formally recommended lumpectomy, the removal of a cancerous lump plus a small amount of surrounding tissue, followed by radiation therapy, as an equally effective alternative to breast removal in many cases. And the success rate for treatment is up -- not dramatically, but up. Nowadays, 76.6% of breast-cancer patients survive five years after surgery, and 63% are alive...
...detection of tumors. Some 65% of American women over 40 have had a mammogram, up from about 20% in 1979. The widespread use of this tool, a low-dose X ray of the breasts, has meant that more women are discovering their tumors in the early stages, before a lump can be felt. In past decades, prior to the spread of mammography, such women might have died of other causes before their breast cancer was diagnosed...
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...
...years ago, lumpectomy would not have been an option for Fallscheer. Since then, studies have shown that when a tumor is small, confined to a single area and readily accessible to the surgeon's scalpel, lump removal plus radiation is no less effective than removing the entire breast. But as Fallscheer's experience shows, not every surgeon is convinced. Nor does every eligible patient choose the lesser operation. Though about 50% of breast- cancer patients are candidates for lumpectomy, only about half of those elect it. Many, including Nancy Reagan, feel safer if the entire breast is removed. "For most...