Re: [MOL] MAEVE ! [01428] Medicine On Line

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I sure do!  I saw this on the new's last night and do believe that it is up
to the individual choice; but I would have to have alot more proof before I
would consider such surgery on healthy organs.  I may well be wrong; but I
would have concern that since all of the breast tissue is not removed (only
the majority) that the possibillity of getting cancer is still there,
perhaps at a lesser risk though.  Reconstruction would concern me; as were
there to be cancer it would be more difficult to locate.  Now this is just
my opinion, I am not in the medical field; but I am a breast cancer
survivor. Your friend, lillian

By the way, welcome to our wonderful forum!
-----Original Message-----
From: maeve alini <>
To: <>
Date: Thursday, January 14, 1999 7:56 PM
Subject: Re: [MOL] Frank cancelled trip,Christine

>To All
>Does anyone have any comments about this recent report on breast cancer
>alternatives from the Mayo Clinic?
>Published Thursday, January 14, 1999, in the San Jose Mercury News
>Extreme cancer surgery backed
>New York Times
>For women with a high risk of breast cancer, a study being published
>today offers hope, but at a cruel price. Removing both breasts while
>they are still healthy reduces the risk of getting breast cancer by 90
>percent, the study found.
>Researchers at the Mayo Clinic in Rochester, Minn., studied 639 women
>who had their breasts removed from 1960 to 1993. Their findings,
>published today in the New England Journal of Medicine, are widely
>regarded as the most reliable information to date on the long-term
>effectiveness of the surgery.
>``It is a horrifying choice, one of the biggest decisions I've had to
>make in my life,'' said Ronnie-Jane Polonsky of Oakland, who had a
>healthy breast removed two years ago. Although not a participant in the
>study, she is one of many American women who opt for the surgery because
>they feel the odds are against them.
>Polonsky was diagnosed with cancer in one breast when she was 37;
>despite treatment, it recurred when she was 52. She also was haunted by
>memories of her mother's painful, ultimately fatal, battle with breast
>cancer decades earlier.
>``I didn't want it to shadow my life. I wanted to be done with it,''
>Polonsky said.
>Like Polonsky, the women in the study were considered ``high risk''
>because of a strong family history of breast cancer or a personal
>history of breast lumps needing biopsies. Tests developed in the 1990s
>to detect genetic mutations also provide an indication of women who may
>be at risk.
>Surgeons had been performing the procedure, known as bilateral
>prophylactic mastectomy, on such women since the 1960s, assuming it
>would reduce a woman's cancer risk. But they did not know whether it
>really did, or by how much.
>One way high-risk women can try to protect themselves is by having
>regular mammograms and breast examinations in hopes of detecting the
>disease early enough to cure it with surgery, chemotherapy and
>Another alternative
>The only other way such women can protect themselves against breast
>cancer is by taking the drug tamoxifen, which in a large study last year
>was shown to reduce the risk of the disease by about 45 percent. But
>women are supposed to take the drug for only five years because it is
>thought to be ineffective after that time. In addition, tamoxifen may
>cause blood clots or uterine cancer in some women, and although it
>reduces the risk of breast cancer, studies have not shown that it lowers
>the death rate from the disease, as mastectomy does.
>Moreover, many high-risk women sense a time bomb ticking in their
>bodies. ``I felt that I had to watch (the healthy breast) so carefully,
>go in to see doctors so often, have so many mammograms, worry over every
>minor change in my breast -- that I just couldn't live with it,''
>Polonsky said.
>``This is a very important paper,'' said Dr. Patrick Borgen, chief of
>breast surgery at Memorial Sloan Kettering Cancer Center in New York,
>who was not involved in the study. ``It's the first credible
>But Borgen and other cancer experts, including the authors of the paper,
>cautioned that the findings should not be used to pressure women into
>having their breasts removed.
>``The study doesn't mean we should sell the surgery to more women,''
>Borgen said. ``But women who are considering it now have a hard-core
>fact to use as they're making their calculation.''
>Fears about study
>San Francisco breast-cancer activist Barbara Brenner said she fears that
>people will think the surgery is an acceptable solution to preventing
>breast cancer -- rather than searching for underlying cause.
>``We need to be looking at what is causing breast cancer, and working to
>eliminate those causes,'' said Brenner, an attorney who is director of
>the advocacy group Breast Cancer Action. ``If we just take off the
>breast, we're covering up the real problem.''
>She also urged women to seek advice from a genetics counselor about
>their individual risk factors, so they have an informed opinion about
>their choices.
>Individual women involved in the study, and others who have undergone
>the procedure, have no way of knowing whether it spared them from cancer
>that might have killed them, or cost them their breasts to protect them
>from a disease they would never have contracted.
>Only two deaths
>Among the 639 women studied, the researchers concluded that at least 20
>and as many as 40 women would have died if they had not had their
>breasts removed. But there were only two deaths.
>Dr. Barbara Weber, an expert on breast-cancer genetics at the University
>of Pennsylvania, and co-author of an editorial that accompanied the
>study, pointed out that although the procedure theoretically saved 18
>lives, 621 other women who had their breasts removed probably would have
>survived without the drastic operation.
>The number of women in the United States who have had their breasts
>removed in hopes of preventing cancer is not known but may be in the
>thousands. There is no registry of cases. Researchers said women who
>wanted the surgery tended to be those who had seen mothers, aunts and
>sisters die young from breast cancer.
>Like most women who undergo the surgery, Polonsky had her breasts
>reconstructed with implants and skin taken from her abdomen. Images of
>stars were tattooed where the nipples used to be.
>Two years later, she is still adjusting to a loss of sensation on her
>abdomen. The feeling of her new breasts is becoming familiar.
>``My breasts look great,'' Polonsky said. ``I never had a single regret
>about it.
>``It didn't buy complete peace of mind. . . . But once I made the
>decision, I never looked back. It was definitely the right thing for
>Mercury News Staff Writer Lisa M. Krieger contributed to this report.
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