Re: [MOL] MAEVE ! [01534] Medicine On Line


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Re: [MOL] MAEVE !



Maeve,
I, too, am a breast cancer survivor. Although there is no family history of
breast cancer, I don't think I would go to such a drastic measure. I would
be concerned, as Lil said, that they cannot remove all of the breast
tissue, therefore, you are still at risk, even if it is a lower degree. I
would also be concerned about early detection once you have had a
mastectomy and/or reconstruction. I think if I was concerned with a family
history, I would make sure I did regular breast self-examination and a
yearly mammogram. Personally, I would probably be worried either way but
would have a hard time handling the psychological aspect of a double
mastectomy. 
Christine

At 08:08 PM 14/01/99 -0500, you wrote:
>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 <maevealini@hotmail.com>
>To: mol-cancer@lists.meds.com <mol-cancer@lists.meds.com>
>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?
>>
>>Maeve
>>
>>
>>Published Thursday, January 14, 1999, in the San Jose Mercury News
>>
>>
>>
>>Extreme cancer surgery backed
>>
>>BY DENISE GRADY
>>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
>>radiation.
>>
>>
>>
>>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
>>calculation.''
>>
>>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
>>me.''
>>
>>
>>
>>
>>------------------------------------------------------------------------
>>Mercury News Staff Writer Lisa M. Krieger contributed to this report.
>>
>>
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