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VOL. 4, NO. 4

IN THIS ISSUE:

Chicago,li|inois60611 Ruth a Martin Lockshin a 3 Fraserwood N Toronto, Ont. M68 2N3 Canada

Breast Cancer

Breast cancer is not an easy subject to write about, both because of the disease itself and because of the fear the very name of the disease has instilled in millions of women, more than 100,000 of whom annually are diagnosed as having breast cancer.

The illnesses that trouble mankind often seem to run in cycles ——the leprosy of Biblical times, the great plagues of the Middle Ages, and tuberculosis during the Industrial Revolution. In the closing decades of the 20th century, the great scourges of our time are heart disease and cancer——both regarded as mysterious and, despite (or because of?) all the efforts of modern medicine, still incurable.

Of all the cancers, breast cancer has been perhaps the most publicized and one of the least understood. Not only have famous women like Betty Ford, Happy Rockefeller, and the late Marvella Bayh become victims of the disease, they also have helped encourage the forms of diagnosis and treatment endorsed by the American Cancer Institute and the National Cancer Institute. Thus, in 1974, these two prestigious institutions involved 280,000 women in a mass screening program. Writing about that program in 1977, science writer William Hines stated, "All the women in the program were enrolled and screened at least twice in examinations that included x—ray exposure (mammography) without being told that the x—rays carry with them a presumed risk of cancer."

In addition, Hines reported, perhaps as many as 100 of those women lost a breast needlessly because cancer was mistakenly diagnosed.

The treatments have proved no better than the diagnosis. Late in 1979, a special scientific panel of the National Institutes of Health recommended the abandonment of the highly—touted radical mastectomy (total removal of the breast and lymph nodes). The two-year (to date) study which provided the basis for this recommendation shows that, so far, patients who have a lumpectomy (removal of the tumor itself) have no different rate of cancer recurrence or survival than women who undergo radical mastectomy. And in many places outside the United States, surgery for breast cancer has been abandoned totally in favor of chemotherapy, radiation and other treatments.

While doctors debate the whys and wherefores of diagnosis and treatment, what happens to the woman who hears she has this dreaded disease? She must do the same as any other patient must do——ASK LOTS OF QUESTIONS. And until her questions are answered to her satisfaction by as many people as she can ask them of, she must forestall a sudden rush to radical treatment.

Dr. Robert Mendelsohn

My breasts seem to be cystic since menopause, and I have had two biopsies in both breasts, which showed the lumps to be non—malignant. However, the Breast Cancer Detection Center claims that their mammograms have