From the July 2018 issue of HealthCare Business News magazine

The first woman underwent a lumpectomy (which removes only a small portion of the breast, including the tumor and a rim of surrounding healthy breast tissue) and a sentinel node biopsy (which involves removing a few lymph nodes under the arm to check for spread). This surgery took 45 minutes, and she went home the same day. Her lymph nodes were normal, and no further surgery was required. She underwent a course of radiation treatment (standard for women who undergo lumpectomy) and took medication to reduce the risk of cancer recurrence. She required no chemotherapy.

The second woman underwent a mastectomy due to her large cancer, as well as more extensive lymph node removal, given that the cancer had already spread. Her surgery, which was combined with simultaneous reconstruction, took four hours, and required overnight hospitalization. Her surgical treatment also involved subsequent procedures to complete the reconstructive process. She was then treated with chemotherapy, radiation, and a course of medication that will probably last 10 years. Five years later, both women are doing well, with no sign of recurrence. But the second patient experienced a much more difficult and painful road to recovery.


Today, the cure rates for all types of breast cancer have never been better, with an approximately 90% overall survival for women newly diagnosed. Between 2000 and 2010, the death rate from breast cancer dropped almost 2% per year, meaning that 20% more women diagnosed after 2010 are expected to survive than survived with a breast cancer diagnosis ten years earlier. More good news: For certain subsets of patients, the likelihood of survival may approach 98-99%. Knowing this provides understandably anxious patients with an unprecedented reason for optimism.

These profound improvements can be attributed to two factors: earlier diagnosis leading to higher cure rates (as with our first patient), and better, more targeted treatment options for those diagnosed later or with more aggressive tumor types (as with the second).

For 40 years, data has clearly shown that mammograms save lives by detecting cancer at an early stage. Significantly, mammography is the only screening modality proven to decrease breast cancer mortality through early cancer detection. Less recognized, however, is the impact of early detection on decreasing the need for aggressive, extensive treatments, including surgery, chemotherapy, medication, and even radiation.

The majority of women diagnosed with breast cancer will opt for a lumpectomy (a smaller, shorter, less disfiguring breast operation) over a mastectomy when possible. However not all women can safely be offered lumpectomy. Larger tumors and more extensive disease decrease the likelihood of a successful lumpectomy, and tumors found through mammograms are significantly smaller than those identified during a manual breast exam.

July 2018 Magazine

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