Date: Fri 20-Oct-1995

Publication: Hea

Author: ANDREA

Quick Words:

breast-cancer-awareness

Full Text:

Breast Cancer Awareness

B Y A NDREA Z IMMERMANN

Joanne Cwikla was, statistically, at zero risk for breast cancer - she was 43,

had no family history of the disease, didn't smoke, was not obese, didn't eat

a high fat diet or drink excessive alcohol, had her first baby before the age

of 30, and breast-fed all her children. But during a routine mammography in

1989, microcalcifications were detected. Further tests determined the presence

of malignant cells.

"I had an emotional brick thrown in my face," said the Newtown resident. "I

had nothing anyone could feel. It could only have been detected by a

mammogram."

Mrs Cwikla went on to have two lumpectomies, 30 treatments of radiation, and

12 treatments of chemotherapy. Two years later, a similar calcification was

found - again through mammography - in a different quadrant of the previously

treated breast. A third lumpectomy was followed by a masectomy and agressive

chemotherapy.

"Breast cancer is a dreadful disease and it devastates the person and the

family," said Dr Thampu Kamar, chief of Gynolcological Oncology at Danbury

Hospital. "And because we don't know the exact cause of the disease, there is

no way we can prevent it. The only way we have now is to make a diagnosis

early enough so we can control or cure it."

It is estimated that in 1995 there will be 182,000 new invasive cases of

breast cancer among women in the US; approximately 2,300 in Connecticut. Right

now the best weapon the female population has against breast cancer is

awareness followed by action. The American Cancer Society (ACS) recommends

yearly breast exams by a physician, monthly breast self-examinations, and

regular mammograms for early detection.

"There are a lot of women who don't want to examine themselves. Either they

don't know what to do, they are scared to find something, or they don't want

to be bothered," commented Dr Kamar. He encourages women to take the active

role in attending to their health because, "The eyes don't see and the hands

don't feel what the mind doesn't think," he said.

Education about breast cancer has gone far beyond hand literature. There are

Web sites on the Internet providing information for all women, as well as

patients and their families (http://nysernet.org/breast/index.html). "Danbury

Hospital supplies patients with a video on breast self-examination to watch,"

said Kathy Foss, RN, MSN. "And we have models so they can learn how to feel

and what to look for - it is tactile and visual."

"Not all women's breasts are the same - obviously we come in different shapes

and sizes, some have had children and some not, we're all different ages and

change physiologically as we age, and we each have our own genetic structure

that determines how we are built."

Healthy breasts in some women may feel lumpy due to fibrocystic changes.

Although most breast lumps are not cancer, anything suspicious should be

reported immediately to a physician. Ms Foss describes that which is

"suspicious" as "anything that feels hard and not moveable in the breast, any

unusual pain symptom, any unusual puckering or dimpling of the skin, newly

inverted nipples, breast discharge, or any sores on the breast that don't

heal."

Women also need to remember that breast tissue extends under the arm pit and

TO check that area for lumps, swelling, and pain, she said.

"Women live with their breasts 24 hours a day, seven days a week, and they

should be the ones who are most familiar with every part of their breast

tissue," said Mrs Cwikla, who now shares her personal experience, knowledge,

and empathy with other breast cancer patients and the general public. She is

coordinator of the ACS Danbury Unit's Reach To Recovery, a visitation program

that provides information and support for women with a personal concern about

breast cancer by someone who has already been there.

"The major function of the breasts is to produce milk to nourish an infant.

The milk milk is produced within glands known as lobules and...[is] carried to

the nipple by slender tubes known as ducts. Most breast cancer (70-80 percent)

begins in the ducts," according to information on the ACS's Internet Web Site.

"A common misconception is that breast cancer automatically means death," said

John A. Spera, MD, of the Radiation Oncology Department of Danbury Hospital.

"That is totally wrong, as well as [the notion] that breast cancer means you

have to lose your breast."

Ten to 15 years ago, the usual medical response to early stage breast tumors

of up to 1« inches in diameter would have been a modified radical masectomy,

according to Dr Spera. Doctors now realize lumpectomy and post-operative

radio-therapy is an extremely effective method, he said.

Danbury Hospital statistics reflect a failure rate, after 5 years of this

combination of breast cancer treatment, to be 4 to 5 percent, according to Dr

Spera. "The cure rates are very high," he said.

Depending on the medical situation, treatment for breast cancer may include

radiation therapy, chemotherapy, hormone manipulation therapy, lumpectomy,

mastectomy. Often a combination of these is used.

Statistics bear witness to increased longevity through early diagnosis. Cancer

Facts And Figures states, "the 5-year survival rate (which includes all women

living five years after diagnosis, whether the patient is in remission,

disease-free, or under treatment) for localized breast cancer has risen from

78 percent in the 1940s to 94 percent today. If the cancer has spread

regionally at the time of diagnosis, however, the 5-year survival rate is 73

percent; for persons with distant metastases at the time of diagnosis, the

5-year rate is 18 percent."

"I am a walking advertisement for early detection of breast cancer through

mammography," said Mrs Cwikla. "And I hope to live to be 104."