Elizabeth Edwards has been diagnosed with breast cancer. She has invasive ductal cancer, which is the most common type, comprising 80% of all breast cancers.
Essentially, surgical therapy would be required for all invasive cancers. Whether this is a mastectomy or lumpectomy plus radiation therapy (i.e. breast conserving therapy – BCT) would depend on several factors. The obvious obstacle to BCT would be the in-breast recurrence of cancer following BCT – estimated to be between 10 and 15 percent. Thus, patient selection is critical in choosing the appropriate surgical method. Tumor characteristics, spread and size all affect candidacy. In appropriate patients, studies have shown an equivalence in survival rates.
What happens after surgery? That depends on what is found. Chemotherapy is required in those with spread to the lymph nodes, and for those with tumors larger than 1cm. If the tumor is hormone-receptor positive, Tamoxifen for 5 years is required.
Prognosis for women with early stage disease would vary according to tumor size and spread. The 5-year survival rates for lymph nodes negative, 1-3 positive, and >4 positive are as follows:
Tumors less than 2cm: 96, 87, and 66 percent, respectively
Tumors between 2-5cm: 89, 88, and 59 percent
Tumors greater than 5cm: 82, 73, and 49 percent.
Breast cancer screening should certainly be a part of routine health care: The U.S. Preventive Services Task Force (USPSTF) recommends screening mammography, with or without clinical breast examination (CBE), every 1-2 years for women aged 40 and older.
Breast cancer is a tragic, but beatable disease – especially if caught at an early stage. I wish Mrs. Edwards all the best.
