Are They Winning the Fight Against Breast Cancer?
By “Awake!” correspondent in Brazil
YOU may be one of the many women world wide asking this worrisome question. Will there be a positive answer soon? What conclusions were drawn at the Fourth Mastology Congress in Campinas, Brazil?
In February of 1977 some 500 international specialists met there to share their findings in the field of mastology, the medical science dealing with the breast and its diseases. The program focused on breast cancer, its diagnosis, prevention and treatment. We invite you to consider some of the highlights.
Prevalence and Cause
Breast cancer has become a scourge of our times. In the United States alone, it has reached epidemic proportions, with 90,000 cases a year. Unhappily, the disease catches up with one in every 13 American women. Although there is a chance of a cure, if discovered in time, breast cancer is now the leading cause of cancer death among women in the United States, killing 26 in every 100,000. Other countries, such as England and France, are not much better off. In fact, about 4 percent of all adult women in the Western world are affected. Only in Latin America are the women more afflicted by cancer of the uterus and skin, while breast cancer ranks in third place, with 10 fatalities in 100,000. For yet unknown reasons, Oriental women are less subject to breast cancer.
Despite the lack of complete international data, it was observed at the Congress that mortality due to breast cancer has remained the same for 40 years. Women of middle age succumb more frequently and there is a high-risk age group between 40 and 65, the risk going up with age. Furthermore, women in so-called developed countries are more prone to breast cancer than are those living in less developed lands. Hence, some doctors are inclined to see a link between breast cancer and the degree of a community’s development. Others regard fewer children, artificial feeding, greater intake of fatty foods—all characteristic of life in developed countries—as the potential causes.
Whatever the actual causes may be, breast cancer starts as a small, painless lump. It grows in size, may spread to the lymph nodes in the armpit and sometimes to the lymph nodes where the ribs join the breastbone. As long as it is halted at these nodes, it is operable and curable.
Early Detection—Surest Way to Combat Breast Cancer
The doctors at the Congress stressed unanimously that the key to curing breast cancer lies in its early discovery. After preliminary biopsy, surgical removal is possible. The smaller the lump at detection, the greater the probability of a cure, which may be as high as 95 percent. For this reason, the countries where breast cancer is killer number one are making concentrated efforts to help women to detect cancer when it is still small. Publicity campaigns alert the women, teach self-examination and advise periodical medical checkups.
In the United States, the women themselves discover 90 percent of the lumps by palpating (feeling) the breast. But besides this simple method, there are modern scientific methods of diagnosis. So what should you do if you discover a lump?
First, a false sense of shame or fear could put your life in jeopardy. Remember that a tumor may or may not be malignant. In fact, most lumps are said to be harmless. Nevertheless, consult a doctor at once. Never forget that if it is cancer, the hope of successful treatment is greater if the disease is diagnosed at an early stage and the lump is surgically removed. It is said that, in most cases, the removal of cancerous lumps prolongs a person’s life. If there is no new cancer after some years, the stage of “no comeback” may be reached. On the other hand, a malignant tumor may double in size every 55 to 110 days, even in as few as 22 days. So, of what methods of early detection can you avail yourself? The following were discussed at the Mastology Congress.
Methods of Early Diagnosis
The epithelial tissue in the breast goes through various stages until it develops into subclinical cancer, that is, the type not detected by the usual clinical tests, and then into clinically detectable cancer. Discovery before it reaches the palpable stage would, therefore, be far more desirable. Modern equipment makes this possible.
Mammography. This is conventional X ray with the use of special film and an apparatus adapted to the breast. But what about recent press reports that mammography radiation itself may induce cancer?
Dr. Philip Strax of the United States pointed out to the Congress that most of such findings were based on women who had previously undergone some radiological treatment for other diseases. At the same time, he highlighted the effectiveness of new low-dosage mammography equipment, which transmits less than one rad in the average mammogram. Former president of the American Cancer Society Dr. Benjamin F. Byrd, Jr., corroborates this view, saying: “There are no conclusive data on the effects of such low doses of radiation. . . . More to the point: risk must be placed beside benefit. The results of mammography in discovering early, curable breast tumors are indisputable.”
It is held, therefore, that yearly low-dosage mammography screening for women in the high-risk age group, or for women with cancer symptoms, or for those who have a family history of cancer, would not induce a nonexistent cancer. Rather, the American Cancer Society fears that some women may endanger their lives by delaying a mammogram until the advantages of early detection are lost.
Thermography, or heat scanning, looks for tumors by means of infrared radiation. It is based on the principle that carcinomas give off a higher temperature than the normal breast tissue or than benign tumors. This method has been improved and produces a photographic temperature map of the breast in just two minutes. The main drawback seems to be its high cost.
Plate Thermography works by placing on the breast a plate containing liquid crystals. According to the coloration of the crystals, the physician can make his diagnosis. However, some doctors claim that the older chamber thermography is more accurate.
Xeroradiography has been in use for some 25 years. It is a simple X ray but with a selenium-coated aluminum plate. Details of tissue are made visible and may be examined in a single exposure.
Treatment plus Compassion
There are experiments under way with the implantation of isotopes, and some women prefer radiation treatment to a mastectomy. However, at the present time, such means are inferior to surgery as a cure for breast cancer. In view of the psycho-social aspects of breast cancer, surgeons now are apt to follow a more compassionate approach toward their patients. Involved is, not only the specter of cancer itself, but also the fear of losing feminine attractiveness. This may even be a reason why many women wait—often too long—rather than subject themselves to checkups.
Some doctors advocate better surgeon-patient relationship and open discussion of treatment options. In a private interview during the Congress, a Brazil Herald reporter heard Dr. Henry Jenny’s belief that biopsies of most tumors are possible under local anesthetic and that more definite tests can be carried out within 48 hours. Says the newspaper: “Besides eliminating the fear of undergoing general anesthetic without knowing the outcome, the more definite tests give the woman time to discuss treatment options with her doctor, or ask for the opinions of other specialists. If breast reconstruction is desired, the surgery can be planned with the help of a plastic surgeon to maximize the potential for later cosmetic treatment.”
Two British doctors also presented to the assembled specialists reports on their own compassion-oriented approach. Dr. Peter Maguire has had excellent results from a program employing trained nurse-counselors for three treatment phases of preoperative, hospitalization and home recovery. Anxiety reactions have been considerably reduced. The other surgeon, Dr. Richard Handley, received acclaim for the use of conservative radical mastectomy. Instead of removing extensive muscle tissue, as in the standard radical mastectomy, he only eliminates the breast tissue and armpit lymph nodes, but leaves the pectoral muscle between the arm and the shoulder, thus assuring recovery of maximum possible muscle function. A similar technique has been developed by Brazilian surgeon Dr. Fernando Gentil of São Paulo.
Although the compassionate approach is highly commendable, one authority states that “in cancer of the breast early and complete operation easily holds the first place for success so far as present knowledge goes.” At the same time, dependent upon the advance of the disease, palliative treatment is possible with radiation methods, intended to destroy the cancer cells. There is also hormone therapy and chemotherapy. The latter makes use of toxic radicals together with chemical substances. Cancer cells absorb these substances and may be killed. Polychemotherapy, a more recent development, is said to offer another potential weapon in the tough fight against breast cancer.
Value of Nursing
It cannot yet be stated categorically that natural feeding of infants either provokes or prevents breast cancer, but there is evidence that the incidence of cancer is lower in women who nurse their babies. Besides, lactation has a direct bearing on the growth, development and physical, perhaps even mental, health of the newborn baby. It may also affect the mother’s health.
A recent survey in Brazil revealed that 50 percent of all newborn babies are weaned after two and a half months, and 20 percent leave the hospital already accustomed to bottle-feeding. Incidence of child illnesses was 10 times as great as that among the group that was not breast-fed. It is true that some mothers feel pains in the breast after nursing, or they may even get cracked nipples. But this should be no reason to stop breast-feeding without first consulting a doctor. According to Dr. José Aristodemo Pinotti, Mastology Congress president and director of Campinas University’s medical faculty, bottle-feeding as a modern status symbol must be replaced by breast-feeding as a status symbol. There is no medical substantiation for the phrase “My milk is weak.” Nor is there any evidence that breast-feeding alters the appearance of the breast.
Hope for a Permanent Cure
The Congress and our brief review have showed up the slowness of human efforts, however commendable. But there is one sure hope of a permanent cure of all diseases, in the near future. It is foretold in the Bible.
Under the imminent millennial rule of Christ Jesus, this promise of divine healing will come true: “And he [God] will wipe out every tear from their eyes, and death will be no more, neither will mourning nor outcry nor pain be anymore.” (Rev. 21:4) Then, at last, the fight against cancer will have been won.