Mastectomy

Mammograms, outpatient care for mastectomy discussedAs a breast cancer patient, I recently chose outpatient surgery at the Johns Hopkins Breast Center, returning home the same day following a modified radical mastectomy. I am grateful that my experience differed greatly from those decribed in Michael Dresser's article (Jan. 31, "Longer hospital stays sought").Prior to the operation, my surgeon carefully explained the circumstances under which I could be an outpatient.If I chose to have reconstructive surgery, that option would not be available to me, as this required a hospital stay of several days.

It's rare that Susan Laugen gets depressed.She remained positive when diagnosed with breast cancer and treated in 1992, and made her friends laugh from her hospital bed when the cancer recurred in 1994 and again last summer. She kept active by joining a band, and she began making jewelry in hopes of earning a living from her craft.Then her studio was burglarized."It just hasn't been a good year," Laugen said. "I thought 1997 would get a little better since I just went through surgery in the summer but the robbery was like a slap in the face."

SAN FRANCISCO -- Venturing into the emotional minefield of gene testing for breast cancer, Kaiser Permanente researchers calculate that some "high-risk" women who test positive could cut their death rate by 90 percent -- if they have their breasts removed.The researchers emphasize that this possibility should only apply to women who undergo testing because they have a strong family history of breast cancer. Most women, however, do not.The calculation was part of guidelines for genetic testing that Kaiser presented Saturday at the annual meeting of the American Society for Human Genetics.

Outpatient surgery not best for mastectomy patientsNo one knows how mastectomy patients feel after this surgery. . . . This is the worst pain imaginable. You have tubes runing into the surgical site for drainage. You are unable to lift your arm, and you are taped and bound together.I cannot believe the comments from Dr. Lauren Schnaper, who runs the breast center at Greater Baltimore Medical Center. She says, "My philosophy is that breast cancer surgery is more of a psychological trauma than it is a physical trauma."

Driven by insurance rules and new attitudes toward recovery, Maryland hospitals are limiting most mastectomy patients to an overnight stay or an outpatient routine that has women going home hours after surgery.A decade ago, women were hospitalized for up to a week after having a cancerous breast removed. It was a time for nurses to check drains and dressings, and for patients to begin recovering from an operation that can be painful and disfiguring.But in an era when hospitals do outpatient hernia repairs and discharge patients a day after gallbladder operations, they are preparing breast cancer patients to recover at home.

A Carroll jury has rejected the claims of a Westminster woman who said two local surgeons caused her to develop multiple personalities after they performed a mastectomy on her in 1989.After deliberating for less than two hours late Monday, the panel of five women and one man found in favor of Dr. Donald D. Coker and Dr. John E. Steers, who had been sued for $1.5 million by Linda Burt, 47, of Westminster."This suit was devastating to them," Susan Boyce, the doctors' lawyer, said yesterday.

A woman testified yesterday that the conduct of a surgeon caused her to develop multiple personalities and other problems, including flashbacks and nightmares relating to sexual abuse as a child.Linda Burt, 47, of Westminster is suing Drs. Donald D. Coker and John E. Steers on several counts, including malpractice, not obtaining her informed consent for treatment, and battery by Dr. Coker.The case is being heard before Carroll Circuit Judge Francis M. Arnold.Much of the suit focuses on Dr. Coker's conduct, but she claims that Dr. Steers should not have left her in Dr. Coker's care, and that Dr. Steers didn't respond adequately when she told him about her problems with Dr. Coker.

Chris Ely recalls the evening, a few weeks after his wife's mastectomy, when Priscilla decided it was time for both of them to face the physical price of her breast cancer.It was a long, emotional moment. He saw his best friend, the mother of their two girls, a beautiful, intelligent, courageous 40-year-old woman struggle with self-doubt, fearful of how he would react to her new appearance."Well, do you want to see this thing?" she asked him."And I said, 'It's O.K.'"Then she just sort of opened her shirt.

Several major scientific articles have indicated that for women with early stage breast cancer, a lumpectomy with radiotherapy offers the same rate of survival as a mastectomy for the surgical treatment of breast cancer.It is surprising then that most American women with breast cancer still have mastectomies. The reasons for this are puzzling to scientists and are clearly complicated, but it points up the need to educate women about these issues so that they can make informed choices. I talked with Dr. Nancy Davidson from the Johns Hopkins Oncology Center about the decisions women must make after they have been diagnosed as having breast cancer.

When Betsy Lambert, a New York lawyer, was told she had breast cancer two years ago, her surgeon advised her to have a lumpectomy, removing only the tumor from her breast, followed by six weeks of radiation treatment.But Ms. Lambert, terrified by the disease, sought two more opinions, one from another surgeon and another from a radiologist. Both urged her to have a mastectomy, removing the entire breast."I really agonized," she said. "It was a very, very scary time." In her heart, she said, she believed "a mastectomy is symbolic of the removal not just of the breast but of the disease."

In a stark reversal of a long-term trend, more early-stage breast cancer patients are choosing mastectomy, despite evidence that the aggressive, disfiguring surgery has the same survival rate as removing the malignant lump, new research shows. The study by doctors at the Mayo Clinic in Rochester, Minn., suggests that a more detailed screening technique may have led additional women to have their breasts removed. But researchers also found a rise in mastectomies among women who weren't examined with the new magnetic resonance imaging technology.

WHEN Mary Simmons of Ellicott City learned in March that she had breast cancer, the news of her illness triggered an outpouring of support among her family, friends, colleagues and neighbors. At a stage when a person can feel most isolated, Simmons has gained strength from the empathy of those around her. "I feel like I'm being carried," Simmons said. "I never feel alone." This is a new role for Simmons, whose optimism, understanding and humor have made her a person to whom others turn in times of difficulty.

Everybody's Quilt Guild of Carroll County recently donated more than 50 mastectomy pillows to The Women's Place at Carroll County General Hospital. The hand-quilted pillows are personalized with inspirational messages and will be used to comfort breast cancer patients who undergo mastectomies at the hospital. Nurses Cheri Fleagle and Alicia Schaeffer accepted the pillows from quilt guild members Diann Paarmann, Pamela Budesheim, Nancy Mosner, Nancy Ogletree, Millie Tracey and Mary Popp.

It's rare that Susan Laugen gets depressed.She remained positive when diagnosed with breast cancer and treated in 1992, and made her friends laugh from her hospital bed when the cancer recurred in 1994 and again last summer. She kept active by joining a band, and she began making jewelry in hopes of earning a living from her craft.Then her studio was burglarized."It just hasn't been a good year," Laugen said. "I thought 1997 would get a little better since I just went through surgery in the summer but the robbery was like a slap in the face."

Mammograms, outpatient care for mastectomy discussedAs a breast cancer patient, I recently chose outpatient surgery at the Johns Hopkins Breast Center, returning home the same day following a modified radical mastectomy. I am grateful that my experience differed greatly from those decribed in Michael Dresser's article (Jan. 31, "Longer hospital stays sought").Prior to the operation, my surgeon carefully explained the circumstances under which I could be an outpatient.If I chose to have reconstructive surgery, that option would not be available to me, as this required a hospital stay of several days.

Outpatient surgery not best for mastectomy patientsNo one knows how mastectomy patients feel after this surgery. . . . This is the worst pain imaginable. You have tubes runing into the surgical site for drainage. You are unable to lift your arm, and you are taped and bound together.I cannot believe the comments from Dr. Lauren Schnaper, who runs the breast center at Greater Baltimore Medical Center. She says, "My philosophy is that breast cancer surgery is more of a psychological trauma than it is a physical trauma."

Driven by insurance rules and new attitudes toward recovery, Maryland hospitals are limiting most mastectomy patients to an overnight stay or an outpatient routine that has women going home hours after surgery.A decade ago, women were hospitalized for up to a week after having a cancerous breast removed. It was a time for nurses to check drains and dressings, and for patients to begin recovering from an operation that can be painful and disfiguring.But in an era when hospitals do outpatient hernia repairs and discharge patients a day after gallbladder operations, they are preparing breast cancer patients to recover at home.

SAN FRANCISCO -- Venturing into the emotional minefield of gene testing for breast cancer, Kaiser Permanente researchers calculate that some "high-risk" women who test positive could cut their death rate by 90 percent -- if they have their breasts removed.The researchers emphasize that this possibility should only apply to women who undergo testing because they have a strong family history of breast cancer. Most women, however, do not.The calculation was part of guidelines for genetic testing that Kaiser presented Saturday at the annual meeting of the American Society for Human Genetics.

A Carroll jury has rejected the claims of a Westminster woman who said two local surgeons caused her to develop multiple personalities after they performed a mastectomy on her in 1989.After deliberating for less than two hours late Monday, the panel of five women and one man found in favor of Dr. Donald D. Coker and Dr. John E. Steers, who had been sued for $1.5 million by Linda Burt, 47, of Westminster."This suit was devastating to them," Susan Boyce, the doctors' lawyer, said yesterday.

A woman testified yesterday that the conduct of a surgeon caused her to develop multiple personalities and other problems, including flashbacks and nightmares relating to sexual abuse as a child.Linda Burt, 47, of Westminster is suing Drs. Donald D. Coker and John E. Steers on several counts, including malpractice, not obtaining her informed consent for treatment, and battery by Dr. Coker.The case is being heard before Carroll Circuit Judge Francis M. Arnold.Much of the suit focuses on Dr. Coker's conduct, but she claims that Dr. Steers should not have left her in Dr. Coker's care, and that Dr. Steers didn't respond adequately when she told him about her problems with Dr. Coker.