European Stars And Stripes (Newspaper) - July 28, 1987, Darmstadt, Hesse                                Old dog new tricks said or. Eric Munoz of Long Island jewish Hospital. Asa general Rule physicians Are like Farmers. They Don l want to change " Henderson agreed. Just  he said you spend four years of your life learning to do a very complicated be ration and you re making your living doing it and now somebody comes along and say i s not necessary. Thai s hard at Munoz s Hospital Aboul half Iho breast cancer patients receive Lumpe Lomies even this is far higher than at most places. In the Eay 1930s, the american College of surgeons estimated thai 7 percent of women got Lumpe Tomies instead of mastectomies. Or. David Winchester the professional organization s medical director estimates Iho nationwide figure is now Aboul 15 percent. In general a woman s chances of having a Lumpectomy rather than a Mastectomy Are boiler at a Large medical Center than Al a Community Hospital. But even among the nation s Best known cancer hospitals hero Are striking differences when or. Samuel Hellman moved from Harvard to become phys clan in chief at memorial Sloan Kathering cancer Center in new York four years ago just 4 percent of breast cancer patients there received Lumpe Tomies. The figure now is 38 Perc sol. A Changa hell Mari attributes in part to turnover in the Hospital Salaff. He says the percentage is still too Low. However mailman Grants room for disagreement. We Are looking at data that Aren t certain he said. People Are entitled to different  those data have been accumulating Lor two decades in Europe where doctors have been studying the procedure longer the statistics show thai women survive just a Well when doctors perform breast sparing surgery. Fisher s study the most intensive look Al the question in the United Stales Lound the same thing. Eighty five percent of the women who got Lumpe Lomies for Early breast cancer survived at least live years and they did As Wall or perhaps belter than those who received Masle Lomies. However breast cancer May recur As Long As 20 years alter the first operation. Sceptics say Many More years of follow up Are necessary to convince them that Lumpectomy is As Good As Mastectomy. They Are hesitant to abandon a procedure that they know saves lives. I go along with Lumpectomy and radiation therapy. It s Prelly much proven to be an effective technique said or. Arthur Holieb of the american cancer society. But i m not really convinced in my own mind thai the 10 or 15-year results Aie going to be As Good and i m waiting to see. T think that s the reason Lor the reluctant dragons out  away from the major medical centers the Odds Are slim that a woman with Bra so cancer will emerge irom surgery with both breasts intact. At Navarro county memorial Hospital in Corsicana Texas Lor instance about 90 percent of breast cancer operations Are Masle Lomies. Or. Lewis e. Gibson one of the surgeons there says thai if a tumor is big enough to feel he recommends a Mastectomy because he believes the chances of survival Are better. I always come Back to putting it in my mind one  he said ii this was my wife or daughter what would i do to her thai a the ultimate Way i make the  Gibson sad there was another concern doctors share bul rarely express a fear they la be sued Lor malpractice if a woman Dies of spreading cancer following a Lumpectomy. If i do the Imit procedure on a larger lesion and that woman Dies of Mela Slatic spreading cancer she might still have died if i d done the modified Radical Gibson said. But i know and her husband knows thai we be done the maximum on her he knows we did All that we could  when a Lump is Cut Oul. The of is Only half done. The woman still needs six weeks or so at radiation therapy this must be administered skill Lully to prevent scarring the breast. Many email hospitals simply do nol have this expertise that s one reason Why women in Caribou. Mama Lor instance Are unlikely to gel Lumpe Tomies if they Check into Cary medical Center the local Hospital. We May have done one or two Lumpectomy is on Small lesions bul not a significant  said John Myers. The physician assistant who administers Gary s operating room. Canabou surgeon Pedro Simon said he did t perform Lumpe Lomies in Parl because patients must travel to Portland at the opposite end of the state to Consul with a radio therapist. This is Loo inconvenient and Imo consuming or. Jay r. Harris clinical director of Iho joint Center for radiation therapy at Harvard medical school said that besides the legitimate double about Lumpe Tomies there was also a machismo element in some surgeons reluctance to switch. They feel Iho surgeon controls How these patients will be treated and hero s a change that s being forced upon them he said. It s  however surgeons arc certainly nol entirely responsible for the persistence of mastectomies. After hearing the options. The patient herself often decides she wants her cancerous breast in moved the doctors say some women air afraid of radiation others simply feel boiler knowing the diseased breast is gone Hinr Jurson said women who d already  mastectomies sometimes Uig cd i hair in rinds with breast cancer to undergo the same operation even Ihu ugh they might be Good candidates for  once a woman has had a Masl Ecloy said Henderson the idea of the next patient nol having Tho Mastectomy is frightening to her because she has to say maybe i made a mistake " Many experts believe the number of women gelling Lumpe Tomies will grow bul Lor now there is no agreement on what percentage of breast cancer patients should receive this surgery. How to examine your breasts before a Mirror inspect breasts with arms Down and then raise arms. Look for any changes in contour swelling dimpling of skin or changes in nipples. Then rest Palms on hips and press Down firmly to flex Chest Muscles. Left and right breasts will not match exactly few women s breasts do. Lying Down with a Pillow or folded Towel under right shoulder place right hand behind head this distributes breast tissue More evenly on the Chest. With left hand and fingers Flat press gently in Small circular motions around the breast a Fidge of firm tissue in the lower curve of each breast is Normal. Move slowly toward nipple while circling to examine every part of the breast repeat procedure on the left breast with a Pillow under left shoulder and left hand behind the head. In the Shower with fingers Flat move gently Over every part of each breast. Use right hand to examine left breast the left hand for right breast. Check for any Lump hard knot or thickening firmly squeeze the nipple of each breast gently Between thumb and Index Finger. Any discharge Clear or bloody should be reported to your doctor immediately. Chk�90 to nouns graphic source american cancer society tuesday july 28. 1987 the stars and stripes Page 17