European Stars and Stripes (Newspaper) - December 29, 1992, Darmstadt, Hesse                                A breast cancer Success Story teenager Robin Schuetz went from High school graduation to Hospital operating room by Steve scholar staff writer a year and a half ago Robin Schuetz had everything going for her. She was 17-years-old, pretty intelligent about to graduate from High school and looking Forward to getting married. However she was not your typical teen. The then Ramstein High school senior had breast cancer. Schuetz had her right breast removed in june 1991, a week after High school graduation. At a time when parties College and dating should be taken top priority. Schuetz s thoughts would turn instead to death and dying one of her vivid memories is of lying on the Gurney in the operating room Lan Stuhl army regional medical Center waiting for a Mastectomy. Quot i was scared. I was Only 17 years old and thought my life was Over Quot Schuetz said. Since then she says getting educated about breast cancer has taught her that she is stronger than she thought and solidified her will to beat cancer. She credits Early breast self examination with saving her life. Quot i was pretty careful about doing my self exams. Although there was no history of cancer in my family i always checked. One Day in May i did a self exam and discovered a Lump. It was Small but i was worried Quot she said. That self examination set in motion a Chain of events that has shaped her life. Quot my doctor sent me to Lan Stuhl for a Biopsy after i discovered the Lump. The doctor there Drew fluid from my breast and did a Frozen Section . Known As aspiration the taking fluid from the breast can Tell a doctor whether the Lump is a fluid filled cyst which is usually noncancerous or a solid mass of potentially cancerous tissue. A local aesthetic is used to numb the area before the Needle is inserted into the breast. If the Lump is solid it will contain no fluid. Generally if fluid is found its removal will How to do breast self examination monthly in not self examinations be   of liven Ench year. Women a mild Hurgin it loin monthly be a let ago 20. If you mensa rutile the Liest Lime to do i self a  is two or three Duys of tar your let Erial ends when your breast is least Likely to he tender or swollen. If you no longer menstruate pick a Dikiy such As the first Dikiy of the month to do be. Familiarity with your breasts makes it easier to notice any changes which should be reported to your physician. Before a Mirror q look at your breasts with your arms at your sides then with your hands clasped behind your head and pressed Forward. Sometimes lumps that Are difficult to feel Are easy to see. Look for any changes in either breast a swelling dimpling of skin changes in the nipple or scaling of the skin. Q now press your hands firmly on your hips and Bow slightly toward your Mirror As you pull your shoulders and elbows Forward looking at your breasts again. To you see any significant difference Between them lying Down these Are some variations in be methods. The following represents the circular method. Q flare a Pillow or folded Towel under your right shoulder and put your right hand behind your head. This position flattens the breast making u easier to examine your breast thoroughly for any unusual Lump or mass. Q now make same Small circular Mol ions with the flattened fingers of your left hand circling your Nghil breast. Start m the Middle of your right breast carry the motion through your armpit and Down the sates of your rib Cage Check the lop outermost part of your breast and work your Way completely around until you have examined it All. Circle at least three More limes. A gently squeeze the nipple and look for any discharge. This could signal a problem. A repeat these same motions on your left breast using your right hand. A women should repeat this exam standing in the Shower because fingers Glide Over soapy skin making it easy to concent Rale on the texture underneath. Pillow or folded Towel pay special attention to the area Between the Brasat and the underarm including the underarm. A  Ovit Tow. Co Imbt 01. Uin. Amp Succour Cummo Homes amps John Bohmer Robin Schuetz with husband Michael says a self examination saved her life. Cause the Lump to dissolve. In her Case after the fluid was drawn the Lump collapsed and the doctor thought that was the end of it. But the next Day the cyst was Back the same size it had been. A Biopsy was ordered. An initial Biopsy seemed inconclusive. However another Biopsy confirmed Schuetz s worst fears. She was immediately faced with with a modified Radical Mastectomy an operation that completely removes the breast the minor pectoral muscle and Lymph nodes. Schuetz said her sense of humor and the support of her parents and her then Boyfriend and now husband Michael helped her to Cope. Schuetz is the daughter of it. Col. George and Mary Kay Thompson. He is Deputy director of transportation at . Air forces in Europe Headquarters at Ramstein a. Thompson said his daughter handled the crisis in a manner far beyond her years when we came out of the doctor s office my wife and i were in a Daze. Robin made All the treatment choices. We decided to face this As a Challenge and knew it was something Robin could beat. She possesses a great inner strength Quot he said. Robin prefers to share the credit. Quot it was a terrible time in my life. I could t have made it without them Quot she said. Reconstructive procedure were begun immediately after the surgery. Schuetz opted for an implant. After the breast with its cancerous growth was removed Schuetz had an inflator inserted. According to or. It. Col Robert m. Wilson a plastic surgeon at the Lan Stuhl Hospital an inflator often is the first step in breast reconstructive surgery Quot the inflator is inserted at the same time As the Mastectomy is done Quot Wilson said. During eight to a weekly visits after the surgery the inflator is filled with silicone to gradually shape and stretch the skin to match As closely As possible the shape and dimensions of the other breast. When that is achieved the inflator is removed and a permanent Saline based implant is inserted the doctor said. The worst part for Schuetz was the postoperative treatments Quot my chemotherapy and drug therapy took six months and i hated it. It started in August 1991 and the treatments made me sick from the first treatment but i was luckier than Many people Quot i was Only sick during the treatment and for a couple of Days afterwards. Other people have had it much worse. My hair fell out and did no to Start growing Back until february 1992,&Quot she said. Quot it really used to make me mad if i went to the base Exchange or food mall some people would stare at me or even make rude remarks. I can t understand Why people might treat someone that  today Schuetz remains cancer free and is embarking on a new life Quot the surgery and implant procedure were successful and i hardly Ever think about it anymore. I guess i really do think about it sometimes but it s getting less and less Quot she said. Despite feeling and looking Well Schuetz faces examinations every two to three months for the next three years and yearly after that. But she s has More important things on her mind. She and Michael Are expecting their first child in june 1993. Quot having a child is extra special to me. I m amazed that a body that is capable of producing destructive cancer cells is the same body that is capable of making a _ Beautiful child Quot she said. Once again Robin Schuetz has everything going for her. Page 14 a the stars and stripes tuesday de breast cancer incidence by age rate per 100,000 women 500 invasive cancers Only. Figures Are age adjusted. Figures for 1987-�?T89 reflect Large increase in number of women screened. 19871989 <9781977 breast cancer kills 46,000 a years amps John Bomor 4 technician at the army Hospital in Lan Stuhl Germany administers e Mammogram test. The screenings Ere most important for women Over 40. <5 5 1015 20 25 30 35 40 45 50 55 60 65 70 75 80 85 age groups source a surveillance epidemiology and end results program National cancer Institute by Linnell Smith the Baltimore Sun statistics of breast cancer leap from billboards and Public service ads everywhere one out of nine women will develop the deadly disease if she lives to be 85. Thirty years ago it was one woman out of 16. Although those numbers Are partially influenced by earlier cancer detection and longer life spans no one knows Why the incidence of breast cancer is growing. And breast cancer activists Point out that mortality rates remain virtually the same As they were in the 1950s. It also appears that the disease is increasing in younger women. Roughly 30,000 women in their 40s will develop breast cancer this year even though it is considered primarily a disease of aging. A leading cause of death for women in this age group breast cancer tends to act More aggressively in younger women doctors say. Lacking knowledge of How to prevent the disease a woman a Only defense is to find it soon enough to improve her Odds of surviving it. The Best Early detection device is mammography an a Ray technology that can find some cancers two years before they can be Felt. Many physicians recommend that women in their 40s have annual screening mammograms because of their susceptibility to fast growing cancers. But some question the effectiveness of mammograms for younger women. Although studies have shown them to reduce cancer mortality by 30 percent in women Over the age of 50, recent reports have increased doubts about the effectiveness of mammograms alone at detecting cancer for women in their 40s. Radiologists say the denser breast tissue common to younger women often obscures lumps that Are detected in the mammograms of older women whose breasts contain More fat. Quot mammography misses 9 to 15 percent of cancers and it generally misses More in women who tend to be younger Quot says radiologist Cynthia Swann who specializes in breast imaging. Others in the health establishment also emphasize that mammograms Are fallible. Or. Joe Aisner director of the University of Maryland cancer Center compares the difference in Reading the a rays of younger women and those of older women to looking for something through a Glass that is very Smoky rather than clean. Physicians say that a Mammogram is merely one part of regular screening which should also include a physical breast examination to detect lumps undiscovered by the Mammogram women should also examine their breasts every month. Last month a Canadian study suggested that screening mammograms provided no Benefit in cancer detection in women under the age of 50. The report was quickly denounced by american radiologists who said that much of the equipment used m. The study was of poor Quality and that Many of the technicians were insufficiently trained also controversial Are american studies conducted in the 1960s and �?T70s, of the effectiveness of screening mammograms for women in their 40s. Some cancer experts like Aisner believe that those findings show a Clear Benefit for younger women. Others like or. Barry Kramer of the National cancer Institute say that the results Are inconclusive. Screening mammograms Are Given to women without any symptoms of breast abnormalities or a history suggesting them. Consultative mammograms Are More extensive a rays for women who report specific problems or have a history at risk for the disease. Since 1987, the Sci the american cancer society and most physicians have recommended women get screening mammograms every one to two years after the age of 40 and every year after the age of 50. These guidelines Are used by Many health insurance providers Quot right now there is absolutely no test Lor breast cancer that is As sensitive As the combination of a Mammogram and a physical examination a says Kramer. Quot nothing has been tested and tried and met the same degree of rigor. Everyone is looking for a better diagnostic test but at this Point nothing measures up to the  some possible successors and additions to mammography technology Are under development including an optical mammography technique using Ultrashort pulses of laser Light. There is also talk of developing a blood test to detect breast cancer. Quot mammography is kind of like the United nations it s not perfect but its All we have Quot says Nancy Evans vice president of the National breast cancer action group. Until recently however the Quality of mammography machines and the skill of the technologists were not always guaranteed. In november Congress adopted uniform standards Tor the first time for the estimated 11,000 mammography machines in the la med states. The next step radiologists say is making sure All women Over age 40 get regular mammograms. Swann says that about 70 percent of breast cancer occurs in women who Are not considered at risk for the disease advocates for women with breast cancer also worry that mammograms May Lull women into a false sense of Security their recent efforts at lobbying Congress resulted in a pledge of $400 million for breast cancer research next year almost three times what the government allocated in 1991. Quot the most important thing for women to be doing is to be advocating More Money for breast cancer research or Anne Kasper director of the Campaign for women a health a project of the older women s league National advocacy group. Quot we still Don t understand what bonuses this disease the dramatic numbers of women who arc diagnosed cacti year and who Are dying a 46.000 women Are dying each year a shows us much More needs to be done n y. Times news service the stars and stripes a Page 15