by Carolyn Weichers

​I was diagnosed with breast cancer in September of 1995. I had had several bouts with lumps and even a biopsy in previous years, but it was a shock to me and my family when I had a lump that was malignant. I can remember the hopeless feelings I had and the scary questions I wanted answered; but I wasn’t sure I really wanted to know the answers. My husband and I felt the need to move quickly and to get every bit of information we could and to get it right now. It was not something we wanted to be patient about.

We did get answers and we found everyone to be helpful but found that we had to work through things in our own way. I underwent chemotherapy and radiation treatments for the rest of that year. It was an experience that has ultimately changed my life. There are many events that have brought me to the peace that I have now, living with the threat of breast cancer. I have, through many different channels, met other women that are brave and strong just as I feel I am. Together we have tried to do something to educate women in our world about breast cancer.

I became one of the original members of Iowa Breast EduAction and we took on the huge project of writing an Iowa Breast Cancer Resource Guide. It was a tremendous amount of work but what a worthwhile project. Finally, I felt that my having experienced breast cancer would actually make a difference to others! It was very important to me to get information out to women right at the beginning of their diagnosis.

I felt strongly that that is the time they need the most support and this Resource Guide will do that! The other avenue that introduced me to breast cancer women, was my volunteering for the Reach to Recovery Program of the American Cancer Society. I know there is a close community of breast cancer survivors. We are a strong and vital group of women. We are braver than we ever thought we could possibly be.

This sisterhood and closeness begins when we first hear the diagnosis of breast cancer. From then on we need to be with others who have had similar experiences. We need to ask and answer questions and communicate hope and strength to each other. I have found this sisterhood to be a healing touch for me and I want to share it with others. Therefore I am a strong advocate of the Reach to Recovery Program and take part in the visits very often.

Breast Cancer survivors are awesome women. They are strong and have a huge voice when they work to help each other. Get involved in some aspect of this great sisterhood and you will be the one to be rewarded!

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by Dr. Douglas Duven

The standard recommendations for treatment of breast cancer are mastectomy or partial mastectomy with Whole Breast Radiation (WBR). Patients with early stages of breast cancer may be offered a partial mastectomy (lumpectomy) followed by radiation treatment to the breast. This should assure the patient that they are reducing their chances of a recurrence in the same breast, an outcome that is similar to complete removal of the breast.

Those choosing partial mastectomy will have WBR as outpatient therapy for 30- 35 days over a 5-7 week time period. For some, this WBR may interfere with jobs and pose a transportation problem for those who travel to radiation treatments. Until recently there has been no alternative to WBR. Currently, however, there are radiation alternatives on the horizon and at a limited number of facilities that are usually involved in a study, that take less time than WBR. These alternative treatments take 20 minutes, twice daily for five days. Early study results suggest these shorter radiation alternatives have similar results as WBR.

The two alternatives to WBR are brachytherapy and intraoperative radiation. Because 80% of recurrences of breast cancers in a lumpectomy occur within 1/2 inch of the biopsy site, the radiation alternatives focus on the lumpectomy site and some surrounding tissue. The first alternative, brachytherapy, has been utilized for years in cancers of the prostate, lung and sarcomas and currently promises to be useful with breast cancer.

Two types are available:
1) Multiple catheter based brachytherapy – This treatment requires multiple small catheters (tubes) to be placed into the breast and left in place for 5 days. Twice a day for 5 days a radioactive seed is placed into each catheter for 20 minutes. Once treatment is finished the catheters are removed.
2) Balloon catheter brachytherapy – This treatment requires placement of a soft balloon attached to a catheter into the lumpectomy cavity. A tiny radioactive seed is placed twice daily into the balloon for 5 days. Once treatment is finished the balloon is then removed.

The second alternative to WBR is intraoperative radiation. This alternative can be done at the same time as the lumpectomy. The radiation therapist brings into the operating room a radiation source that is given after the lumpectomy has been performed but the incision is not closed. The cavity in which the cancer has been removed is given a one-time, 20-minute dose of radiation, which is about equal to six weeks of WBR.

Currently, these alternatives are available primarily in studies and are not yet readily available in all communities. Additionally, not all patients are candidates for the WBR alternatives. Favorable patients are post-menopausal women with stage To, T1, T2, small tumors and negative lymph nodes. Patients that are premenopausal, have large tumors or have small breasts may not be candidates for alternative therapy.

On a positive note, current studies continue to explore the outcome of each alternative and all seem to have similar results to six weeks of WBR. Outcomes so far show similar rates of recurrence, good cosmetic results and high patient satisfaction. Other benefits include no longer having to travel for several weeks to the WBR appointments and less loss of income due to spending less time away from work. 


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