Relay-Version: version B 2.10 5/3/83; site utzoo.UUCP Posting-Version: version B 2.10.1 6/24/83; site unc.UUCP Path: utzoo!decvax!mcnc!unc!oliver From: oliver@unc.UUCP (Bill Oliver) Newsgroups: net.med,net.women Subject: Re: Breast Cancer Treatment. Message-ID: <3@unc.UUCP> Date: Sun, 21-Jul-85 19:12:20 EDT Article-I.D.: unc.3 Posted: Sun Jul 21 19:12:20 1985 Date-Received: Mon, 22-Jul-85 15:11:24 EDT References: <1765@aecom.UUCP> <602@unc.UUCP> Reply-To: oliver@unc.UUCP (Bill Oliver) Distribution: na Organization: CS Dept., U. of N. Carolina at Chapel Hill Lines: 49 Xref: pepe net.med:652 net.women:3156 Summary: In article fsks@unc.UUCP (Frank Silbermann) writes: >In article oliver@unc.UUCP (Bill Oliver) writes: >> This is not a question of functionality. The women are no more >>concerned about losing one half of their potential for lactation >>than a woman contemplating a cholecystectomy is concerned about >>a decrease in her ability to store bile. > >You are forgetting that radical masectomy ALSO removes a great deal >of muscle tissue underneath the breast. Women who receive this treatment >lose a great deal of strength and functionality in the respective arm. >Furthermore, the woman's weight is no longer balanced across her spine. >This can eventually lead to lower back pain. > > Frank Silbermann On the contrary, I am aware of the morbidity associated with a radical mastectomy. I must remind you that the original posting was a speculation on why random assignment to treatment protocols is a necessary part of an experimental protocol. My response was in reply to the accusattion that I was being callous in stating that cosmetic results were important to younger women. I am making a statement about the primary concerns of a women when faced with the possibility of losing a breast. Weakness of the arm, lymphedema, hypesthesia/paresthesia, and imbalance are important, but are less encountered with modern therapies, and can be dealt with more easily in day to day life than an assault on a woman`s self-image. Radical mastectomies , while still claiming some adherents, are much more rarely performed today than 10 years ago, and a more approriate ruler is the modified radical, in which the pectoralis major (the loss of which causes the arm weakness) is preserved. In discussing any subject in a forum where one wants to limit the length of an article to a manageable size, it is necessary to make some assumptions. One assumption I made was that the woman was contemplating a lumpectomy versus modified radical or simple mastectomy, not the relatively obsolete full radical mastectomy. The second was that I should stick as closely as possible to my point. Still, my purpose is not to write a review on therapies for breast malignancy. It is to explain why random assignments are made and to show that cosmetic results are nontrivial. sigh, Bill Oliver