Elizabeth Edwards, wife of former Democratic vice presidential nominee John Edwards, on Tuesday began four months of chemotherapy for breast cancer, a spokesman said Wednesday.
Four to six weeks after completing chemotherapy, Edwards will undergo a lumpectomy followed by radiation, family spokesman David Ginsberg said. Ginsberg said she is being treated at Georgetown University Hospital, which is near her Washington, D.C., home.
One of the main reasons to schedule chemotherapy before surgery is to shrink a tumor enough to make a lumpectomy possible. In a lumpectomy, surgeons remove only the tumor and surrounding tissue. In a mastectomy, the entire breast is removed. Radiation is standard treatment after a lumpectomy.
In an article in the Nov. 22 issue of People magazine, Edwards, 55, says she first noticed a half-dollar-size lump in her right breast on Oct. 21.
She told the magazine that she had not had a mammogram since the birth of her son, Jack, 4. Most experts believe that annual mammograms for women in their 50s reduce the risk of dying from breast cancer.
When a sonogram Oct. 29 suggested that the lump was malignant, she called her husband on the campaign trail to break the news, according to People. A needle biopsy Nov. 3, the day after the election, at Massachusetts General Hospital confirmed that Edwards has invasive ductal carcinoma, the most common type of breast cancer.
George Sledge, a professor of medicine and pathology at the Indiana University School of Medicine, says any woman with a half-dollar-size breast tumor needs chemotherapy. The chemotherapy is designed to kill microscopic cancer cells that might have broken off the main tumor and traveled elsewhere in the body.
Research shows that the timing of chemotherapy relative to surgery makes no difference as far as survival rates. But one advantage of administering chemotherapy before surgery is that doctors can monitor its effectiveness against tumor cells, says Marjorie Green, an assistant professor of medicine at the University of Texas MD Anderson Cancer Center.
That's why virtually all MD Anderson patients who need chemotherapy for Stage 2 breast cancer opt to take it before surgery, Green says.
Tumors larger than about 0.8 of an inch in diameter that have not spread into nearby lymph nodes are considered Stage 2. So are smaller tumors that have spread into nearby lymph nodes.
Ginsberg says a needle biopsy found no sign that Edwards' cancer had spread to her lymph nodes, and doctors say her outlook is ''very, very good.''
Harry Bear, surgical oncology chief at Virginia Commonwealth University, says preoperative chemotherapy might eventually eliminate the need for surgery in some women.
For now, though, Bear says, he believes that the main advantage is enabling a woman to undergo a lumpectomy instead of a mastectomy.
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