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First Lady on Mend; Cancer Had Not Spread

October 19, 1987|ROBERT STEINBROOK | Times Medical Writer

WASHINGTON — Nancy Reagan continued to recuperate from a mastectomy Sunday, and final pathology results showed that the tiny tumor removed from her breast had not spread to the lymph nodes or surrounding tissue, the White House said.

On the day after surgeons removed her left breast, the First Lady ate her usual breakfast, walked around in her suite at the Bethesda Naval Medical Center and shared cards and get-well wishes with the President.

"Mrs. Reagan is recovering remarkably well from surgery," Dr. John E. Hutton Jr., the White House physician, reported in a statement that called her chances for a full recovery "excellent" and said no further treatment was planned, other than "normal routine examinations."

'Very Little Pain'

"Her temperature is normal and she is experiencing very little pain," Hutton said. "The medical team visited her this morning and we are completely satisfied with her progress in every respect."

Hutton added: "Final laboratory analysis of tissue and lymph nodes removed . . . confirm there is no further malignancy or evidence of other disease."

Over the next several weeks, the First Lady can expect to have "some temporary discomfort and limitation of motion of her left shoulder, which should completely resolve," said Dr. Armand Giuliano, director of the breast surgery service at UCLA Medical Center.

During the 50-minute operation Saturday, Mrs. Reagan's left breast and the lymph nodes under her left arm were removed. The procedure is known as modified radical mastectomy.

The surgery was performed immediately after doctors biopsied a suspicious lesion discovered on a routine, annual mammogram and found microscopic evidence of "non-invasive intraductal adenocarcinoma."

The tumor--approximately 5/16 of an inch in diameter--was confined to the channels within the breast that make and transmit milk. More than 95% of all breast cancers are not diagnosed until after they have penetrated the linings of these channels and invaded surrounding breast tissue.

"Her prognosis is outstanding," Giuliano said. "Intraductal tumors lack the ability to spread. These are the earliest types of breast cancer and are totally curable."

President Reagan flew by helicopter from the White House to Bethesda to visit his wife Sunday morning. He was carrying a gift tied with a red, white and blue ribbon.

Call to Child's Parents

The White House reported that from the hospital, the Reagans telephoned the parents of Jessica McClure, the 18-month-old Texas girl who survived 58 1/2 hours trapped in an abandoned water well, to express their happiness at her rescue.

The White House, citing the First Lady's desire for privacy and her concern about excessive publicity after Reagan's 1985 colon cancer surgery, has not made her physicians available to answer news media inquiries about her surgery and prognosis.

Mrs. Reagan joked on Sunday, however, that she and her husband had decided to give each other for Christmas "framed copies of our medical diagrams that we see on television," Elaine Crispen, her press secretary, said.

Although her breast cancer was diagnosed early, Giuliano said that it was "very reasonable" for Mrs. Reagan to have chosen mastectomy instead of less radical surgery to remove only that part of the breast that contained the cancer. The second procedure, lumpectomy, when followed up with radiation therapy, has been shown to be as effective as mastectomy in stopping the more common, invasive type of breast cancer.

Two Types of Treatment

Mastectomy is virtually 100% effective against intraductal tumors, according to Giuliano, but so few cases of breast cancer are diagnosed this early that surgeons have had less experience with lumpectomy-and-radiation therapy for these tumors.

"It may seem illogical to treat a non-invasive breast cancer with more extensive therapy than an invasive tumor," he said. "Yet, given this uncertainty and the prospects of six weeks of radiation therapy, (mastectomy) is a very sound thing to do."

The 66-year-old First Lady is expected to remain in the hospital five to seven days, depending on the speed of her recovery. She will rest at the White House for several weeks before resuming an active schedule.

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