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Transcript: "Treatment Decisions"

Announcer: Not so long ago, if you were diagnosed with breast cancer, you almost always had a radical mastectomy, in which the breasts and much of the surrounding tissue were removed. Today, there are many other less drastic options for treatment, and that's good news. But it can also make facing cancer even more challenging -- you not only have to deal with the fact that you have cancer, but you also have to start making choices about what sort of treatment you should have. In our next story, we follow one woman as she makes those vital decisions.

Pat: I was in the airport that morning, feeling pretty good about getting the information back, and there on the newsstand was the headline that Linda McCartney had died of breast cancer, and I thought, Oh, great, so today I'm getting the biopsy results back in -- you know, is this an omen or not?

Announcer: Pat Swindle, a 50-year-old marketing consultant from Minneapolis, was on her way home from a client meeting when she called her doctor from the airport.

Pat: She said, "Do you want to talk now?" and I knew when she said it that way that it was not a good report, and I said, "Yes, I really want to know now."

Woman: This is the post-biopsy mammogram.

Announcer: The news was bad -- Pat had a cancerous tumor in her left breast. What was your reaction to that news?

Pat: You almost can't -- I couldn't feel anything for quite a while. I was really very numb, and they talk about the darkest hour, and it really is the first 24 to 48 hours when you get the diagnosis. It's really a very catastrophic piece of news in many ways. It hits you that suddenly your life has changed forever.

Announcer: Instead of rushing into a treatment plan, Pat took more than a month to decide what was best for her. She did research, questioned specialists, and sought help from her primary care doctor to make sense of all the information she was getting.

Carol Sharpe: Statistics aren't as bleak as they might seem at the outset.

Announcer: Internist Carol Sharpe says despite the cancer diagnosis, there was some good news.

Carol: Pat was very, very fortunate, extremely fortunate, that on a purely screening mammogram, she had a small -- but suspicious abnormality, that when it was biopsied, was found to be about the earliest stage breast cancer that you could possibly have.

Announcer: Pat's cancer was caught early because she'd been getting regular mammograms.

Woman: So the wire's been put in. The little clip is where she previously had her needle biopsy.

Announcer: After many consultations, Pat has decided on a lumpectomy, followed by radiation, but without having her lymph nodes removed. She remains awake for the hour-long procedure, receiving only local anesthesia.

Pat: Okay, I felt something.

Surgeon: Okay, this is a little more of the local going in.

Pat: Okay.

Announcer: Most patients have the lymph nodes under their arm biopsied, to see if the cancer has spread. According to Pat's surgeon, Margaret Bretzke of Abbott Northwestern Hospital in Minneapolis, very few women find their cancer early enough to opt out of this part of the procedure.

Margaret Bretzke: In the usual case, in an invasive breast cancer, we would want to do a node sampling at least to see if they're involved or not, and that's part of the staging that's done for invasive breast cancers. But given the fact that her tumor was so extremely small, measuring about a millimeter and a half in diameter, the odds of her having a lymph node involved is in the 1% to 2% range, maybe at the most.

Surgeon: We're done for now. Okay, thanks. So far the margins are clear so we're done for now.

Announcer: The initial report from pathology is good. Pat is clearly relieved, and she's finally able to let her guard down.

Pat: Oh, I'm tired -- I can't wait for a nap.

Announcer: It's now two weeks after surgery. Today, Pat is having her chest area marked, for the most effective and safest place to direct the radiation.

Woman: OK, this will be a little bit cold while it touches your skin.

Announcer: When the treatment starts, Pat discovers the radiation burns her skin, making it uncomfortable to wear a bra. She feels tired, and needs to take afternoon naps. And she has to stop traveling for nearly two months, while undergoing the daily treatments.

Pat: I've been working to bring my schedule under control for July and August, so that I wouldn't be traveling as much, and a couple of my clients have been really nice and said they will come here for that period of time. Sometime between the surgery and the radiation, I managed to sort of convince myself that, you know, life was normal, and then when -- the radiation is a very sobering thing.

[ bell ringing ]

Announcer: Her medical treatments are nearly finished, and Pat is taking more time for herself. So far, she's feeling good about the decisions she's had to make in the four months since she was first diagnosed with cancer.

Pat: I wanted this incredibly wise, perfectly informed doctor to come along and say, "This is what you will do, and then when you do that, you will be cured." That's very much a fantasy, I think, that someone can give you those answers, and one of the really -- one of the things that really kept hitting me over and over again is that there are no black and white answers in cancer treatment.

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