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UNC professor provides breast cancer update
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Carolina Meadows

Dr. Hyman Muss gave an excellent presentation in the Carolina Meadows Medical Update series recently about breast cancer in older women. He is a professor of medicine at UNC and Director of Geriatric Oncology with a special interest and long experience in breast cancer treatment.

The facts about breast malignancy include 230,000 new patients in the United States every year. The average age at presentation is 61. Fortunately, the cancer has not spread in the majority of these patients. However, the overall death rate for breast cancer remains high with 40,000 US deaths annually. Unfortunately it is estimated that a drop of blood may have thousands of tumor cells. If marble sized, there are a billion. The rapidity of spread is related to the patient’s age and gene factors.

The older woman at age 75 is less likely to have spread or involvement of lymph nodes if a tumor is found. The role of screening mammography is controversial. To have mammography should be a decision made with the patient’s doctor. The lesion in the older breast can be recognized because of surrounding fat with greater ease than the younger breast with dense fibrous tissue in mammograms. If a small tumor appears at age 75 with current treatment there is a survival of 5 years or more and other problems of aging don’t supervene.

Without evidence of spread of the cancer there is an increasing interest in chemotherapy, endocrine therapy, lumpectomy, and radiation therapy. There is the same survival rate as mastectomy. Lumpectomy allows for breast conservation although breast reconstruction can be done in the post mastectomy patient. If there is metastatic disease, although ominous, some patients may live many years with appropriate chemotherapy, pain control and maintenance of muscle mass. Dr. Muss emphasized the most important steps for breast cancer prevention are maintaining a healthy weight, exercise, and diet including ample fruits and vegetables.

Dr. Muss was a dynamic, thoughtful, and interesting speaker. It was nice to have him here at Carolina Meadows.

From resident Public Relations Committee member Dr. James Scatliff

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