Elizabeth Edwards Diagnosed with Breast Cancer
BLITZER: Yesterday was clearly a difficult day for the Democratic candidates and their families, but we now know it was even worse for John Edwards and his family, who got some very alarming news about his wife's health.</s>SEN. JOHN EDWARDS (D), FORMER VICE PRESIDENTIAL CANDIDATE: In this hour, I'm held up by the love of my life, Elizabeth, and by our beautiful children. And...</s>BLITZER (voice-over): On the same day that Senator John Edwards conceded defeat in his vice presidential race, his wife learned she had breast cancer. A spokesperson says Elizabeth Edwards discovered a lump in her right breast during a campaign trip last week. On Friday, her family doctor told her the lump appeared to be cancerous, but Mrs. Edwards put off an appointment with a specialist until the campaign was over. A biopsy conducted at Massachusetts General Hospital in Boston Wednesday confirmed that Mrs. Edwards has invasive ductal cancer, the most common form. More tests are be conducted to determine the appropriate treatment. In a written statement, Senator Edwards said, quote, "Elizabeth is as strong a person as I've ever known. Together our family will beat this," unquote. Elizabeth Edwards is 55 years old. She was born in Florida but went to law school in North Carolina, where she met John Edwards. They married in 1977 and had two children. After their teenage son died in a 1996 car wreck, Mrs. Edwards gave up her law practice to being a full-time mother to their daughter. She underwent a vigorous hormone regimen in hopes of having more children, and gave birth to another daughter at the age of 48, and another son at the age of 50.</s>BLITZER: For more now on the specific type of breast cancer Elizabeth Edwards has and her prognosis, I'm joined by Dr. Claudine Isaacs of Georgetown University Hospital here in Washington. Doctor Isaacs, thanks very much for joining us.</s>DR. CLAUDINE ISAACS, GEORGETOWN UNIVERSITY HOSPITAL: Thank you for having me.</s>BLITZER: What happens to her now? What does she have to go through?</s>ISAACS: Well, from the information that we have, Mrs. Edwards has just had a biopsy done to make a diagnosis of breast cancer. She has been diagnosed with the most common subtype of invasive breast cancer, called invasive ductal cancer. And the usual next steps are that she will undergo further surgery. From the information that's been released she's had what's called a needle biopsy, which is really just a means of determining what the lump is. And the next usual step in this is more surgery to take out the lump, and the surgeon will also do an analysis or take out a sampling of the lymph nodes in the underarm area.</s>BLITZER: To see if it's spread to other part of the body?</s>ISAACS: To see if it spread to the lymph node area under the -- in the underarm area, which is the most common site for it to go to.</s>BLITZER: Now, we know there are various forms of surgery. There's the mastectomy and there's also a lumpectomy -- a lumpectomy. Explain the difference, what the options she may have before her.</s>ISAACS: From most women with a diagnosis of breast cancer, it's a personal choice, whether to undergo a lumpectomy, which is coupled with radiation therapy following that, and then the other choice is to undergo a mastectomy. What the lumpectomy means is that the tumor lump itself, or mass, is taken out, and the lymph nodes in the underarm air are sampled. And then following that, in terms of local treatment for the breast itself, women then undergo radiation therapy to the breast. The other option, as you mention, is what's called a mastectomy, which involves a removal of the breast itself, and at the same time, the lymph nodes are sampled in the underarm area.</s>BLITZER: And what of the -- why would some women decide for one option as opposed to the other option? From a medical standpoint, which is better in treating breast cancer?</s>ISAACS: For -- most women are good candidates for both of them. So for a woman who is a candidate for both of them, there have been a number of very large randomized clinical trials that have extremely long follow-up now that indicates that the survival is exactly the same between both of these options. So for most women for whom it's an option, it's a personal choice. Some women, and many women do prefer to undergo a lumpectomy followed by radiation, because they preserve their breast, but some women don't want to do that for a variety of reasons, and so they elect to undergo a mastectomy.</s>BLITZER: What would -- most women, I assume, would not want to remove their breasts, but -- so why would there, if there's no difference medically for both of these, why go with a full mastectomy?</s>ISAACS: Some women feel more comfortable with that approach. Some women are far from radiation facilities. And radiation, at least the standard of radiation, involves daily treatment for about 6 1/2 weeks in a row, Monday through Friday. So for some women that's not a feasible option. There are a lot of personal choices that go into the decisions that women make about breast cancer treatment. The important thing to understand, though, is that for the women who are candidates for both of these options, that it really is simply a personal choice and not a medical decision.</s>BLITZER: How treatable is breast cancer? I assume it depends on how early it's detected?</s>ISAACS: And obviously, you're right. We don't have a lot of information, but I think the most important thing for people to understand and for the population as a whole to understand is that breast cancer is extraordinarily treatable. Breast cancer mortality continues to diminish. The vast majority of women with breast cancer will be cured of their disease. So it is an enormously treatable disease and a disease that most women survive and beat.</s>BLITZER: She had hormone treatment in order to get pregnant at a relatively late stage in a woman's life. In her late 40's, she had two little kids. Is that -- could that possibly have aggravated this problem or has nothing to do with it?</s>ISAACS: The data suggests that women who get fertility treatment for pregnancy purposes, that there is no increased risk of breast cancer associated with fertility treatment. There's different information when we're talking about hormone replacement therapy, post-menopausally. And most people have seen some of these studies that have come out that have shown that there's an increased risk of breast cancer in women who take post-menopausal hormone replacement therapy. But there are no studies that suggest that taking fertility treatments, hormones for fertility treatments increase the risk for breast cancer.</s>BLITZER: As you know, there's a lot of weird things out there, a lot of people speculate causes of cancer. Is stress or tension or anything along those lines, especially during a campaign, is that something that could bring on a problem like this?</s>ISAACS: No, there are absolutely no indications that stress is associated with an increased risk for breast cancer. The other thing about breast cancer is we think that for -- by the time somebody's been diagnosed, the breast cancer has been there for quite a while. So that short period of time -- I'm sure it didn't feel so short. But the campaign period of time, one couldn't even have implicated in any way.</s>BLITZER: She apparently discovered this in her own personal examination. She felt a lump and then she went to the doctor. She waited a few days before she had the needle biopsy. Help our viewers understand better what they should be doing right now in order to make sure that they don't have breast cancer. They should do some self-examinations themselves.</s>ISAACS: That's a prudent thing to do. The most important thing to do and the thing that has been proven -- has been demonstrated to -- to be a good screening tool is mammography. So annual mammography is recommended for women over the age of 50. And also many women should -- most women should discuss with their doctor whether they should begin having annual or every two-year mammograms between the ages of 40 or 50.</s>BLITZER: If your mother or a relative had breast cancer, are you more likely to get it yourself?</s>ISAACS: That is an increased -- that increases somebody's risk for the disease.</s>BLITZER: And there's scientific evidence showing that it could be hereditary?</s>ISAACS: Absolutely. But that's different than having a mother or a relative. Most people who have a family history of breast cancer don't have hereditary breast cancer. They have a familial predisposition to this disease. But when we say hereditary, we mean that somebody inherits an alteration, a specific gene that significantly increases the risk for this disease.</s>BLITZER: But are there other causes beyond genes?</s>ISAACS: Yes, there are. There are a number of factors that are associated with women's reproductive history, like early age at first menstrual period, late age of menopause, relatively later age at first full-term pregnancy. There are also certain uncommon benign breast conditions that are associated with an increased risk for this disease.</s>BLITZER: And one final question. As much as we associate women, of course, with breast cancer, men can get breast cancer, as well.</s>ISAACS: Absolutely. It's very uncommon in males, but it's important if a man feels a breast lump to bring to the attention of their doctor for evaluation.</s>BLITZER: Dr. Claudine Isaacs, thanks very much for joining us.</s>ISAACS: Thank you for having me.</s>BLITZER: Very useful information for our viewers. 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