"I Guess It's My Turn"

By Jacob V. Lamar Jr

The helicopter ride from the White House to Bethesda Naval Hospital has become an all too familiar one for Ronald and Nancy Reagan, but the trip last Friday was the first occasion when Mrs. Reagan traveled as the patient. After a biopsy Saturday morning revealed a tiny malignancy in her left breast, the First Lady immediately underwent a modified radical mastectomy. Once the 50- minute operation was completed, however, the prognosis was good: the cancer did not appear to have spread beyond a small area. Doctors foresee no need for future radiation treatments or chemotherapy, and Mrs. Reagan's chances for a full recovery are considered excellent.

The 66-year-old First Lady learned of her health problem on Oct. 6, after doctors found a "suspicious lesion" in her breast when she had her annual mammogram. The discovery marked the second serious bout with cancer for the Reagans in recent years. In July 1985 the President had surgery to remove a cancerous growth from his colon; since then he has undergone minor operations to remove basal-cell skin cancers from his nose. Upon hearing the results of her breast examination, the First Lady said simply, "I guess it's my turn."

Nevertheless, Mrs. Reagan forged ahead with a full schedule over the past two weeks, including a state dinner for Salvadoran President Jose Napoleon Duarte. When the White House announced on Friday that the First Lady would be entering Bethesda for a biopsy, she was in New Hampshire, urging a conference of foster grandparents to get involved in the fight against teenage drug abuse. The First Lady declined to make any comment on her pending test. Said Conference Participant Shireen Tilly, executive director of the Friends Program: "She put on a brave front and a warm, gracious one."

The President too put the best face on the situation, telling reporters he ( had 'great confidence" in Mrs. Reagan's doctors. But sources close to the Reagans reported that his wife's condition has distracted the President while the White House was trying to manage the crisis in the Persian Gulf and salvage Robert Bork's sinking Supreme Court nomination.

Mrs. Reagan was under general anesthesia as doctors performed the biopsy, surgically removing affected breast tissue for laboratory analysis. The biopsy revealed a "noninvasive intraductal adenocarcinoma," a common form of breast cancer found in the ducts of glands embedded in the fatty tissue of the breast. The First Lady had already decided to have a mastectomy if cancer was discovered, and she immediately underwent surgery. Moments after she emerged from the operating room, the President reportedly said to her, "Honey, I know you don't feel like dancing, so let's just hold hands."

Nancy Reagan became the second First Lady to undergo a mastectomy. In 1974 Betty Ford had her right breast removed after cancerous tissue was discovered. The publicity surrounding the operation awakened public consciousness about breast cancer and inspired thousands of women to undergo regular breast examinations.

Until a decade ago, virtually the only treatment American doctors offered women with breast cancer was the Halsted radical mastectomy, a physically and emotionally devastating operation that involves amputation of the breast as well as removal of the underlying chest muscle and all lymph nodes in the armpit. The modified radical mastectomy that Mrs. Reagan underwent involves removal of the breast and adjacent lymph nodes but, unlike the Halsted procedure, allows the patient to maintain the strength in her shoulder and upper arm. According to the American Cancer Society, 130,000 women will be diagnosed with breast cancer this year; an estimated 41,000 women will die of the disease in 1987. But as Mrs. Reagan recovers at Bethesda, she can take some comfort in a reassuring statistic: the five-year survival rate after treatment for noninvasive breast cancer is higher than 90%.

With reporting by David Beckwith/Washington