3

Thursday, July 28, 2016

The Michigan Daily — michigandaily.com NEWS

Doctors say surgery 
is case-based and not 

for everyone

By MEHRUNISA KHAN

Daily Staff Reporter

When it comes to a patient’s 

decision on how to treat a health 
threat, knowledge is key to 
navigate through a myriad of 
treatment options.

Each year, more than 230,000 

women are diagnosed with breast 
cancer, and more than 40,000 
will die from the disease. It is 
considered a common medical 
condition in women; one in eight 
women will be diagnosed with 
breast cancer sometime in their 
life.

Steven Katz, University of 

Michigan professor of internal 
medicine, explained that the 
treatment 
process 
can 
be 

stressful, since there are different 
options for patients, including 
surgery, radiation, chemotherapy 
and 
pills. 
Information 
for 

treatment recommendations has 
become increasingly complicated, 
as it now includes stages of cancer, 
its spread and the biological 
characteristics of the cancer.

“All women have the decision 

about surgery, and it’s not that 
easy to do because they have to 
consider the choices they have 
for surgery and all of the other 
treatments that go into the 
management of breast cancer,” 
Katz said.

One possible breast cancer 

treatment is bilateral, or double, 
mastectomy, 
which 
removes 

both breasts to prevent cancer. 
The number of women who 

underwent double mastectomies 
performed has tripled in the past 
10 years. In 1998, 3.6 percentof 
women younger than 40 had 
the procedure, but, in 2011, the 
percentage jumped to 33 percent. 
In spite of this increase, double 
mastectomies do not necessarily 
improve chances of survival, Katz 
said.

Michael Sabel, University chief 

of surgical oncology, wrote in 
an e-mail to the Daily that some 
double 
mastectomies 
can 
be 

warranted. Genetic testing looks 
for changesin a patient’s genes, 
proteins or chromosomes. For 
breast cancer, mutations in genes 
called BRCA1 and BRCA2 put 
patients at a higher risk for breast 
cancer. Younger women who have 
the cancer or are at a higher risk 
for developing breast cancer in 
the future may choose to undergo 
double mastectomies to prevent a 
second or first incident of breast 
cancer, respectively.

“In 
2002, 
genetic 
testing 

became available for decision 
making prior to surgery and 
so younger women with breast 
cancer, or women with very strong 
family histories, could undergo 
genetic testing, and, if they 
harbored a genetic mutation, they 
stood a high chance of developing 
a (second) cancer and thus opted 
for bilateral mastectomy to not 
only treat the known cancer but 
also prevent a second cancer in the 
future,” Sabel wrote. “However, 
genetic testing is (im)perfect — 
there are young women or women 
with very strong family histories 
who test negative for a genetic 
mutation, and we don’t know 
every gene responsible for breast 
cancer, so many women who are 
considered high-risk may also opt 

for bilateral mastectomies.”

Sabel said, in addition to genetic 

testing, other factors — such as 
imaging from MRIs or improved 
reconstruction surgery — could 
be involved in the decision to 
have a double mastectomy. 

However, Sabel wrote there 

is still misinformation on the 
benefits of a double mastectomy 
that can mislead women in their 
decisions. 
Sabel 
cited 
media 

coveragesof 
celebrities 
who 

have had double mastectomies, 
and other social media outlets 
as possible sources that spread 
misinformation.

“While doing the more drastic 

surgery may reduce risk of a 
(second) cancer, for most breast 
cancer patients that risk is not 
that high and it is important to 
note that bilateral mastectomy 
does not improve survival over 
other options, such as breast 
conservation,” 
Sabel 
wrote. 

“These ideas likely come from 
multiple 
sources. 
 
We 
just 

wrote an article studying the 
possible impact of celebrity news 
reporting on perpetuating this. 
There are more blogs, support 
groups, 
websites, 
etc. 
about 

breast cancer that may propagate 
this. There is also likely word of 
mouth from family or friends who 
have gone through breast cancer 
treatment.”

Katz 
explained 
that 
the 

pressure of the situation tends 
to make patients react quickly 
— going with their guts and 
the recommendations of their 
doctors. 
Sometimes 
these 

decisions are made after one visit.

“In 
that 
context, 
people, 

men or women can prefer or 
favor an extensive treatment 

‘U’ experts weigh pros and 
cons of double mastectomy

Incumbent defends 

seat against two 

challengers

By ISHI MORI

Daily Staff Reporter

City 
Councilmember 
Sumi 

Kailasapathy (D–Ward 1) faces 
two different challengers — Jason 
Frenzel and Will Leaf — in next 
week’s Democratic primary for 
City Council elections. 

Incumbent Kailasapathy is a 

fiscally conservative pragmatist 
who has held her City Council 
seat since 2012. A child of Sri 
Lankan academics, Kailasapathy 
came to the United States to 
attend college and is currently 
an accountant at Edwards, Ellis, 
Armstrong & Company, P.C., 
an accounting firm based in 
downtown Ann Arbor.

As a candidate with a financial 

background, Kailasapathy said 
there are low-hanging fruits 
when it comes to increasing 
revenue and cutting costs in 
city government. She named 
revisiting the tax capture policies 
of the Downtown Development 
Authority 
and 
the 
Local 

Development Funding Authority 
to make their revenue cap $4 
million instead of the current $6 
million as one way to increase 
revenue.

In a July 12 televised candidate 

forum, she pointed out that 
revenue 
for 
these 
entities 

increased by 50 percent over 
the last four years, advocating 
and redirecting that income to 
city funds. She says there are 
challenges, however.

“I think a lot of council 

members feel indebted to the 
DDA members because a lot of 
them support the candidates 
who are running for City Council 
and they really don’t want to 
step on their toes,” Kailasapathy 
said in an interview with the 
Daily. “Anything to do with the 
DDA, council members are very 
hesitant to take action even 
though there was all this extra 
money this year that was beyond 

projection.”

This commitment to fighting 

existing 
structures 
was 

showcased 
in 
the 
televised 

forum when the candidates were 
discussing the portions of emails 
regarding the construction of a 
planned Amtrak station redacted 
by city staff members in June.

City 
Council 
candidate 

Jason Frenzel said that, though 
he 
supported 
maximum 

transparency, he felt there was 
a justified reason for city staff in 
withholding information.

“I 
think 
in 
(the 
e-mail) 

conversation we need to realize 
what’s the situation,” Frenzel said. 
“We don’t as a public understand 
what that conversation is and 
what it was, why it was redacted. 
In my honest opinion, I know our 
staff to be strong, professional 
leaders in their industry … and I 
think challenging our staff in a 
public forum isn’t necessarily a 
valid way for an organization to 
behave.”

Kailasapathy quickly pounced 

on Frenzel’s ambiguity, stating 
that she supports a Freedom 
of 
Information 
Act 
request 

concerning the redacted portions, 
especially because the documents 
in question do not reveal the 
location 
of 
highly 
classified 

government nuclear plants.

“This is not national security 

issues we’re talking about, spies 
or spying on other countries,” 
Kailasapathy said in an interview 
with the Daily. “This is about that 
train station, and if you want the 
train station to serve best for our 
people’s needs, at every stage it 
should be transparent.”

Kailasapathy also suggested 

Frenzel 
cannot 
make 
the 

necessary 
reforms 
for 

transparency 
because 
of 
his 

financial and family ties.

“DDA 
reforms, 
having 

oversight, term limits … I doubt 
Jason Frenzel will be able to do 
that because I think his backing 
comes from the DDA and his 
stepmother (Sandi Smith) was the 
head of the DDA.”

Candidates for City 
Council’s first Ward 
maintain split visions 

ANN ARBOR

See MASTECTOMY, Page 9

Read more at MichiganDaily.com