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By happenstance, the leading U.S. authorities on breast-cancer detection and treatment are meeting at the National Cancer Institute, just across Rockville Pike from Betty Ford's suite at the Naval Medical Center. They are deep in debate over what operation should be performed in cases like Betty Ford's. One conservative school argues that only the lump need be removed (lumpectomy), or at most, the breast tissue surrounding it (simple mastectomy). Surgeon Fouty chose the course now approved by the great majority of U.S. breast surgeons: a radical mastectomy.
He stopped short of the supra-radical operation, in which lymph nodes under the breastbone are removed. These are less likely to be involved in situations similar to the First Lady's, in which the cancerous lump was on the outer, upper aspect of the breast, toward the arm. The argument over the best way to treat breast cancer cases like Betty Ford's is likely to continue long after she recuperates.