But because they now can, Rell's recovery - like that of hundreds of thousands of other women with breast cancer - is expected to be complete.
"It's a very early cancer and she'll do very well," Denise Mariconda, breast cancer coordinator for the New Milford Hospital Regional Cancer Center, said Monday. "She'll be like the millions of other women who have survived breast cancer."
The American Cancer Society estimates that about 216,000 women will be diagnosed with breast cancer in 2004 and that about 40,600 will die of the disease. Breast cancer is the most common type of cancer in women.
However, because of mammography and other diagnostic tools, most of these cancers are now found early, when they are most treatable. The cancer society estimates that 97 percent of women with localized breast cancer - cancer that has not spread to another site - will live for at least five years after diagnosis.
In all likelihood, Rell will be one of those women. An advocate for regular mammograms, she had one herself last week, and doctors noticed abnormalities on it.
After finding she had a small cancerous growth in one breast, surgeons at Danbury Hospital operated on the governor Monday, removing the breast and then performing reconstructive surgery. Her office said the surgery went well, without complications.
Rell is expected to stay at the hospital for three or four days. Because she had her entire breast removed, her office said she may not need radiation or chemotherapy and she expects to be well enough to open the General Assembly's 2005 session Jan. 5.
Dr. Pierre Saldinger, chairman of surgery at Danbury Hospital, said doctors and patients alike are much more aware of breast cancer than they were a few decades ago. Often it's women themselves who find a lump or abnormality during a self-exam.
"We say no one knows about their breasts better than women themselves," Saldinger said.
But in Rell's case, a self-exam would have never found the tiny calcium buildups - one millimeter or smaller - that develop inside the milk ducts of the breast. They can't be felt. Instead, radiologists spot them while studying mammograms.
"Studying mammograms has become a science on its own," said Saldinger. "The eye gets better at reading them and they get more experienced at seeing something and being able to say, 'In all likelihood, that's nothing to worry about.'"
Dr. Howard Lee of Northeast Radiology, which has six offices, including locations in Danbury, Southbury and Brewster, said many women develop calcifications. In 80 to 85 percent of the cases, he said, radiologists can identify these growths as benign and not a cause for concern.
But in Rell's case, radiologists saw a group of calcifications that set off alarms. Doctors removed these growths, and two more nearby. One of the latter - which did not even show up on the mammogram - proved cancerous.
Lee said most breast cancer begins in the milk ducts. Sometimes, he said, as a cancer develops, calcifications will crop up next to it.
"They can be indicative of an interductal cancer," he said.
Once doctors discover cancerous growths in a woman's breast, they work with the patient to explore all treatment options.
In recent years, studies have shown that breast conservation - removing only the cancerous growths and a small amount of surrounding tissue in what is called a lumpectomy - is as effective as a total mastectomy.
However, a woman undergoing a lumpectomy must undergo six or seven weeks of radiation after the operation. If a woman chooses a mastectomy, and - as in Rell's case - the cancer has not spread to the lymph nodes, the radiation may not be necessary.
Saldinger said patients must be well-informed about both procedures. The size, location, and type of cancer are all factors - some cancers are more aggressive than others.
Family history may also be an issue in these decisions. One of Rell's neighbors said Monday that Rell's mother died of breast cancer about three decades ago.
Saldinger said that, in itself, may not be an indication for a total mastectomy, simply because breast cancer is such a common disease. The case histories of other family members - and the age of those family members at diagnosis - are also important factors.
"But when you're doing a screening, it's one of the things that makes your ears perk up," he said.
And deciding on the type of surgery may also involve personal preference. Some woman may prefer a mastectomy; others may opt for the more conservative surgery and radiation.
"It's a personal choice," said Mariconda of the New Milford Hospital Cancer Center.
Saldinger said if woman choose mastectomy, the ability of plastic surgeons to reconstruct the breast has greatly improved in recent years. Often, he said, they can partially detach a flap of muscle from the stomach, flip it up onto the woman's chest, and shape a breast out of it so that the tissue isn't artificial - it comes with its own blood supply.
Saldinger also said plastic surgeons can reshape a woman's healthy breast so that it more closely matches the reconstructed one.
"It's amazing what they can do," he said of the reconstructive surgeons' work.
"Oh my gosh, yes," said Mariconda, when asked about the improvements in reconstructive surgery. "Everything in breast cancer medicine has improved."
What her case proves is the importance for women to get regular mammograms so radiologists can see if any changes develop from year to year.
The American Cancer Society recommends that all women over 40 get an annual mammogram, plus a clinical exam by a doctor every two or three years. Women at higher risk of the disease should ask their doctors if they should begin mammography earlier, or have additional diagnostic tests, such as an MRI. The society also recommends that women over 20 do regular self-exams.
"Early detection is essential," Saldinger of Danbury Hospital said. "If we find it early, women have a good chance of doing well."
Contact Robert Miller
or at (203) 731-3345.