Twenty-four years ago, when the press corps crowded outside Bethesda Naval Hospital to hear President Gerald Ford announce that his wife, Betty, had undergone a mastectomy, “it was the first time they’d seen him cry,” recalls the former First Lady, now 80. “Breast cancer pretty much meant death back then.” Two decades later the disease still ranks among women in the U.S. as the most common form of cancer and the sixth leading cause of death (179,000 women—and 1,600 men—will be diagnosed this year, and 43,500 will die). Still breast cancer is no longer an automatic death sentence. In the 1970s a woman with the disease had a roughly fifty-fifty chance of surviving. Today, thanks largely to earlier detection through mammograms, her chances are nearly 80 percent.
Soon those odds are likely to improve even more. Medical advances, including more-selective lymph-node biopsies and chemotherapy with fewer side effects, have improved care and reduced the need for mutilating surgery, and there have been significant innovations in breast reconstruction. Even more tantalizing are the new drug therapies—especially the estrogen-blockers tamoxifen and raloxifene and the tumor inhibitor Herceptin [see page 68]—that mark the first significant steps toward possible prevention and cure of the disease. “The story isn’t over, and there are a lot of people who are going to die of this disease before we’re done,” says Dr. Marc Lippman, director of the world’s largest breast-cancer research program, at Georgetown University Medical Center in Washington, D.C. “But there has been a quiet revolution. We are entering an era in which the rules will be different.”
For now, experts know that breast cancer’s likeliest victims share three primary traits: They are over 65, have blood relatives who have suffered from the disease, or have been exposed to excess estrogen (a potential cancer fuel) because they menstruated early, began menopause late or were never pregnant. Still 70 percent of women diagnosed have no known risk factors at all. Until there is a cure, then, the best advice is familiar: Practice self-examination, schedule regular doctor’s exams and (for women beginning at 40) annual mammograms.
That, and bear in mind the words of actress Marcia Wallace, herself a 13-year survivor: “If you’re a woman and you’re alive, you can get breast cancer.” On the following pages, PEOPLE examines the latest medical advances, as well as the lives of 11 well-known women who found the cancer diagnosis difficult to accept but who fought back and, with the support of their loved ones, survived.