High Court’s O’Connor Has Breast Surgery

Supreme Court Justice Sandra Day O’Connor, the first woman to serve on the high court, underwent surgery for breast cancer Friday but predicted she would make a quick and “total recovery.”

O’Connor, 58, had a mastectomy at Georgetown University Hospital to remove what doctors there said was apparently a small tumor.

The justice issued a brief statement through the court’s information office, saying the cancer “was found to exist in a very early form and stage. The prognosis is for total recovery. I do not anticipate missing any oral arguments.”

Dr. Christine Berg, a breast cancer specialist at Georgetown University Medical School who said she was familiar with O’Connor’s case but did not participate in her treatment, told The Times: “Her tumor was more extensive than could be handled by a lumpectomy alone.” In a lumpectomy, only the tumor is removed, while the more extensive mastectomy involves removing the breast.

“But it was still a very early-stage tumor,” Dr. Berg added. “She certainly may be able to recuperate and be back at work in a week.”

She noted that Nancy Reagan had a mastectomy for breast cancer last October and returned to the White House four days later.

The high court is now in the midst of a two-week recess. The justices return to the bench on Monday, Oct. 31.

Typically, the members of the high court have been reticent about discussing their health, and several have bristled at being asked about their medical troubles.

Court spokeswoman Toni House said she would not be able to disclose any further details about O’Connor’s operation, the doctors who performed it, her recovery or any continuing treatment.

President Reagan, in a historic move, appointed O’Connor in 1981 while she was serving as an Arizona appeals court judge. On the high court, she has proved to be a moderate conservative, usually voting with her former Stanford University Law School classmate, Chief Justice William H. Rehnquist.

This year, O’Connor has emerged as the most closely watched justice because her vote may tip the balance on key cases involving religion, affirmative action and the death penalty for juveniles.

O’Connor, an active golfer and tennis player and the third youngest member of the court--after justices Anthony M. Kennedy and Antonin Scalia, both 52--also had an appendectomy in March, but was back at work within two weeks.

Breast cancer strikes about 135,000 American women each year, and 42,000 die of the disease, according to the National Cancer Institute. Doctors say the chances for a patient’s full recovery depend generally on the size of the tumor and whether it is removed before it can spread through the lymph system.

An important clue to O’Connor’s recovery may depend on whether the lymph nodes were also removed and whether any cancer is found in them. Dr. Berg said most breast cancer patients also have lymph nodes under the arm removed. If so, test results should be available two days after the surgery, she said.

The five-year survival rate for breast cancer patients whose cancer is confined to the breast is greater than 85%, according to the cancer institute. If the cancer has spread to the lymph nodes, the survival rate drops to 70% or below.

Dr. Berg and other cancer specialists said most breast cancer patients receive some continuing treatment--such as chemotherapy or radiation--to prevent a recurrence. O’Connor’s doctors will probably examine laboratory reports on the excised tumor and any lymph node tissue and then make a recommendation on further treatment.

“You have to weigh all the factors, but chemotherapy is becoming very common. But I wouldn’t think that would affect her work schedule,” Dr. Berg said.

In July, 1987, Justice Harry A. Blackmun, 79, was treated for a recurrence of prostate cancer, but he did not miss any work at the court. Justice William J. Brennan Jr., 82, also was earlier treated for prostate cancer, but he has been in good health recently. His fellow liberal, Justice Thurgood Marshall, 80, has suffered an array of medical problems, including emphysema and a recent blood clot in his foot.

On Oct. 31, the high court will hear a case involving a crucial test of sex discrimination in the workplace. O’Connor, who was unable to get a job in a law firm after graduating third in her Stanford law class of 1952, has understandably taken a special interest in the court’s sex discrimination cases.