Minnesota Senator Amy Klobuchar, 61, Reveals She Was Diagnosed With Breast Cancer; What Does Stage 1A Mean and How Is It Treated?

Klobuchar, after a number of tests, had a lumpectomy a surgery to remove cancerous breast tissue along with a rim of normal tissue on her right breast. A few months later in May, she completed a course of radiation treatment; it was determined in August that the treatment "went well."

"Of course this has been scary at times, since cancer is the word all of us fear, but at this point my doctors believe that my chances of developing cancer again are no greater than the average person," she writes in her Medium post. Klobuchar was also a Democratic presidential hopeful up against President Joe Biden in the 2020 election.

Understanding Stage 1 Breast Cancer

Dr. Elizabeth Comen, a breast oncologist at Memorial Sloan Kettering Cancer Center in New York City, tells SurvivorNet that generally speaking, early stage breast cancer, or stage 1, means there's a small tumor in the breast and that no lymph nodes are involved.

Comen explains stage 1 breast cancer.

To dive a little deeper, Dr. Michael Zeidman, assistant professor of surgery at Icahn School of Medicine at Mount Sinai in New York City, tells SurvivorNet that stage 1 is divided into two subcategories 1a and 1b. Stage 1a breast cancer means the cancer hasn't spread outside the breast. This is what happened in Klobuchar's case as calcifications were discovered only in her right breast. Stage 1b means there's no tumor in the breast; instead, small groups of cancer cells are found in the lymph nodes. Stage 1b can also mean there's a tumor in the breast as well as small groups of cancer cells in the lymph nodes. Stage 1 also means the cancer was caught very early, he says.

The difference between stage 1a and 1b is almost splitting hairs, Zeidman says, as the prognosis is "excellent" regardless of whether the cancer is stage 1a or 1b the survival rate for this stage breast cancer is approaching 100%.

"For a patient, while I do think it's important to know the difference (in stages), it really makes no difference," Zeidman says. "The prognosis is more or less going to be the same." That prognosis is between 98% and 100% survival rate.

"For stage 1 breast cancer, the first step is to remove the cancer," Comen says. "If a woman needs a lumpectomy, most often she will have radiation after that, although in some instances, depending on her age, she may not need radiation." Klobuchar was one of those women who needed radiation after her lumpectomy.

Related: An Overview of Breast Cancer Treatment

Once the cancer is out of the body, doctors can also look at the lymph nodes in the armpit, Comen says, "then we can really say what stage is this cancer and what are the molecular features (of the cancer)." Zeidman reiterated this point, saying that he doesn't tell a patient what stage breast cancer they have until a pathologist has been able to look at the cancer.

Stage 1 breast cancer has a very, very small chance of coming back, but there is always a chance that even just one cancer cell escapes and travels elsewhere in the body.

"It's not the cancer in the breast that kills the patient," Zeidman says, "it's if the cancer has spread to a different part of the body that's when patients die from breast cancer."

Dr. Connie Lehman, director of the breast imaging clinic at Mass General Hospital in Boston, tells SurvivorNet that once a woman has gone through breast cancer treatment, like Klobuchar, she's often "very, very eager" to return to wellness, to return to feeling like herself.

"… as this patient returns to wellness, as she now goes into what we call going back to surveillance, we're going to go back to screening we're going to celebrate a successful treatment of the breast cancer, and then go back into screening because while we are so pleased with the successful treatment, we know women with a personal history of breast cancer have an increased likelihood of having breast cancer in the future."

Don't Delay Cancer Screenings

Screenings for breast cancer and cervical cancer through the U.S. Centers for Disease Control and Prevention's Early Detection Program dropped 87% and 84% respectively during the height of the pandemic, according to CDC data released earlier this year. For cancer across the board, in some cities hit hard by COVID, cancer screenings dropped nearly 70%.

Related: Cancer Screenings Have Dropped Nearly 70% Amid The Coronavirus Pandemic Delays In Routine Checkups Disrupt Early Detection

Klobuchar said she was one of those people who delayed their cancer screenings because of the pandemic, and she used her diagnosis announcement as a space to advise people not to do what she did.

"I also want to call attention to the fact that many people have been delaying physicals and routine examinations because of the pandemic. I know that because I delayed mine. In fact, more than one in three adults reported delaying or forgoing health care because of coronavirus-related concerns," she writes. "Studies have found that thousands of people who missed their mammogram due to the pandemic may be living with undetected breast cancer. Over and over, doctors are seeing patients who are being treated for more serious conditions that could have been caught earlier."

There’s rarely a good time to go in for a mammogram or routine health screening, she adds, and she's right.

When Should I Get a Mammogram?

"It (being diagnosed with stage 1 breast cancer) should highlight the fact that women should continue to get their mammograms," Zeidman says. "It's the only reason we're able to catch it (the cancer) early."

"It's easy to put off health screenings, just like I did," Klobuchar writes in her Medium post. "But I hope my experience is a reminder for everyone of the value of routine health checkups, exams, and follow-through. I am so fortunate to have caught the cancer at an early enough stage and to not need chemotherapy or other extensive treatments, which unfortunately is not the case for so many others."

Learn more about SurvivorNet's rigorous medical review process.