Edwards's wife diagnosed with breast cancer

Elizabeth Edwards, the wife of former Democratic vice presidential nominee John Edwards, was diagnosed with breast cancer at a Boston hospital shortly after her husband and Senator John F. Kerry conceded the 2004 presidential race, spokesmen for the family said yesterday.

Edwards, 55, rested at home in Washington, D.C., yesterday with her family. "She's feeling absolutely fine," said family spokesman David Ginsburg. "She's in great spirits."

A lawyer by training, Edwards spent much of the year on the campaign trail, a feisty yet warm presence who charmed many who met her. She apparently soldiered on even suspecting that she might have cancer, stumping until Election Day.

"Elizabeth is as strong a person as I've ever known," her husband said in a statement released yesterday. "Together, our family will beat this."

The diagnosis occurs at an uncertain time for the Edwards family. Having lost his bid for the second-highest office in the land, Senator Edwards's political future is unclear, and he plans to move his family back to North Carolina after his US Senate term ends next month.

Ginsburg said it was not clear whether Elizabeth Edwards would receive treatment in Washington or in North Carolina, where the Edwards family has its permanent residence.

Edwards felt a lump in her right breast while on the campaign trail last week. Her doctor said it was safe to wait until after Election Day to get it examined. As soon as Kerry's concession speech ended Wednesday, the Edwardses dashed out of Faneuil Hall for an appointment at Massachusetts General Hospital. A needle biopsy confirmed a cancer had invaded her breast's milk duct.

Edwards's prognosis will depend greatly on whether her cancer has spread, said cancer specialists. If the tumor is small and limited to her breast area, with proper treatment there is only a 10 percent or less chance the cancer will return in the next decade -- the closest thing to a cure modern cancer medicine can offer.

But if the cancer has spread to her lymph nodes or beyond, it "could be very life-threatening," said Dana Farber Cancer Institute's Dr. Lawrence N. Shulman, who added that there was great variability in cancers that spread beyond the duct. Test results are expected back "in a couple of days," said Ginsburg.

Edwards's invasive ductile cancer is the most common form of breast cancer, afflicting about 80 percent of the 216,00 American women diagnosed annually with the disease. Most cases are detected at an early stage, when treatment is quite effective.

"The vast majority are cured," said Shulman. "For most women, the prognosis is pretty good, but there is a lot of variability, depending on the size of the cancer."

Typically, mammogram tests catch these cancers before patients are aware of them. The full extent of the cancer's spread would probably not be apparent until after surgery, when her doctors will get a clear look at the tumor and its surroundings, as well as a chance to test Edwards's lymph nodes.

Edwards is likely to face two surgical options. The first is a lumpectomy, in which the tumor and some surrounding tissue is removed through a small incision. This is followed by radiation treatment, and recovery takes about two weeks. Some women opt for a mastectomy, or breast removal, as a preventive measure. Recovery can take more than a month. About 5 percent of mastectomy patients have relapses within a decade, half the rate of lumpectomy patients, though studies have not confirmed that these women will on average live longer.

"It's truly the patient who makes this choice," said Dr. Mehra Golshan, a cancer surgeon at Brigham and Women's Hospital, explaining that doctors do not typically urge one option or the other.

Edwards gave birth to her daughter Emma Claire at age 48 and son Jack at 50 with the help of fertility treatments. Some physicians believe such treatments slightly elevate cancer risk in women, though the evidence is far from clear.

Edwards and her husband decided to have children later in life after the 1996 death of their 16-year-old son Wade in a car accident, which upended their lives: Elizabeth Edwards quit working as an attorney to dedicate herself to family and volunteering, while her husband began contemplating a run for the US Senate in North Carolina. Another daughter, Cate, graduated from Princeton University this year.

Globe staff writer Raja Mishra can be reached at rmishra@globe.com.