As a surgeon, I’ve been involved in breast care for more than fifteen years; it has been a most rewarding part of my career. I also have the great pleasure of being the Physician Lead for the Komen Accelerating Breast Cancer Diagnosis (ABCD) Project in Washington, DC. This project is a collaboration of Providence Hospital and Unity Health Care, and seeks to improve breast care for women, particularly those from lower socio-economic communities.
Areas of D.C. and neighboring Prince George’s County, MD have extraordinarily high death rates from breast cancer, despite relatively high screening rates. One of the reasons is that women face a hodge-podge of providers, accepting different insurance at different institutions for different procedures. Precious time and vital information is too often lost as patients and providers try to maneuver the maze our health care system has become.
Not so for one of my most recent patients, who I’ll call Theresa. I’ve never seen the health care system work as quickly as it did for her. Theresa is a 51-year-old African-American woman who never got regular mammograms–she did not have a family history of the disease, her medical insurance lapsed as she changed jobs, and it simply wasn’t a priority. Then, one day, she felt an unusual lump. Read more
Guest post by Cheryl Perkins, Ford Model of Courage
May 2003: Clean bill of health from my doctor. October 2003: I found an almond-sized lump in my right breast. After two weeks of thinking that it might be a clogged milk duct due to breast feeding, my doctor scheduled a mammogram which later turned into an ultrasound and biopsy – all in the same day. “Invasive ductal carcinoma, stage 2B and triple negative. It’s a very aggressive breast cancer and we need to act fast.” What a shocker! In that one moment, my life was changed forever.
At the time, my children were aged 11, 9, 4 and 2. I had just finished nursing school and had started my orientation as a NICU nurse at Children’s Hospital in Detroit. That week I met with the oncologist and the surgeon. I had a battery of tests, scans, classes and I bought a wig. I started chemotherapy the following week which lasted six months. This was followed by a double mastectomy, reconstruction and radiation. September 2004: I was able to go back to work as a labor and delivery RN.
The hard part was over, or so I thought. The whirlwind year of ups and downs left me feeling uncertain of what to do next. For years, I think I just waited for the shoe to drop, to hear that I’d had a recurrence. I prayed that I would be around for my children and husband. Somehow, I kept pressing on getting back to a new normal. My children are now 21, 19, 14 and 12 and my oldest will graduate from Spelman College in May. I am so thankful for the blessing of days that turn into years which mean more time with my family. Unfortunately, the stressors of a cancer diagnosis can change people. You are never the same after battling cancer. My marriage of 22 years was a casualty.
What makes one person survive when so many lose the battle, I don’t know, but I am thankful for the opportunity to share my story. Ford, a longtime Susan G. Komen Race for the Cure sponsor, gave me an opportunity to share my story as a Ford Warriors in Pink Model of Courage. As a Ford Model of Courage, I have shared my story through print, social media and television as a way to encourage other men and women who are battling breast cancer and those who need an extra push to empower them to take control of their bodies. If something does not feel right, do not sit on it. Get it checked out. I am alive because I did not stop with the initial diagnoses of a clogged milk duct. I have learned to embrace the new me.
A new mammography study from Canada – the Canadian National Breast Screening Study – is getting attention today for its conclusions about the value of regular mammography screening in reducing mortality from breast cancer. This study adds to a growing body of evidence that mammography is an imperfect screening tool for breast cancer. We agree. It is based on 1950s technology, and can lead in some cases to overdiagnosis and overtreatment of breast cancers. The problems with mammography have been established for many years.
The more important question, and the one we ask every time one of these studies is released, is what we can do to provide women with more reliable and cost-effective tests to detect breast cancer. Once detected, we need tests that can tell us, with more certainty, which tumors are likely to become invasive and which might not require extensive treatment. The search for better early detection methodologies is an important focus for research.
This is why Komen has invested more than $33 million in early detection research, investigating tools like blood and tissue tests for breast cancer, and will continue to do so. Until we have those tools, we will continue to recommend that women have access to mammography, that they discuss their risk with their healthcare providers, and that they maintain a screening schedule that is right for them.
Despite the continuing debate over mammography, even the Canadian study authors acknowledge that “early diagnosis, and excellent clinical care” are important. We believe that early detection gives women and their healthcare providers more options for treatment.
We encourage all women to learn about their risk, discuss the right screening schedule for them with their doctors, know the look and feel of their breasts and report changes to their healthcare provider. Komen’s screening recommendations can be found at this link. An overview of Komen’s research into early detection can be found here.
After serving as a public policy advocate and volunteer for Susan G. Komen for many years, I decided to focus my interest in research advocacy and joined Advocates in Science (AIS). The AIS community is very fulfilling and provides a wide range of educational and training opportunities as well as opportunities for service as a patient advocate in a variety of settings.
In January of 2012 my role as an advocate changed when I was diagnosed with triple negative breast cancer (TNBC). My AIS experience and education helped me understand the implications of the diagnosis and made decisions about my care easier. During one visit, my breast oncologist remarked, “Peggy, I think you know too much.” But honestly he was pleased with the fact that I was engaged in my treatment.
In May 2012 I was invited, through my AIS membership, to join a consensus panel convened by Monica Morrow, MD, a prominent breast surgeon, and Meena Moran, MD, a highly respected radiation oncologist. The Komen-funded panel addressed the issue of re-excision – a second surgery after lumpectomy to achieve wider or cleaner margins. Participants on this consensus panel included a diverse group of distinguished members of the breast cancer medical community, each representing a different area of breast cancer treatment and research.
Dr. Nehman Houssami, MD, PhD, from the University of Sydney, revisited her previous meta-analysis on re-excision using the most current data and provided updated results to the panel. Other members of the committee also gave presentations in order to provide multiple perspectives for the panel to consider.
The following blog appeared in The Huffington Post on February 4, 2014.
Development of the polio vaccine, progress in AIDS research and new cancer treatments — these are just a sample of how much we owe to an African-American woman who died of cervical cancer in Baltimore in 1951. The world learned of her heretofore unacknowledged contributions in one of the most compelling reads of the last few years – The Immortal Life of Henrietta Lacks by Rebecca Skloot.
Mrs. Lacks’ cancer cells were taken without her knowledge or permission, and because they replicated almost without end, her “immortal” cells, called HeLa cells (short for Henrietta Lacks) have arguably been one of the most powerful tools in medical research ever since. It’s fitting, during Black History Month and on World Cancer Day, that we acknowledge and honor the contributions of this one African-American woman to medical history.
I think of what cancer patients like Henrietta Lacks endured in the 1950s, when segregation laws meant that African Americans could legally be treated in “colored wards” of hospitals or denied treatment all together. Skloot notes in the book that African Americans often were treated at later stages of their disease. A Johns Hopkins University study in 1966 reported that African-American women with breast cancer in the 1950s had lower survival rates than the national average, and far below those of their white counterparts.
With segregation thankfully a thing of the past, we are still deeply concerned about outcomes for African-American women facing breast cancer today. Although African-American women are less likely to be diagnosed with breast cancer, they are still 41 percent more likely to die of it than white women. African-American women also are more likely to be diagnosed with late-stage and aggressive breast cancers, and more likely than white women to be diagnosed under the age of 45, according to American Cancer Society statistics (there is extensive information about African Americans and breast cancer on our website).