In the United States, 230,000 cases of female breast cancer will be diagnosed this year and 40,000 women will die from the disease. Next to lung cancer, breast cancer is the second leading cause of cancer death in the U.S. Female breast cancer is also a leading public health concern with the yearly continuing costs of treatment and care at $16.5 billion with higher projections expected by 2020.
Each day, thousands of U.S. women grapple with making personal decisions about breast cancer screening, treatment and recovery. Many of these decisions are agonizing and go unnoticed to the public unless one knows the person personally or a celebrity is added to the breast cancer dialog. Angelina Jolie's report of her preventive double mastectomy because of her overwhelming odds of breast cancer due to her BRCA1 gene mutation brought an avalanche of discourse in media and blogs. One celebrity's Wednesday morning Op-Ed ignited the issue of an inherited gene from an intimate discussion with health care providers to a blazing media craze. Ms. Jolie's purpose for exposing her personal issue and preventative measures was to encourage others to seek information, talk to medicals experts, and then "make your own informed choices." I commend Angelina Jolie for sharing her story to aide other women as they face personal decisions based on their individual breast cancer risks and challenges. Because of the Big Screen, TV and Tabloid Headlines, celebrity breast stories become palpable as if a member of our own family is struggling with the same issue.
Within the past six months, TV personalities Stephanie Harris, Amy Roback and Joan Lunden have been added to the Breast Cancer Register. Each of their diagnoses illuminates the public journey of the disease. Reading about their initial diagnoses and treatment decisions transported me to the anxiety-laden days when, 10 years earlier at the time of my diagnosis, everything breast cancer was foreign. Within a few weeks, my medical vocabulary increased impressively as I encountered treatment terms and other multi-syllabic words that I never thought I would be able to pronounce and spell.
In 2004, I was stunned that my breast cancer was detected at stage 3C in spite of a normal mammogram weeks before. Believing that I was a well-informed patient and, in the unlikely event that I was diagnosed with breast cancer, my yearly mammogram would be my insurance policy to find cancer early. No cancer organization, health care provider or popular women's magazines ever told me differently in the decade prior to my diagnosis. What I learned from my diagnosis and my consequential ongoing lifetime of treatment, catapulted me to launch two nonprofit organizations to help others escape an avoidable advanced-stage diagnosis. I was denied crucial information about my breast tissue composition that might have exchanged my advanced stage cancer for an earlier one. Decades of research demonstrate that breast density is the strongest predictor of the failure of mammography to detect cancer and having extremely dense breast tissue is an independent risk factor for breast cancer. My desire was for these scientific facts to jump from the pages of innumerable medical journals to every-day discussions in the examining rooms as women make informed choices about their personal breast cancer screening surveillance.
Joan Lunden's recent diagnosis of breast cancer, invisible by mammography, made the headlines in late June. She tells Good Morning America that her yearly mammogram was normal, but this relief was fleeting as her adjunct ultrasound, which her physician order because of her dense breast tissue, illuminated a suspicious lesion diagnosed later as breast cancer. Lunden's own words revealed her all too common false sense of security when her mammogram was normal.
Nothing showed on my mammogram and you come out of there like, Yes, one more year. I'm okay. And then you go all happy-go-lucky into the ultrasound and she kept going back to one spot.
In that one sentence, Ms Lunden's invasive, aggressive cancer diagnosis, invisible by mammography, uncovered the challenge of screening the dense breast across the media.
Since our organization, Are You Dense Inc., and subsequent website launched in 2008, women have shared their personal tragic story of missed, delayed and later stage cancer because of their dense breast tissue. Several of these women died from the disease. Like Joan Lunden, we imagine every woman having access to adjunct screening tests if she has dense breast tissue to protect her from advanced-stage disease. What if Joan Lunden's physician did not order an ultrasound? When, and at what stage, would her aggressive cancer finally be discovered?
A Connecticut television anchor who interviewed me a few months back reported that Joan's story reminded her, because of her dense breast tissue, to make her appointment for a screening ultrasound, even though her mammogram was normal. I am grateful that Joan Lunden decided to share her personal story of the impact of dense breast tissue on the reliability of mammography screening. Her story will further expose the secret of dense breast tissue to women across the globe. Like Angelie Jolie, Joan Lunden is drawing on her celebrity platform to assist others as they confront critical breast health decisions that may well be life-changing.