Television journalist and author Joan Lunden thought she had sailed through her mammogram last summer.
“I got a clean mammogram and walked across the hall and found out I had cancer,” the former Good Morning America host said.
Lunden and her doctor had wisely taken the next step — getting an ultrasound — thus avoiding a potentially fatal oversight. She, like 40 percent of American women, has dense breast tissue. Women who have dense breast tissue of more than 50 percent need to consult a radiologist for an ultrasound to complement the initial mammogram.
“If you have dense breasts it’s like looking through a snowstorm for a snowball,” she said in a phone interview from New York. Tumors and tissues appear white. An ultrasound can detect abnormalities a mammogram might miss.
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“We must give women all the information they need in order to make informed health decisions. This is information that can save lives,” said Lunden, 64, a week after concluding her radiation treatment. “I’m a woman who believes in more screenings, not less, and not backing up the age of first mammograms from 40 to 50. … We know early detection is key in the survival of breast cancer.”
Lunden had triple negative breast cancer in her right breast, a less common subset that can only be targeted by chemotherapy. On Saturday morning she will deliver the keynote speech to more than 1,000 doctors and other medical experts from around the world at the 32nd annual Miami Breast Cancer Meeting. The conference, aimed at the health care community, will be held at the Fontainebleau Miami Beach Thursday through Sunday.
“This is the longest running breast cancer meeting in the world and is so well known the word ‘Miami’ is synonymous with breast cancer,” said conference chairman Dr. Patrick Borgen, chairman of the surgery department at Maimonides Medical Center in Brooklyn. “You hear doctors say, ‘What does Miami think?’ ‘What does Miami do?’ If you say the word ‘Miami’ to doctors across the 50 states that’s what Miami represents,” he said.
In addition to Lunden’s talk, this year’s meeting will feature discussions on the latest advances in breast cancer diagnostics, including genomic tumor profiling; the link between breast cancer and obesity; the latest strategies to prevent and reduce breast cancer recurrence and the newest pain management techniques to reduce reliance on opioids and narcotics.
“I think of breast cancer as the great American tragedy and the great American victory,” Borgen said. “Tragedy, because a quarter of a million women are still getting this disease — 235,000 last year — and about 40,000 American women per year still die. But victory, because our nation has invested more heavily in the fight of breast cancer than the entire rest of the world. And we have made more progress with breast cancer than any other tumor known to man.”
Borgen’s optimism is fueled by several recent developments. Among them:
▪ 3D mammography, or tomosynthesis mammography, which, used along with standard digital mammograms, increased breast cancer detection rates by more than 40 percent. “The best we’ve seen in a long time to diagnose breast cancer,” Borgen said.
▪ An understanding of how obesity is a factor in elevated risk for breast cancer in women and men. (Yes, men get breast cancer, too, though it is 100 times less common.) About 2,350 new cases of invasive breast cancer will be diagnosed this year and about 440 men will die, according to the American Cancer Society.
The reasons? “Fatty tissues store and release estrogen so a woman or a man with more body fat will have a very different profile of estrogen in their body,” Borgen said.
Also, “Humans form microscopic tumors all the time. Our immune system repairs those cells or kills them. But if someone is obese their immune system will not be as strong as an athlete’s or a healthy person’s, so there really is a link we are seeing more and more.”
▪ Genomics, or personalized treatment, “means opening up the hood and looking at the engine that drives these breast cancers so we can match treatment to breast cancer — massively important,” Borgen said.
▪ New pain management techniques. “Pain weakens the immune system and when you add opiates and narcotics it can make even the prognosis worse,” he said. In place of these, Exparel, a sustained-released formulation of bupivacaine HCL, a local anesthetic of little bubbles that open up in time and are administered into the surgical site, is used for treating postoperative pain. A “game changer” Borgen calls Exparel.
“A lot of doctors are not aware it is out there. We want to introduce it. One of our mottoes in Miami is ‘Hear it on Friday, use it on Monday.’”
Having a face like Lifetime’s Health Corner host Lunden, who, during her 17-year span on GMA covered five presidential administrations, is crucial to the success of the event.
“Joan Lunden has a lot to teach us about how to do our job better,” said Borgen. “The more we understand about what women go through the better we are going to do our job. I think that the bravery it took for a woman who relies on her image and persona and her apparent age and vitality, for her to agree to have herself photographed for People magazine with no wig on was extraordinary.”
Lunden, who had a lumpectomy, chemo and radiation, did the cover bald to foster a national conversation.
“Yes, you will lose your hair. There’s no getting around it. Going bald is weird,” she said.
But it will grow back. “I remember the Sunday night before going on the Today Show for a week. I woke up with eyebrow lashes and washed my face. And they were gone. And a breast cancer patient was looking back at me. And I thought, ‘Really? Right before we go on the Today Show?’ But all these experiences taught me.”
Borgen asked Lunden to be involved, partly because of her reach. She’s an advocate for women’s health issues through her video blog and TV appearances and she’s currently a contributor to NBC’s Today Show.
“She’s seen the healthcare system from the inside out and she’s a trained observer of life,” he said.
“I want to put a face on their patients,” Lunden said about her goal for this week’s conference. “And I want to make sure they see thousands of women and I want them to remember that each and every one of those women who becomes a patient needs to have a good relationship with their doctors in comfort and trust. I tell women that if you don’t feel that then find another doctor.”
And in this instance, the educator has been educated.
“My biggest surprise this last nine months has been discovering this breast cancer community. Not a sorority any woman wants to join but certainly a sorority of strength and compassion. I knew right away I had a new mission in my life for all the other women out there,” Lunden said.
“I think I’ve learned by sharing our stories with each other we can not only provide each other with answers but with much needed emotional and psychological strength.”
Follow @HowardCohen on Twitter.