Understanding Breast Cancer
- Joan Lunden, 72, doesn’t “look back,” but the breast cancer survivor recently shared the reasons behind her “Good Morning America” departure after co-hosting the show for 17 years.
- Lunden was diagnosed with stage 2 triple-negative breast cancer in 2014.
- Lunden had dense breasts, so doctors didn’t see her cancer during her annual mammogram. One of our experts suggests patients with dense breasts get ultrasound screenings in addition to mammograms for the best results.
- If you are at a higher risk for developing breast cancer, you should begin screening earlier. Risk factors for breast cancer include: being a woman, age, family history of breast cancer or a genetic mutation such as BRCA, having had a prior biopsy on an abnormal area, radiation exposure, lifetime estrogen exposure, not having a child before age 30 or never having children, obesity, drinking alcohol and lack of exercise.
- Screening for breast cancer is typically done via mammogram. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
Lunden co-hosted ABC's “Good Morning America” for 17 years in the 1980s and 1970s. She was later a correspondent on NBC's “TODAY” show, and it was during her time with “TODAY” that she learned of the cancer in her right breast.
Read MoreShe even decided to gracefully give the network an out despite their actions.
“I picked up the phone and I called the president of the network and I said, ‘I’m about to do you a very big favor,'” she explained. “I said, ‘A year ago, NBC let Jane Pauley go and brought in Deborah Norville, and the audience was so upset with them because it was so obvious that you pushed out a woman, as she was getting older, to bring in this younger woman. Like, did you guys not learn anything?'”
That’s when Lunden suggested that the official reason for her departure could be because she was “tired of the morning shift.” The former network president promptly agreed.
Despite her handling the situation so well, it’s understandable that she would want to discuss the ordeal more openly now.
“I mean, I was 47 years old. That’s not old. They don’t push men out because they’re 47,” she said while quickly adding, “I don’t look back. I’m not the kind of person that looks back.”
Joan Lunden’s Cancer Journey
And this topic is not the only thing Joan Lunden’s opened up about for fans. She’s also readily shared details of her stage 2 triple-negative breast cancer diagnosis in 2014 at age 64.
"Candidly, I never thought I would be one of the women who would get breast cancer," Lunden told SurvivorNet in a previous interview.
Lunden is, thankfully, cancer-free today, but she had a hard time with screening. In fact, her cancer news didn’t arrive promptly after her annual mammogram in 2014 because her doctors said they didn’t see anything significant. Now, she’s worked to educate others about dense breasts.
When You're Getting a Mammogram, Ask About Dense Breasts
"The fact that I didn't understand the significance of dense breast tissue kind of just lit a fire in me and sent me on this mission to say, 'Here I am a journalist, and how could I have been so uneducated about something so incredibly important," she said.
Women with dense breasts like Lunden can, unfortunately, have a harder time with breast cancer screening. Dr. Linda Pak, a breast cancer surgeon/oncologist at NYU Langone's Perlmutter Cancer Center and clinical assistant professor of surgery at NYU Grossman School of Medicine, suggests patients with dense breasts get ultrasound screenings in addition to mammograms for the best results.
"Ultrasound screening is a very helpful supplemental method of imaging, to be used in addition to a mammogram, for women with dense breasts. Increased breast density can make tumors more difficult to see on mammograms," Dr. Pak told SurvivorNet in a previous interview. "Ultrasound can detect additional cancers that are not seen on mammography.
"Therefore I recommend a supplemental screening breast ultrasound in addition to mammography for all patients with dense breasts."
Joan’s Approach To Life
"I've always loved the quote, 'There are two great days in our life: the day we're born and the day we discover why,’" Lunden told SurvivorNet in a previous conversation.
In a wide-ranging and intimate interview with SurvivorNet about her book, "Why Did I Come Into This Room?" dealing with the aging process Lunden explained that for her, the quote really resonates because she feels one of the reasons she was born was to use her own experience with breast cancer to advocate and spread awareness for other women.
"I probably ended up where I needed to be," Lunden says. "Those are the things, when you fight a life-changing battle, that you contemplate and maybe you would never have contemplated them otherwise. So, when you contemplate those things it sure does focus you on what you want to do with the rest of your life."
Understanding Your Breast Cancer Risk
The risk of developing breast cancer varies greatly from person to person, so it's important to discuss your specific risk level with your doctor. That being said, there are some important risk factors to keep in mind.
Major Reduction in Cancer Risk by Following Old Standbys Diet and Exercise
In a previous interview with SurvivorNet, Dr. Elizabeth Comen, a medical oncologist at Memorial Sloan Kettering Cancer Center, laid out several risk factors for breast cancer including:
- Being a woman: Women are at a higher risk for breast cancer, though men can get the disease too.
- Age: "Breast cancer becomes increasingly more common as women age," Dr. Comen said.
- Family history: "Some people think that breast cancer is only inherited through genes on the mom's side,' Dr. Comen said. "But it can also be related to genetic mutations that could be found on the father's side."
- Having had a prior biopsy on an abnormal area: "There are different markers, that if a woman has had a biopsy, it's important that she talk to her doctor about whether those markers are lending themselves to an increased risk of breast cancer," Dr. Comen said. If you've had a biopsy that indicated atypical hyperplasia, for example, you are at an increased risk of breast cancer. Atypical hyperplasia isn't cancer, but it is a precancerous condition that describes an accumulation of abnormal cells in the milk ducts and lobules of the breast.
- Radiation exposure: Cancer survivors who've had radiation to their chest are at an increased risk of breast cancer.
- Lifetime estrogen exposure: "About 2/3 of breast cancer are driven by the hormone estrogen," Dr. Comen said. "So, that means if a woman has had her period at an early age and started to go through puberty at an early age, at seven, eight, nine, and potentially a later age of menopause, means that her lifetime of having had menstrual periods and being exposed to higher levels of estrogen is higher, and therefore her risk of breast cancer is slightly higher."
- Not having a child before age 30 or never having children
- Obesity
- Drinking alcohol
- Lack of exercise: "While there's more research to be done in this area, it looks like if a woman is not exercising, she may also increase her risk for breast cancer," Dr. Comen said.
Alcohol Can Increase the Risk of Developing Breast Cancer
Learning about Breast Cancer Screening
Screening for breast cancer is typically done via mammogram, which looks for lumps in the breast tissue and signs of cancer. The American Cancer Society (ACS) says women should begin yearly mammogram screening for breast cancer at age 45 if they are at average risk for breast cancer. The ACS also says those aged 40-44 have the option to start screening with a mammogram every year, and women age 55 and older can switch to a mammogram every other year, or they can choose to continue yearly mammograms.
When Should I Get a Mammogram?
For screening purposes, a woman is considered to be at average risk if she doesn't have a personal history of breast cancer, a strong family history of breast cancer, a genetic mutation known to increase risk of breast cancer such as a BRCA gene mutation or a medical history including chest radiation therapy before the age of 30. Beyond genetics, family history and experience with radiation therapy, experiencing menstruation at an early age (before 12) or having dense breasts can also put you into a high-risk category. If you are at a higher risk for developing breast cancer, you should begin screening earlier.
In a previous interview with SurvivorNet, Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital, said people who hadn't reached menopause yet should prioritize getting a mammogram every year.
"We know that cancers grow more rapidly in our younger patients, and having that annual mammogram can be lifesaving," Dr. Lehman said. "After menopause, it may be perfectly acceptable to reduce that frequency to every two years. But what I'm most concerned about is the women who haven't been in for a mammogram for two, three or four years, those women that have never had a mammogram. We all agree regular screening mammography saves lives."
It's also important to be on top of self breast exams. If you ever feel a lump in your breast, you should be vigilant and speak with your doctor right away. Voicing your concerns as soon as you have them can lead to earlier cancer detection which, in turn, can lead to better outcomes.
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