Twins and Breast Cancer
- Identical twins received the same breast cancer diagnosis in the same spot.
- Both twins have dense breasts. Having dense breasts is considered a risk factor for breast cancer.
- Treatment for breast cancer varies greatly from person to person, so ask your doctor about your best options.
Meagan McCallum had a mammogram that came back “perfectly clear” in October 2019, but an ultrasound follow-up showed an abnormality that doctors had to investigate further. After a biopsy to double check the spot in question, McCallum was diagnosed with invasive ductal carcinoma, the most common kind of breast cancer.Read More
“When I showed her where the scars were, she went pale as a ghost,” Meagan told Good Morning America. “I didn’t know at the time that she found her own lump, and the reason she went white was because her lump was in the exact same spot.”
Courtney received a mammogram that was also negative for any abnormalities, but – just like her twin – an ultrasound found a mass. This discrepancy in results is probably because both women have dense breasts. Courtney was also diagnosed with invasive ductal carcinoma in the same spot as her sister.
Both twins had radiation and did not need chemotherapy. And, thankfully, both women are doing well, according to Good Morning America.
In a 2016 study of more than 300,000 twins, researchers estimated that when one fraternal twin was diagnosed with any cancer, the co-twin’s risk of getting cancer was 37 percent; among identical twins, the risk jumped to 46 percent.
Courtney and Meagan’s advice is simple: Get screened.
“Early detection will save your life, it absolutely will,” Courtney said.
Options for Women with Dense Breasts
The twins also emphasized the importance of ultrasounds as a breast cancer screening option for women with dense breasts.
Millions of women have dense breasts, and it’s important to know if you do because dense breasts make it difficult for traditional mammography techniques to detect cancer. 3D mammography is highly recommended for women with dense breasts because it helps with detection.
“Fatty breast tissue has sort of a grey appearance. An X-Ray beam just runs right through it. But the dense structures, they block the x-ray and so that looks white,” says Dr. Connie Lehman, chief of the Breast Imaging Division at Massachusetts General Hospital. “Unfortunately, cancers also block the x-ray, and so cancers also look white. And so when you have a white cancer, hiding in white dense breast tissue, it can be missed.”
“Digital mammography, it turns out, significantly improves the quality of the mammogram,” Dr. Lehman says. “We also have a new tool that’s even more exciting, it’s 3D tomosynthesis mammography. This allows us to find more cancers and to significantly reduce our false positive rate.”
“We’re taking thin slices through that breast tissue, like slices through a loaf of bread, and we can look at each slice independently, rather than trying to see through the entire thickness of the entire loaf of bread,” Dr. Lehman says. “So those thin slices help us find things that were hidden in all the multiple layers, and also important is that some of the things that looked a lot like it could be a cancer, when we went through the thins slices saw that this is just overlapping, normal breast tissue, and that’s when we reduce our recall rates significantly.”
Dr. Lehman recommends woman seek out tomosynthesis 3D mammograms because, in her opinion, they are simply better.
“Lower false positives, better chance of finding those cancers through those thin slices, and at high quality centers in the right hands, it can really improve the mammography experience,” Dr. Lehman says.
Having dense breasts is considered a risk factor for breast cancer for two reasons, according to Dr. Cindy Ly, a radiologist at NYU Langone Medical Center.
“First, it has a masking effect on how well we can perceive cancer and find cancer on mammograms,” Dr. Ly says. “Second reason is that it means the patients have more fibroglandular breast tissue, which produces a density on the mammogram. When you have more breast tissue, your risk for breast cancer is significantly higher.”
“Breast density increases when you are a younger woman. So, that means you have more fatty breasts and less dense breasts as you get older in general,” Dr. Ly says. “But it’s really an individual difference. Most of our younger patients will have dense breasts by nature. And the only way to tell if your breasts are dense is to have a mammographic evaluation. Clinical breast exam is great, but it’s not very reliable on determining whether your breasts are dense, and other forms of breast imaging, such as ultrasound and MRI, are not as cost effective in determining whether you have dense breasts.”
Types of Breast Cancer Treatment
Many people facing breast cancer choose surgery for their treatment. When Dr. Ann Partridge, an oncologist at the Dana-Farber Cancer Institute, talks to women with breast cancer, she evaluates their best treatment options on a case-by-case basis.
“[Options] typically include cutting out the cancer– which is either a lumpectomy if you can get it all with just a little scooping around of the area that’s abnormal, or a mastectomy for some women meaning taking the full breast because sometimes these lesions can be very extensive in the breast,” Dr. Partridge says in an earlier interview with SurvivorNet. “And I’ll talk to a woman about that, and I’ll say these are two main options or the big fork in the road.”