The Importance of Knowing Your Family's Health History
- “Today” show contributor Jill Martin revealed this week that she was diagnosed with breast cancer just six months after receiving a clear mammogram and one week after learning she was BRCA2 positive.
- A BRCA mutation increases a person’s risk of breast and ovarian cancers.
- Martin will be taking an immediate leave of absence to under go bilateral mastectomy (the removal of both breasts) and additional treatment. She plans to have a preventative hysterectomy (removal of her ovaries) later this year.
- A double mastectomy is when both breasts are removed to get rid of cancer. The procedure may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
A BRCA mutation increases a person’s risk for developing breast and ovarian cancers.Read More
Speaking to PEOPLE about her unexpected diagnosis, Martin said, “I am in shock, but at the same time I’m so grateful because it could be a very different story that we’re talking about. Of course I’m devastated. You hear the C-word and you think the worst. But after you hear the word and you absorb it, you then have to be your own best friend.
“And also having the platform to share my story has given me strength, because I feel like while I’m healing, I will be able to help literally save lives. And if I save one life from this, then this process will have been worth it for me.”
Expert Breast Cancer Resources
- You Should Be Aware of These Signs of Breast Cancer
- 6 Common Excuses for Skipping a Mammogram That You Need to Stop Using!
- Mammograms Are Still the Best Tool for Detecting Breast Cancer — A Warning About Thermography
- Major Advance: PARP Inhibitor Pill Extends Life For Women With High Risk Breast Cancer & BRCA Mutations
- What is a BRCA Mutation?
The diagnosis was particularly shocking, since she had been screened for the breast cancer just six months ago.
“I had a mammogram in January and it was perfect!” she told the news outlet.
Martin explained further in her essay how she’s talking about her diagnosis to raise awareness, “so that maybe you can be tested and identify a BRCA or other genetic mutation earlier.”
She continued, “If I had known I was BRCA positive, I would have gotten screened more regularly, with an MRI alternating with my mammograms. What I didn't know before this experience was that an MRI can pick up cancers that mammograms miss.
“So while my mammograms missed the presence of breast cancer, an MRI might have helped me catch it earlier. Earlier testing also might have led me to the opportunity to have preventative surgery which is something I had planned to do only days before I found out that I actually had cancer.”
This morning, TODAY contributor Jill Martin reveals her breast cancer diagnosis.@jillmartin joins us live alongside her doctor Dr. Elisa Port to discuss how her doctors' recommendation saved her life and the one thing she hopes you'll do for her. https://t.co/nyrkWoXbMw pic.twitter.com/SZuWBWUk0a
— TODAY (@TODAYshow) July 17, 2023
Martin also spoke on the “Today” show Monday morning, where she informed viewers she would be taking an immediate leave of absence to undergo a bilateral mastectomy (the removal of both breasts) and additional treatment. She plans to have a preventative hysterectomy (the removal of her ovaries) done in the fall.
While on the “Today” show, Martin, sitting next to her physician Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, tearfully opened up to Savannah Guthrie and Hoda Kotb.
When Martin was introduced onto the show she first said, “Hi. This feels like an outer-body experience. I have been diagnosed with breast cancer, and it feels like someone else telling this story, and six weeks ago, it happened very fast.”
She insisted the BCRA-test “saved my life,” explaining, “Had I not had gotten the test, I wouldn’t have gotten the scans, and we would have been telling a very different story. So, I feel super grateful to be here, to be able to say talk to your doctors and go get tested. And I have mine here.”
Her doctor, Dr. Elisa Port, who has previously spoken to SurvivorNet about breast cancer and will be Martin’s surgeon, added, “Mammograms do save lives and they are still the number one way to detect breast cancer, but no test is perfect and mammograms certainly aren’t.
“They pick up about 85% to 90% of cancers, but not 100%. And that’s why we screen and recommend screening our high risk patients adding on other imaging tests to close that gap.”
In regard to what led her to get checked for the breast cancer gene mutation, Martin wrote in her essay, “My grandmother passed away from breast cancer. And my beautiful mother who is healthy now had a double mastectomy in her late 40s after being diagnosed with ductal carcinoma in situ, often referred to as stage 0 breast cancer. If left untreated, DCIS can turn into invasive cancer, according to the American Cancer Society.”
Martine continued, “After her surgery, she tested negative for mutations in her BRCA genes, and she is still negative. So I assumed I didn't need to test for that, but was vigilant on keeping up with my screenings. And I had wrongly thought, like so many other friends I have since spoken to about this, that breast cancer was mostly something only women needed to monitor.
“I was wrong. Very. If you are not familiar with this test, the BRCA1 and 2 genes, which I now know are inherited from your mother and father, are tumor suppressing genes that are important for fighting cancer. Mutations to these genes can greatly increase your risk of developing certain types of cancer, especially breast, ovarian and prostate cancer, according to the Centers for Disease Control and Prevention.”
Martin’s doctors ultimately encouraged her to get genetic testing done to be “sure.” Thankfully after the test revealed she was BRCA2 positive, she had a sonogram and an MRI, which led to her diagnosis.
Understanding Stage Zero Breast Cancer
In order to reduce the fear around very early stage breast cancer, we want you to understand the definition and the debate around treatment.
Stage zero breast cancer, also known as ductal carcinoma in situ (DCIS), refers to cancer that's confined to the breast milk duct. There are two important facts about DCIS breast cancer:
1. It doesn't spread to other parts of the body.
2. The risk of death is essentially zero.
Among breast cancer doctors, there is some debate about how to treat DCIS. Some doctors don't even consider it a cancer, but rather a collection of abnormal cells or a pre-cancer, which is why some women opt for a watch and wait approach.
Others may suggest the surgery route, which usually involves a lumpectomy (removal of just the cancer from the breast) and potentially radiation as well. This somewhat more aggressive treatment (which is the standard protocol at major cancer centers) does have side effects, and potentially, long term effects.
You should ask your doctor about the very large study going on which is comparing outcomes and long-term impact for treatment vs. watchful waiting in stage zero breast cancer.
Less commonly, doctors and their patients will decide on more aggressive approaches depending on the amount of DCIS in the breast and a woman's specific risk factors for a future breast cancer. One reason some doctors may want to remove DCIS is if a biopsy reveals any evidence that a more invasive breast cancer could be present.
The good news about DCIS: it's usually always treated successfully (many oncologists do use the word cure in this situation), and you can take some time to digest the options, and then make a decision that's right for you.
Considering a Double Mastectomy
A double mastectomy, which Jill Martin will soon undergo, is when both breasts are removed to get rid of cancer. The procedure may also be performed as a preventative measure for women who are at a very high risk of developing breast cancer.
Following the procedure, some women may choose to have their breasts reconstructed and have implants put in, while others don't have reconstruction at all.
"A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue," Dr. Elisa Port told SurvivorNet in an earlier interview. "The real length, the total length of the surgery, can often depend on what type of reconstruction [a patient] has.”
Dr. Port notes that these days, most women do opt to have some sort of reconstruction. The length of these surgeries can vary a great deal. When implants are used, the procedure can take two to three hours (so the total surgery time would be around five hours). There is also the option to take one's own tissue (usually from the belly area) and transfer it into the breast area but this is a much longer procedure.
"When you take tissue from another part of the body and transfer it to fill in the empty space where the breasts are, this is a very long operation," Dr. Port says. "It can take anywhere from six to 12 hours because it's really like having a tummy tuck and then transferring the tissue and grafting the tissue, connecting the vessels, so those tissues have blood flow to live in."
Deciding the Right Course of Treatment
Doctors treating breast cancer may seek out markers on your particular cancer to help decide what course of treatment is best. This is due to the cancer cells possibly having what are known as receptors that help identify the unique features of the cancer.
The three main receptors are the estrogen receptor, the progesterone receptor, and the HER2 receptor. The estrogen and progesterone receptors go together because they are fueled by hormones. Think of the cancer cell as having little hands on the outside of the cell which grab hold of proteins that help it grow. These proteins are sometimes called "ligands."
An example of a type of ligand that can stimulate a cancer cell is the hormone estrogen. An estrogen receptor-positive breast cancer will be stimulated by estrogen to grow. In this instance, your doctor may offer you treatment to specifically target the estrogen receptor
Another important receptor to test for is the HER2 receptor. For HER2 positive breast cancers, therapies that uniquely target the HER2 receptor are essential to treating the disease.
What is a BRCA Mutation?
BRCA is actually two genes (BRCA1 and BRCA2), which are each proteins that work as tumor suppressors and help repair damaged DNA. These genes are important for ensuring the stability of each cell's genetic material.
When either of these genes is altered, that mutation can mean that its protein product does not function properly, or that damaged DNA may not be repaired correctly.
These inherited mutations in BRCA1 and BRCA2 can increase the risk of female breast and ovarian cancers and have also been associated with increased risks for several other cancers, including fallopian tube and peritoneal cancer (which are ovarian cancers).
As Dr. Rebecca Arend, Associate Scientist at the University of Alabama, Birmingham, previously explained to SurvivorNet, "What a BRCA mutation is, is a defect in your ability to repair a double-strand break (in your DNA)."
When the BRCA gene has a mutation, that basically means that cells have a tougher time repairing their DNA the "right" way. When cells repair their DNA the wrong way, that's when cancer is more likely to develop.
According to the Centers for Disease Control and Prevention (CDC), approximately 1 in every 500 women in the U.S. has a mutation in either her BRCA1 or BRCA2 gene.
The CDC also explained that "about 50 out of 100 women with a BRCA1 or BRCA2 gene mutation will get breast cancer by the time they turn 70 years old, compared to only 7 out of 100 women in the general United States population."
"About 30 out of 100 women with a BRCA1 or BRCA2 gene mutation will get ovarian cancer by the time they turn 70 years old, compared to fewer than 1 out of 100 women in the general U.S. population," the CDC adds.
Contributing: SurvivorNet Staff