Early Screening Saves Lives: For ‘Anne With An E’ Star Miranda McKeon, 22, And So Many Women, Dramatic New Evidence About Getting Mammograms Sooner

Dr. Monticciolo said, “The biggest takeaway point of our study is that annual screening beginning at 40 and continuing to at least age 79 gives the highest mortality reduction, the most cancer deaths averted, and the most years of life gained.

“There’s a huge benefit to screening annually until at least 79 and even more benefit if women are screened past 79.”

RSNA’s news release explains the review of CISNET estimates revealed a mortality reduction of 41.7% when women between the ages of 40 and 79 had a digital mammography or tomosynthesis.

“Biennial screening of women 50-74 and 40-74 showed mortality reduction of 25.4% and 30%, respectively,” RSNA adds.

“Annual screening of women 40-79 years showed the lowest per mammogram false-positive screens (6.5%) and benign biopsies (0.88%) compared to other screening scenarios.”

Monticciolo says mammogram rates took decreased significantly following a 2009 recommendation by the U.S. Preventive Services Task Force (USPSTF) that women should be screened every other year beginning art age 50. That recommendation, however, was since changed last year to screenings every two years starting at age 40 if the person is considered healthy.

Monticciolo explained in the news release, “The risks of screening are non-lethal and manageable for most women. But advanced breast cancer is often lethal. Breast cancer is easier to treat if it’s found earlier; we’re able to spare women extra surgeries and chemotherapy.

“It’s just a better idea to shift to early detection, and that’s what screening does.”

She added, “This paper is important because it shows once again that there’s a tremendous increase in mortality benefit by screening annually between the ages of 40-79, and that the chances of experiencing harm are low on a per-exam basis.

“It comes down to valuing women’s lives. I am hoping that primary care physicians see that risks of screening are manageable, and the benefits are tremendous. We need to do this for women.”

Miranda McKeon’s Cancer Journey

Miranda McKeon was diagnosed with stage three hormone-positive breast cancer on June 14, 2021, after she went to the doctor because of a lump “the size of a jellybean” in her breast. She was only 19 at the time.

“I spent most of that time confused and scared, but mostly in shock,” she told Coping magazine in an earlier interview. “Most of us go through life with the belief that we are untouchable. It’s a crazy feeling when the spinner lands on you.”

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After freezing her eggs for fertility preservation, treatment began with eight rounds of AC-T chemotherapy over the course of four months. AC-T stands for a breast cancer combination of drugs that includes doxorubicin hydrochloride (Adriamycin) and cyclophosphamide, followed by paclitaxel (Taxol).

RELATED: Hope For Some Early-Stage Breast Cancer Patients: Verzenio

She then had a double mastectomy reconstruction followed by 25 rounds of radiation in the form of proton therapy a relatively new type of radiation.

“I never would have anticipated that going through cancer treatment would feel like working five full-time jobs at once!” she said. “For months, my schedule was filled with all-day doctor’s appointments. “If I had a day off, I was managing symptoms, resting (also a job), not to mention trying to see friends and keep a level of normalcy for my mental health.”

McKeon is in remission, but we’ve previously learned via her Instagram story that does not mean she can forgo further treatments. Still, she continues to do an incredible job of maintaining positivity and joy throughout all aspects of her life, which is often seen on her Instagram page.

She celebrated being one year “cancer free” on February 25, 2023, so she’s likely prepared to commemorate year two in just a matter of days.

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McKeon also recently underwent breast reconstruction surgery. Back in October, she wrote alongside a photo of herself, “A year and a half ago I was sitting down with my doctor to discuss surgery options. We were trying to figure out the best way to 1. Remove all existing cancer 2. Create an aesthetic outcome that I was excited about and 3. Ensure I felt empowered and safe with my choices.”

McKeon opened up about the type of implants she received and how she has “peace of mind and [is] feeling confident” about her reconstruction decisions.

Helpful Information About Breast Cancer Screening

The medical community has a consensus that women between 45 and 54 have annual mammograms. However, an independent panel of experts called the U.S. Preventive Services Task Force (USPSTF) is saying that women should start getting mammograms every other year at the age of 40, suggesting that this lowered the age for breast cancer screening could save 19% more lives. For women aged 55 and older, the American Cancer Society recommends getting a mammogram every other year. However, women in this age group who want added reassurance can still get annual mammograms.

Women with a strong family history of breast cancer, have dense breasts, have a genetic mutation known to increase the risk of breast cancer, such as a BRCA gene mutation, or a medical history, including chest radiation therapy before age 30, are considered at higher risk for breast cancer.

WATCH: Understanding the BRCA gene mutation

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.

Breast density is determined through mammograms. However, women with dense breasts are at a higher risk for developing breast cancer because dense breast tissue can mask potential cancer during screening. 3D mammograms, breast ultrasound, breast MRI, and molecular breast imaging are options for women with dense breasts for a more precise screening. It is important to ask your doctor about your breast density and cancer risk.

RELATED: 3D Mammography Detects 34% More Breast Cancers Than Traditional Mammography

Family History & Breast Cancer Risk

Although breast cancer can happen to anyone, certain factors can increase a person’s risk of getting the disease. The known risk factors for breast cancer include:

• Older age
• Having a gene mutation such as the BRCA1 or BRCA2
• Added exposure to estrogen
• Having children after the age of 30
• Exposure to radiation early in life
• Family history of the disease

RELATED: Is Genetic Testing Right for You?

Different types of genetic testing can help people with a family history of cancer better ascertain their cancer risks. Your doctor will discuss your family history of cancer with you in the context of your type of tumor and your age at diagnosis. Hereditary genetic testing is usually done with a blood or saliva test.

WATCH: Understanding genetic testing for breast cancer.

About ten percent of breast cancers are hereditary, says Dr. Ophira Ginsburg, Director of the High-Risk Cancer Program at NYU Langone’s Perlmutter Cancer Center.

“We encourage only those with a family history to get [genetic testing],” Dr. Ginsburg previously told SurvivorNet. “I would say that if you have anyone in your family diagnosed with a rare cancer. Or if you have a strong family history of one or two kinds of cancer, particularly breast and ovarian, but also colon, rectal, uterine, and ovarian cancer, that goes together in another cancer syndrome called the Lynch Syndrome.

The second test involves the genetic sequencing of your tumor if you’ve been diagnosed with cancer by this point. These genetic changes can be inherited, but most arise during a person’s lifetime. This process usually involves examining a biopsy or surgical specimen of your tumor. This testing can lead to decisions on drugs that might work against your cancer.

“Digital mammography, it turns out, significantly improves the quality of the mammogram… It’s 3D or tomosynthesis mammography,” Dr. Lehman explains.

“This allows us to find more cancers and significantly reduce our false-positive rate. With digital mammography 3D tomosynthesis, we’re taking thin slices through that breast tissue, like slices of a loaf of bread. We can look at each slice independently rather than trying to see through the entire thickness of the entire loaf of bread. So those thin slices help us find things that were hidden in all the multiple layers,” Dr. Lehman adds.

Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and her physician’s guidance.

Screening Options for Women with Dense Breasts

Women with dense breasts should get additional screening to supplement their mammograms. Dense breasts mean more fibro glandular tissue and less fatty breast tissue exists.

The dense tissue has a “masking effect on how well we can perceive cancer and find cancer on mammograms,” Dr. Cindy Ly, a radiology doctor at NYU Langone Medical Center, told SurvivorNet in an earlier interview.

Survivors Encourage Women to Ask Their Doctors About Dense Breasts

Glandular tissue within dense breasts appears white on mammograms, which can help mask potential cancer. The “frosted glass” effect from the glandular tissue can thus mask cancerous areas, especially developing ones. Undetected, these cancers can progress, growing large and advanced. They will then likely require more intensive treatments to cure or can become incurable altogether.

Women with dense breasts may not know they have it based on feeling alone. It’s important to know that breast density is determined by its appearance on a mammogram. Dr. Connie Lehman, the chief of the Breast Imaging Division at Massachusetts General Hospital, previously explained to SurvivorNet that fatty breast tissue appears gray on an X-ray. Conversely, dense breast structures appear white during an X-ray. Cancers also appear white on an X-ray, meaning the dense breast structures can mask the possibility of cancer. Luckily, advanced mammograms exist to help doctors navigate this obstacle.

WATCH: 3D Mammograms explained.

“Digital mammography, it turns out, significantly improves the quality of the mammogram…It’s 3D or tomosynthesis mammography,” Dr. Lehman explains.

“This allows us to find more cancers and to significantly reduce our false-positive rate. With digital mammography 3D tomosynthesis, we’re taking thin slices through that breast tissue, like slices of a loaf of bread. We can look at each slice independently rather than trying to see through the entire thickness of the entire loaf of bread. So those thin slices help us find things that were hidden in all the multiple layers,” Dr. Lehman adds.

Additional testing can be considered for dense breasts, depending on a woman’s personal history, preferences, and her physician’s guidance. These tests include:

• 3-D Mammogram (Breast Tomosynthesis): This technology acquires breast imaging from multiple angles and digitally combines them into a 3D representation of the breast tissue. This allows physicians to see breast tissue architecture better, even in dense breasts. 3D mammograms are fast becoming the standard way of performing mammography.
• Breast Magnetic Resonance Imaging (MRI): An MRI machine uses magnets to create highly detailed, intricate images of the breast. These are mostly reserved for women with an extremely high breast cancer risk. Dense breasts alone may not be a valid reason to obtain a breast MRI. However, dense breasts in women with genetic mutations, like BRCA1 and BRCA2, or a strong family history of breast cancer could justify obtaining breast MRIs.
• Molecular Breast Imaging (MBI): MBI is a newer imaging technique that uses a radioactive tracer to detect breast cancer. It is beneficial for women with dense breasts. However, MBI is not as widely available as other screening methods.

A new rule from the Food and Drug Administration (FDA) says that facilities offering mammograms must notify patients about their breast tissue density and recommend they speak with a doctor to determine if further screening is necessary. There will be “uniform guidance” on what language to use and what details must be shared with the patient to make the communication clear and understandable.

Breast Cancer Symptoms & Self-Exams

Women are encouraged to do regular self-exams to become familiar with how their breasts feel normally so something like a lump forming can be easily detected. A self-exam includes pressing your fingertips along your breast in a circular motion.

If you feel something abnormal, such as a lump or discharge from the nipple, you should contact your doctor for further examination.

Below are common symptoms to look out for:

• New lump in the breast or underarm (armpit)
• Any change in the size or the shape of the breast
• Swelling on all or part of the breast
• Skin dimpling or peeling
• Breast or nipple pain
• Nipple turning inward
• Redness or scaliness of breast or nipple skin
• Nipple discharge (not associated with breastfeeding)

Contributing: SurvivorNet Staff

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