Learning about Breast Cancer
- Rita Wilson is many things – an actress, a producer, a singer, a songwriter and a breast cancer survivor. Her latest work involved being a producer for a new film starring her husband, Tom Hanks, and contributing a heartfelt song to the film’s soundtrack.
- Wilson was diagnosed with breast cancer in 2015. Her diagnosis, more specifically, was invasive lobular carcinoma – a type of breast cancer that begins in the milk-producing glands (lobules) of the breast.
- There are many treatment options for people with breast cancer, but treatment depends greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor.
- 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.
A Man Called Otto is an adaptation of the Swedish novel and movie A Man Called Ove. And a part of the reason the new film came to be was because Wilson had a “visceral feeling” after watching A Man Called Ove. Upon deciding America needed a remake, she became a producer for the film that stars her husband, Tom Hanks, 66.Read More
In an interview with the Los Angeles Times, Wilson talked about learning she had a brother who died in infancy as an adult. She also described the details of her parents’ difficult journeys from Greece and communist Russia to the United States. Both of her parents have since passed, and it was director Mike Nichols’ words upon her father’s death that inspired the song for A Man Named Otto: “The conversation continues.”
“I didn’t understand when he said it. Then you start having conversations with the people you’ve lost. You’re talking to your dad, you’re talking to your friends … and you hear them back,” she said. “It’s because you know them so well, you hear what their answer’s going to be.”
Wilson’s new song is a beautiful display of vulnerability. But this work is certainly not the first time she’s opened up for fans. She’s also been a source of inspiration for cancer warriors everywhere after overcoming a breast cancer diagnosis that arrived in 2015.
Rita Wilson’s Cancer Battle
Rita Wilson’s specific diagnosis was invasive lobular carcinoma – a type of breast cancer that begins in the milk-producing glands (lobules) of the breast.
“Last week, with my husband by my side, and with the love and support of family and friends, I underwent a bilateral mastectomy and reconstruction for breast cancer after a diagnosis of invasive lobular carcinoma,” she said in 2015. “I am recovering and most importantly, expected to make a full recovery.
“Why? Because I caught this early, have excellent doctors and because I got a second opinion.”
Wilson was closely monitored with yearly mammograms and breast MRIs prior to her diagnosis because doctors knew she had an underlying condition called lobular carcinoma in situ, or LCIS. LCIS isn’t cancer, but it is an uncommon condition in which abnormal cells form in the milk glands (lobules) in the breast. Being diagnosed with LCIS indicates that you have an increased risk of developing breast cancer.
“Recently, after two surgical breast biopsies, PLCIS (pleomorphic carcinoma in situ) was discovered,” she said of her journey to a diagnosis. “I mention this because there is much unknown about PLCIS and it is often found alongside DCIS (ductal carcinoma in situ). I was relieved when the pathology showed no cancer.”
PLCIS is similar to LCIS in that it also means that abnormal cells are found in the lobules. But PLCIS cells tend to look larger and more abnormal under a microscope than cells from LCIS. PLCIS is also more likely to become invasive breast cancer and spread to other tissues in the breast than LCIS, according to the National Cancer Institute. So, despite her relief at the initial findings, Wilson had a gut feeling that she needed to investigate further.
“A friend who had had breast cancer suggested I get a second opinion on my pathology and my gut told me that was the thing to do,” she said. “A different pathologist found invasive lobular carcinoma. His diagnosis of cancer was confirmed by, yet, another pathologist.
“I share this to educate others that a second opinion is critical to your health. You have nothing to lose if both opinions match up for the good, and everything to gain if something that was missed is found, which does happen. Early diagnosis is key.”
Understanding Breast Cancer
Breast cancer is a common cancer that has been the subject of much research. Many women develop breast cancer every year, but men can develop this cancer too – though it is much more rare, in part, due to the simple fact that they have less breast tissue.
Signs and symptoms of breast cancer may include:
- A breast lump or thickening that feels different from the surrounding tissue
- Change in the size, shape or appearance of a breast
- Changes to the skin over the breast, such as dimpling
- A newly inverted nipple
- Peeling, scaling, crusting or flaking of the pigmented area of skin surrounding the nipple (areola) or breast skin
- Redness or pitting of the skin over your breast, like the skin of an orange
It’s important to keep an eye out for these symptoms while remembering that having one or many of them does not necessarily mean you have breast cancer. Regardless, you should always speak with a doctor promptly if anything ever feels off or you’re experiencing one or more of the signs listed above. You never know when speaking up about your health can lead to a very important diagnosis.
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.
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.
There are many treatment options for people with this disease including surgery, radiation therapy, chemotherapy, hormonal therapy, targeted therapy and immunotherapy.
Appropriate treatments depend greatly on the specifics of each case. Identifying these specifics means looking into whether the cancerous cells have certain receptors. These receptors – the estrogen receptor, the progesterone receptor and the HER2 receptor – can help identify the unique features of the cancer and help personalize treatment.
“These receptors, I like to imagine them like little hands on the outside of the cell, they can grab hold of what we call ligands, and these ligands are essentially the hormones that may be circulating in the bloodstream that can then be pulled into this cancer cell and used as a fertilizer, as growth support for the cells,” Dr. Elizabeth Comen previously told SurvivorNet.
One example of a type of ligand that can stimulate a cancer cell is the hormone estrogen, hence why an estrogen receptor positive breast cancer will grow when stimulated by estrogen. For these cases, your doctor may offer treatment that specifically targets the estrogen receptor. But for HER2 positive breast cancers, therapies that uniquely target the HER2 receptor may be the most beneficial.
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.
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
- 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.