Dense Breasts, Delayed Mammograms: Lessons Learned from Katie Couric’s Breast Cancer Diagnosis

When Katie Couric asked, “Why NOT Me?” in announcing her breast cancer diagnosis, she highlighted what we all know: Any of us can get breast cancer.

The media personality’s story is also encouraging. It shows that doctors can often treat early-stage breast cancer with a trio of actions that, frankly, are unpleasant but far from awful. Most important, once the treatment is complete, the cancer will be gone and is not likely to return.

Admitting she is lucky to have the medical and financial resources to get top-care service, Couric shared crucial information.

Early Detection Is Crucial

The germs, the masks, the close proximity to a mammographer — let’s face it, many women delayed getting mammograms during the pandemic. While Couric herself has been outspoken about the need to keep up with colonoscopies since her first husband died of colon cancer in 1998, the self-described “Screen Queen” was six months late to her annual mammogram.

Depending on your risk factors, you might be advised to get mammograms every six months, annually or every other year. The screening test might reveal breast cancer when it’s so small that you won’t yet feel a lump during a self-exam.

Earliest is best when it comes to treating and beating breast cancer, so stay on schedule. When breast cancers are found and treated before they spread, 99 percent of patients survive for five years, according to the National Breast Cancer Foundation, Inc. And most are fine for many years after that.

If family members have had breast cancer, your doctor might advise you to also periodically get a sonogram and/or MRI. Each of the screening technologies can show irregularities the others might not.

Pay Extra Attention if You Have Dense Breasts

It’s harder for radiologists to spot cancers in women who have dense breasts, a situation that refers to nearly half of women. In addition, women with dense breasts are at higher risk of developing breast cancer. Many states, including Florida, require doctors to inform women with dense breast tissue about their increased risk.

Here’s the good news: Having dense breasts does not change the outcome of your breast cancer treatment. Find it early, treat it immediately and go on to live a normal active life.

Type of Cancer Matters

Breast cancers are so diverse that no one course of action is best for all patients. Couric found out that her tumor, while the size of an olive, was hormone receptor-positive and Her2neu-negative. A tumor profiling test resulted in a  reasonably low score of 19. Put simply: “highly treatable.”

Couric’s three-part treatment plan is common for many people diagnosed with a cancer that isn’t ultra-aggressive, was caught early and has not spread to the lymph nodes or beyond.

• A lumpectomy. Also called breast conservation surgery or partial mastectomy, a lumpectomy is a surgery that removes the tumor and the tissue around it. The rest of the breast stays as it is, and reconstructive surgery generally is not needed.
• Radiation. Breast cancer patients often receive adjuvant radiation — radiation designed to reduce the risk of cancer’s return, specifically external beam radiation therapy. Using photons, electrons and in certain cases protons, it targets the cancer while sparing important organs such as the lungs and heart. Patients lie on a table as a machine rotates around them, delivering the special high-energy X-rays.  The purpose is to damage the DNA in the tumor cells; that’s to ensure that any rogue cancer cells left behind are unable to repair themselves and grow into more cancer. The radiation also gets to some regular cells. They will heal themselves. Most people go for radiation treatments five days a week for three or four weeks.
• Medication. Medical researchers continue to develop new drugs to battle breast cancer and its recurrence. Many of the drugs do not have the negative side effects that chemotherapy might. In Couric’s case, she will take aromatase inhibitors for five years. These are common and effective for post-menopausal women who have had hormone-receptor-positive breast cancers.

Like any cancer treatment plan, this one has its down sides. As in all surgeries, lumpectomies involve anesthesia, which in rare cases is dangerous, and incisions, so there may be some pain during recovery. Radiation often causes skin to be red and uncomfortable, as if sunburned; that will heal within two weeks after treatment ends. Many patients feel fatigued, especially late in the day, while undergoing radiation. That, too, tapers off. And aromatase inhibitors might cause joint and muscle pain.

That three-part treatment for this type of early-stage breast cancer is no fun, but it only temporarily interrupts a woman’s lifestyle, with time out for surgery, recovery and daily radiation therapy. Once those parts are done, most patients have a full recovery. They’ll take their aromatase inhibitors every day while living, working and socializing as they did before.

Learn from Katie Couric. Get your mammogram regularly.