An interesting story aired a few weeks ago on the Today Show about twin sisters, both recovering from breast cancer.

While the main focus of the piece was the nearly made-for-TV story of two very close and loving sisters battling breast cancer together, there were several strong messages that were completely missed by the story. The situation of these very courageous siblings presented an opportunity for the type of television that gets the viewer emotionally connected. What an incredible opportunity for the medical editors of the Today Show to drive home some critical points about breast cancer to their demographic of viewers- who are exactly those we as surgeons yearn to reach with such information.

A Genetic Predisposition to Cancer?

The story was basically about the bond between twin sisters in their mid-thirties and the fact that they are both recovering from breast cancer surgery.

The interesting point of the story was that, as these sisters are identical twins, one sister was able to donate tissue to the other sister for use in her reconstruction. The story centered on the emotions behind such a process.

The fact that identical-twins can more easily share such transplanted tissue is a fascinating concept and one that certainly makes for an interesting discussion.

The story was a perfect and obvious opportunity for the media to drive home the point that there is a clear familial and even a genetic predisposition to breast cancer…and this was only hinted at in the piece more so because, in this case, the sisters were so close.

Please don’t get me wrong, this was meaningful television and a story that certainly underscored some of the great work that Plastic Surgeons are involved in.

Thoughts on Breast Cancer Awareness from the Medical Community

I am a Plastic Surgeon in relatively affluent and educated parts of New York including Manhattan, Nassau County Long Island, and Westchester. My practice is one of the busiest cosmetic and reconstructive breast practices in the area and every single breast patient I see – cosmetic or reconstructive- is questioned about their breast health including both personal and family history.

It always amazes me how uninformed many otherwise very intelligent people are about breast cancer risk factors and diagnostic screening procedures.

I see many people in their late forties or fifties who haven’t yet had a screening mammogram. Educating women regarding familial predisposition, other risk factors, and recent concepts regarding genetic testing is something we must not become complacent about. Although it is on some level the responsibility of the medical community to be sure that the message gets out there, we could never reach people as effectively or as efficiently as the media.

The other issue that was mentioned but not impressed upon during the news story was the fact that the first sister’s breast cancer diagnosis came during pregnancy.

This is an incredibly real issue that is also important to address.

Most women during their childbearing years are dwelling on things that are wonderful…as they should. As their bodies change during pregnancy it is normal to expect significant changes in the breasts. The last thing a young woman would logically consider during pregnancy, when it’s normal for breasts to change, is breast cancer.

The fact is that many breast cancers are sensitive to estrogen, which spikes to sky-high levels during pregnancy. An early estrogen-sensitive breast cancer exposed to the dramatically high estrogen levels of pregnancy may grow quickly and become aggressive. This was the case in one of the two sisters in the televised story.

I had a similar patient two years ago – she was in her late twenties and pregnant with her first child. Her astute OB-GYN recognized the large mass in the upper part of her left breast as something unusual – even though, to the patient, this was assumed to be just the normal expected changes of pregnancy. A biopsy was performed and confirmed the diagnosis of cancer. Her beautiful child was delivered a little early and she went on to be treated for her cancer including a nipple-sparing reconstruction. The comprehensive exam and suspicion by the OB-GYN, together with the team approach of the Oncologist, Breast Surgeon and Plastic Surgeon gave this patient swift treatment, a good reconstructive result, and a great prognosis – despite the aggressive nature of her diagnosis.

This was a very well done piece by the Today Show. I can only hope that the show’s medical editors recognize the important opportunity such an emotionally compelling story presents and air an informative follow-up to the story.