NO ONE DOES BIG THINGS BY THEMSELVES

This year is my 30th year as a breast surgeon. For the past two months I have had lots of time for reflection on what has changed in my chosen profession. Thirty years ago, a breast surgeon was a new kind of doctor. I was one of the very first in New Jersey, a pioneer. In those days there was a real hunger for a surgeon, particularly a woman, to take care of women with breast cancer and I became busy from the start. But what I realized early on was that women needed more than a breast surgeon to surgically remove their cancer and send them on for chemo and radiation therapy. They needed to get better advice BEFORE they developed breast cancer. They needed better mammograms and ultrasounds and information about their risk of getting breast cancer. So began our multidisciplinary approach to breast health and the birth of Montclair Breast Center.

Creating Montclair Breast Center has been my way to improve the process of care by changing the way medical professionals and women approach breast health and thereby breast cancer. This is a new type of facility dedicated to proactive breast care, prevention and early detection of breast cancer. We encourage women to consider us their “Breast Home.” Our goal is to empower women with information so they can take appropriate action to protect themselves against this most common cancer in women; to provide a thoughtful and professional approach that creates a sense of calm around an issue that is of such deep concern to so many women.

But change is happening all too slowly for so many women in our community. Women are missing out on life-saving information and are getting breast cancers that could have been avoided. I was inspired by Barak Obama’s commencement address to all high school students when he said, “No One Does Big Things By Themselves.” So, I have decided to ask for YOUR help. We need to raise the level of breast care for our entire community of women. Breast cancer does not need to be a life-threatening disease. After my 30 years, I can see that change is way too slow. We need to “set the world on a different path.” We need to work at a grass-roots level and build a community.

Nancy Capello, a breast cancer activist who died at age 66 of complications from breast cancer treatment, started her own grass-roots movement to educate women about the dangers of increased breast density. She was diagnosed in 2004, with locally advanced breast cancer, six weeks after a “normal mammogram!” She went on to get aggressive chemo and radiation therapy. But when she questioned how, after she DID EVERYTHING RIGHT, and still there was no early detection in her case, she found out she had dense breast tissue. She went on a quest to expose this best-kept secret of dense breast tissue, to ensure that women with dense breasts receive supplemental screening in addition to mammography to find cancer at its earliest stage. She realized that MAMMOGRAPHY IS NOT ADEQUATE SCREENING for so many women. She was outraged that she was never informed of her condition or the shortcomings of mammography. If she had an ultrasound or MRI, which are better at finding cancers in dense breast tissue, she might not have even needed chemotherapy.

Because of her tireless efforts, in 2009 her home state of Connecticut became the first state to require that women be told if they have dense breast tissue and that insurance companies must cover the cost of this additional testing. She founded the non-profit organization: areyoudense.org and worked vigorously for the subsequent passage of similar bills in 36 states, until her death in 2018.

Her husband, Joe, took over her work and on February 15, 2019 the National Breast Density Disclosure Law was passed. This Federal Law requires that all mammography providers include information about breast density in reports to patients and their physicians. We need to continue to build on what she and others have started.

Many other women have had pivotal roles in the evolution of the current culture of breast cancer; Mary Lasker, Shirley Temple Black, Betty Ford, Betty Rollin, Rose Kushner, Nancy Brinker, Fran Visco and Susan Love to name a few. But we still have a long way to go. Now is not the time to be complacent. Women should never die from breast cancer. Breast cancer can be prevented.

I am recruiting all of you to become breast health evangelists. Women need a Breast Home, where all elements of breast care including personalized prevention guidance, early detection and treatment are contained in one facility. This changes the entry point of breast care for women to PRECEDE the diagnosis of breast cancer, resulting in prevention, early detection, improved outcomes and better quality of life.

Many of you have benefited from the improvement in the breast health delivery concept that is personified by Montclair Breast Center. Many have had cancers diagnosed early and avoided chemotherapy. Many more have come to rely on our expertise and advice moving forward in a high-risk world, feeling secure and safe in our hands.

Now we need your help to promote change because NO ONE DOES BIG THINGS BY THEMSELVES. All women deserve access to early breast cancer diagnosis. Screening Mammography is NOT enough. Women need to be empowered to ask for more. It can spare the lifelong anguish of families whose loved ones die prematurely from breast cancer that goes undetected with only yearly mammography. “So, if the world’s going to get better, it is going to be up to you.”

Below are PDFs that you can download to email, fax or print for your friends, family, human resources administrator, employees, co-workers, or any email list you may have access to. I am asking my patients, my girlfriends, to join our effort to raise the bar for breast care for more women in our community.

Let us work together “with awareness, empathy, passion, and even righteous anger to change what isn’t working and forge a new path.”

Nancy Elliott, MD
Founder and Director
Montclair Breast Center
nelliott@mcbreast.com

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