A beloved actress from one of America’s most popular TV shows has shared the story of her breast cancer journey with the world. 

Jenna Fischer, widely known as Pam from “The Office,” announced on social media she was diagnosed with Stage 1 Triple Positive breast cancer in December 2023.

The 50-year-old’s cancer journey unknowingly began after her routine mammogram in October 2023. She tells The Today Show’s Hoda Kotb that her doctor called with the results, saying they were fine, but that there were a few spots that were difficult to see. The doctor added that Fischer has very dense breast tissue.

Fischer went in for a follow-up breast ultrasound and received the news on her patient portal while on a hike by herself.

“I checked the portal on the hike, and that’s when I saw words like ‘invasive,’ ‘ductal,’ ‘carcinoma,’ ‘malignant,’” Fisher told Kotb. “And I was like, ‘Those words sound like cancer words.’”

Nearly one year later, Fischer announced that she completed surgery, chemotherapy and radiation and is now cancer free. She hopes by sharing her story, she can provide comfort and hope to other women receiving similar diagnoses.

Jamin Addae, MD, is a breast surgeon with OSF HealthCare. He says having dense breast tissue does not necessarily mean you have breast cancer, but it does indicate that you have a higher chance of developing the disease.

Different types of breast tissue

"Dense breast tissue is absolutely normal. Like everything else in life, there are variations of things. You don't have one thing being the same in everybody. Breasts are made of different tissues and some of them we call fatty tissues, which are plain fat. Then we have glandular tissue which is the tissue that forms all the glands that produce milk," Dr. Addae says. “Then you also have the fibrous tissue that supports the breast itself.”

Dr. Addae says seeing the combination of the three types of tissue helps determine how dense the breasts are. He recommends getting routine breast screenings once you reach the age of 40, which is recommended by the American Cancer Society.

That way if you end up having dense breast tissue, your physician may recommend additional imaging to better assess the breast if the needs should arise. Fischer’s story is a perfect example of this.

“Knowing that you have dense breast tissue makes you aware that you have a slightly increased risk than someone who doesn't have dense breast tissue," Dr. Addae says. “It also makes you aware that it's more challenging to read your mammograms, compared to somebody who just has fatty tissue or fatty breasts.”

Technology advances helping survival rates, quality of life

Dr. Addae says the number one technology helping breast surgeons do what they do are what are called localization devices.

“If it's a small, five-millimeter area of calcification, you should be able to get that area out without taking the whole breast off. But that's a big challenge and I think the localization devices have made it possible for us to have a little clip placed in that area. So, in the operating room, we're able to go exactly where the five-millimeter tumor is, only take out that area and conserve the rest of the breast,” Dr. Addae says. “There's also a lot of improvements we're having in treatments. We have better chemotherapy and immunotherapy, which we consider systemic therapy. Radiation is also improving. These have all translated into much better survival rates and quality of life for our patients, compared to 20 or 30 years ago.”

Dr. Addae adds that oncoplastic surgery, which includes combining plastic surgery techniques that improve cosmetic appearance in breast cancer surgery have also led to an improvement in aesthetic outcomes and quality of life of breast cancer survivors.

Ways to decrease the risk of breast cancer

-          Stop smoking

-          Decrease the amount of alcohol you drink

-          Maintain a healthy weight

-          Eat healthy

-          Be physically active

-          Breastfeed

-          Know your family history

-          Avoid hormone replacement therapy

Factors that increase the risk of breast cancer

-          Female at birth

-          Older age

-          Immediate family member has or has had breast cancer

-          Genetic mutations

-          Hormone replacement therapy

-          Early onset of menstrual cycle (before 12 years old)

-          Late menopause (menopause after 55 years)

-          Dense breast tissue

-          Smoking

-          Alcohol

-          Post menopausal obesity

-          Physical inactivity

-          Never breast-fed

-          No full-term pregnancies

-          Radiation treatment for Hodgkin’s lymphoma

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A federal panel recently advised women get a mammogram every other year starting at age 40, rather than 50.

And the American Cancer Society estimates that in 2023, nearly 300,000 women in the United States will learn they have breast cancer. About 43,700 women will lose their life due to the disease.

The headlines are reminders to know your breast cancer risks. While many risks are out of your control, there’s just as much you can control, says Heather Thompson, a breast health navigator at OSF HealthCare.

Major risks you can control

• Active lifestyle and healthy eating: Thompson puts it plainly. If you eat junk, you’ll feel like junk. And any exercise will give you more energy and burn fat. Fat produces estrogen, which feeds cancer cells.

“You want to make sure you’re well-maintained with your weight, even after menopause,” Thompson says.

• Taking hormones: This impacts your ovaries, reducing or adding estrogen. Whether you’re at a routine appointment or you have been diagnosed with breast cancer, talk to your provider about what hormones you’re taking.

“We don’t encourage people who are having menopause symptoms [like hot flashes] to take hormones,” Thompson lists as an example. “We encourage other things to help treat those. It eliminates those estrogen cells increasing.”

• Alcohol and smoking: They are a risk for any type of cancer. But Thompson says one drink per day can increase a woman’s breast cancer risk by 12%. Alcohol is sugary, and that’s a fuel for estrogen.
   
• Night shift work: Thompson says our body expects to sleep when the sun goes down. Night work throws that off.

                “You’re getting artificial light all night. That changes the melatonin that the body naturally makes,” Thompson explains. “When your melatonin is off, it increases estrogen.”

                If you don’t work the traditional day job, see if you can work different shifts so you are not up all night all the time.

Risks you can’t control

• Age: Thompson says women generally develop breast cancer at age 50 and above. 
   
• Family history and genetic mutations: A family history of breast cancer puts you at a higher risk. Thompson says the higher risk is often seen on the person’s mother’s side of the family. For example, your mother and her sister (your aunt) may have breast cancer, and so you’d need to talk to your provider about your risk.

              Some women diagnosed with breast cancer and who have a family history may undergo a genetic test.

“Those tests can tell us if this is something being passed down from generation to generation,” Thompson says.

• Reproductive history: Young women who develop menstruation before age 12 and women who go through menopause after age 55 have an increased risk.

“That gives them a longer time with their ovaries working. They’re producing estrogen,” Thompson says.

• Dense breast: More tissue and less fat mean a dense breast and an increased cancer risk, Thompson says. Usually, the younger you are, the denser your breast is. The density of your breast is something that will be noted on every mammogram result. Thompson says mammogram technology is getting better at finding cancer in dense tissue. An early diagnosis may mean a better outcome.

Takeaways

Make sure your health care provider knows about your circumstances so they can decide on the best preventive care, like a different schedule for mammograms. Some of the information to have handy: a family history of cancer and any physical change you noticed during your monthly breast self-check.

Learn more about breast health and breast cancer care on the OSF HealthCare website.

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Previous coverage

A breast cancer survivor's toolkit
Say yes ma'am to the mammogram
FDA dense breast rule promotes earlier cancer detection
A woman's battle with breast cancer
Prevention of breast cancer starts with awareness

“I found a lump.”

It’s the unsettling phrase providers sometimes hear from women when they are performing their monthly breast self-check for cancer signs.

But lumps are not the only thing to watch for, says Heather Thompson, an OSF HealthCare breast health navigator who is herself a breast cancer survivor.

Signs to know

Each month, keep these in mind.

• Lumps, the most talked about sign.

“A lot of women, especially younger women, have very dense breasts. Sometimes it feels like a bag of rice with little bumps. That’s just the tissue,” Thompson says. “When you feel a hard nodule, fixed in place or sometimes mobile, you definitely want to get that reviewed.”

• Skin changes. This could be an orange peel skin appearance, flaky skin, irritation or a new dimple.
   
• Unexpected release of fluid or blood from the nipple. For example, if you are not breastfeeding, a nipple discharge would be unexpected.
   
• Unexpected inversion of a nipple.
   
• One breast larger than the other, or generally, any unexpected change to breast size.
   
• Any new pain in breast area.
   
• Tenderness, swelling, pain or lumps under your armpit. This is one some women may overlook since it doesn’t deal with the breasts.

“Your lymphatic system drains to armpits,” Thompson explains. “So, if there’s anything going on in the breast, it’s going to show up in your armpit eventually.”

When and how

Thompson recommends women pick a date each month for a self-check and stick with it. The first of each month, for example. This way, you can put it on your calendar, and it’s easy to remember. And, she says the feel of your breasts will change as days go by. But, choosing the same time each month gives you a baseline feel and helps avoid false positives. Thompson also advises making your chosen date a week after your menstrual cycle ends.

Thompson says many women find it convenient to examine themselves in the shower. Regardless of where, she says a good technique is to move your fingertips in a circle from the outside to the center of the breast, pressing down and feeling for abnormalities. Then, do the same under each armpit. And also, glance in the mirror for a good look at visual signs, such as one breast larger than the other.

Some women have a trusted adult, like a spouse, also feel their breast for a second opinion. Others may take photos during their self-check to show their provider. Both ideas are acceptable, Thompson says.

“When you go to the doctor, they can look at the picture. If the abnormality has changed or gone back to normal, then we know it’s nothing to really worry about. But if the issue has increased in size or looks worse, it’s something to be concerned about,” she says.

What happens next

If you find something concerning in a self-check, call your primary care provider or OB/GYN right away and explain what you found. Thompson says the provider will likely order a diagnostic mammogram, an outpatient procedure at a doctor’s office. The radiologist should read the results on the spot. If a closer look is needed, you may undergo an ultrasound, another way to image the breast, or a biopsy, which takes a tissue sample for testing.

It's important not to panic, Thompson stresses. If you have severe pain or an abscess, you should go to the emergency department. But for abnormal findings on a self-check, that’s not necessary.

“If you go to the emergency department with a lump, they’re going to send you home, and you’re going to have to go through the process of calling your provider.

“Breast cancer is not going to change that drastically in three to four weeks,” Thompson adds. “It’s not going to make that big of a difference. However, you want to get yourself scheduled and be proactive. Don’t say ‘Oh let me watch it for a few months and see if it changes.’”

But do keep track of any changes between when you make the appointment and appointment day.

Why it’s important

Thompson says a monthly self-check goes hand-in-hand with regularly scheduled mammograms as the most important ways to prevent breast cancer. You should talk to your primary care provider or OB/GYN about what mammogram schedule is right for you.

“Typically, we do a mammogram every year to get the breast image,” Thompson says. “But during the year, things can develop that you don’t notice. Some things can develop very quickly.

“By doing a monthly exam, you learn your body. You know how it feels,” she adds. “Each month you may say ‘Well I didn’t remember that there last month.’ So you can address it right away.”

Early detection is key for a better outcome. Conversely, unchecked breast cancer is a major killer in the United States. The American Cancer Society estimates about 43,700 women will lose their life to the disease in 2023.

Learn more

Read more about breast health and breast cancer on the OSF HealthCare website.

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Related stories

OSF HealthCare Newsroom breast cancer stories
OSF HealthCare Blog breast cancer stories

In May 2023, federal officials drafted a groundbreaking recommendation for women to get the common breast screening known as a mammogram. 

A year later, the United States Preventive Services Task Force (USPSTF) finalized their recommendations, saying starting at 40, women should start to get breast screenings every other year. This new guidance given by the  USPSTF lowered the age from 50 to 40.

Breast cancer is the most common form of cancer in women in the United States, according to the American Cancer Society (ACS). It makes up for roughly 30% of new female cancers every year.

OSF HealthCare advanced practice registered nurse Banesa Chavez says early intervention is key to preventing breast cancer deaths.

“The benefit of completing your screenings is being able to find it earlier and get it treated,” Chavez says. “The outcomes are a lot better when the cancer is found in the early stages.”

Alongside seeing a breast health specialist, Chavez says there are ways to perform self-checks for breast cancer at home. She adds it’s vital to be vigilant in detecting any signs or symptoms and reach out to your medical provider if you find something concerning.

“If you experience any pain, any discharge,” Chavez says. “Women should be doing breast self-exams monthly.”

If you’re unsure how to perform breast self-exams, you can read Breast self-checks 101 on the OSF Newsroom.

Chavez says the new breast screening recommendations should be reason for younger women to pay attention to any bumps or lumps they see or feel on their breasts.

“Just because you’re not in your 40s or 50s, that doesn’t mean you should ignore any abnormalities or breast changes,” Chavez says. “Come and see us. There are other things we can do, other than mammograms, to detect what’s going on with your breast changes. Especially if there is a strong family history of breast cancer, it’s important not to ignore your symptoms.”

The Centers for Disease Control and Prevention (CDC) reports about 240,000 cases of breast cancer are diagnosed in women and about 2,100 in men each year. About 42,000 women and 500 men in the U.S. die from the disease every year.

The OSF HealthCare recommendations for mammograms can be found here.

Spanish version here

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En mayo de 2023, funcionarios federales redactaron una innovadora recomendación para que las mujeres se realicen el estudio habitual de detección de cáncer de mama, conocido como mamografía. En esa nueva orientación presentada por el Grupo de Trabajo de Servicios Preventivos de Estados Unidos (United States Preventive Services Task Force, USPSTF), se redujo la edad de 50 a 40.

El cáncer de mama es el tipo de cáncer más común en mujeres en Estados Unidos, de acuerdo con la Sociedad Americana contra el Cáncer (American Cancer Society, ACS). Constituye cerca del 30 % de los nuevos casos de cáncer en mujeres cada año.

Banesa Chavez, enfermera registrada de práctica avanzada de OSF HealthCare, afirma que la intervención temprana es clave para la prevención de la muerte por cáncer de mama.

“El beneficio de los estudios de detección es la posibilidad de detectarlo y tratarlo antes”, agrega Chavez. “Los resultados son mucho mejores cuando el cáncer se detecta en las etapas más tempranas”.

Además de consultar con un especialista de salud mamaria, Chavez dice que hay formas de realizar autoexámenes de mama en casa. Añade que es vital mantenerse atento a todos los signos y síntomas y consultar con un proveedor médico si se detecta algo preocupante.

“Si tienen dolor o secreciones”, dice Chavez. “Las mujeres deberían realizarse autoexámenes todos los meses”.

Si no saben cómo realizarse un autoexamen de mama, pueden leer la Introducción a los autoexámenes de mama (Breast self-checks 101) en la Sala de prensa de OSF.

Según Chavez, las nuevas recomendaciones de exámenes de detección de cáncer de mama deberían ser un motivo por el que mujeres más jóvenes presten atención a cualquier bulto o protuberancia que puedan ver o sentir en las mamas.

“El hecho de que no tengan 40 o 50 años, no significa que deban ignorar las anomalías y cambios en las mamas”, dice Chavez. “Vengan a vernos. Hay otras cosas que podemos hacer, además de las mamografías, para detectar lo que está sucediendo con los cambios en las mamas. Especialmente si hay antecedentes familiares de cáncer de mama, es importante no ignorar los síntomas”.

Los Centros de Control y Prevención de Enfermedades (Centers for Disease Control and Prevention, CDC) informan que todos los años se diagnostican cerca de 240 000 casos de cáncer de mama en mujeres y cerca de 2100 en hombres. Cerca de 42 000 mujeres y 500 hombres en EE. UU. mueren a causa de esta enfermedad todos los años.

Las recomendaciones de OSF HealthCare para mamografías están disponibles aquí.

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As technology advances, so does the treatment for breast cancer.

For several years, OSF HealthCare has used 3D mammography at a number of its screening sites to help detect cancer. Also referred to as breast tomosynthesis, 3D mammography helps detect breast cancer earlier than 2D mammography, particularly for women with dense breast tissue.

The 3D mammogram is done alongside the traditional 2D digital mammogram. The X-ray arm sweeps in a slight arc over the breast and takes multiple images instead of one straight-down picture. Then, a computer produces a 3D image in one millimeter slices, which provides better visibility for the radiologist to see breast detail in a way never before possible.

Jason Davis, MD, a radiologist at OSF HealthCare, says this newer technology has been a game changer into breast cancer detection.

“There were still some components of sensitivity we were missing from women with dense breasts,” Dr. Davis says. “The 3D mammography really helped that. Just going from digital mammography to 3D mammography was a really big leap. It helped us look at breasts in sections. It’s almost like looking at a CT scan. It helped with cancer detection in all women, but it helped a little bit more with women with denser breasts.”

Advances in mammography can be credited with detecting 80% to 90% of breast cancer in women without symptoms. During his time working with OSF HealthCare, Dr. Davis has seen mammography technology change greatly.

“We have come a long way since film-screen mammography, which is where someone takes an X-Ray and they print out a picture. Then the picture is hung and the radiologists read it that way.  We went from there to digital mammography and now we have 3D mammography.  This tool, along with artificial intelligence, computer-aided, detection has significantly increased breast cancer detection,” Dr. Davis adds.

Across Illinois and in Michigan, OSF HealthCare offers breast health resources. It’s recommended that women over 40 should speak with their health care provider on when the best time is to begin yearly mammograms.

When it comes to getting a mammogram, Dr. Davis says there are “no wrong answers.” He adds if there are only 2D mammograms offered in your area, it’s still best to speak with your doctor and get checked if advised.

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