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

Video Interview Clips

Mammography remains the gold-standard imaging tool for early detection of breast cancer but some women might need additional screening. That includes women who have dense breasts.

The FDA is now recommending any facility that offers mammograms must tell women if they have dense breasts that could put the at higher risk for breast cancer. The regulation will begin being enforced next year.

Illinois and Michigan are among 38 states in the country that already require imaging centers to disclose if women have dense breasts but rules vary on how much information they require in the notification. The new federal regulation will mandate that notification in all states and standardize what must be disclosed.

Jessica Guingrich, MD, is radiologist and medical director of OSF HealthCare Center for Breast Health in Peoria. She says for women with dense breasts, it can be more difficult to detect cancer with mammography, which relies on contrast to detect cancer. She says dense tissue, which is white, can mask changes in breasts such as a tumor.

“We’re trying to see white findings (tumors) so the denser tissues means there’s more whiteness in the background and it’s harder to see those white findings,” Dr. Guingrich explained.

Having dense breasts not only makes cancer detection more challenging, it can also increase cancer risk, particularly for the roughly 10% of women over 40 that fall into the category of very dense breasts. Dr. Guingrich says a woman can’t determine her own breast density through self-exams or through a clinical exam. Radiologists use national guidelines based on the amount of fibrous tissue within the breasts.

“The density actually has nothing to do with how they feel on physical exam or the breast size. It actually has to do with that appearance on the mammogram.”

Breast density can change over time so a women who earlier was considered for advanced imaging such as a breast ultrasound or MRI might not qualify another time if the density has changed. But, the goal of the notification is to promote a discussion with medical providers about whether advanced imaging is needed to detect cancer earlier and reduce the need for aggressive treatment.

So what are the best options for women who receive the notification? Dr. Guingrich says that will depend on a woman’s risk factors. She stresses having dense breasts is a minor risk factor compared to other considerations such as family history.

“Like if one has a first-degree relative or a pre-menopausal relative diagnosed with breast cancer or if they have a personal history of breast cancer, those women are at higher risk. If a lady is a gene carrier or if a lady has had chest wall radiation.”

The American Cancer Society says breast cancer is the most common cancer diagnosed among U.S. women and is the second leading cause of death from cancer among women after lung cancer. Insurance coverage for advanced breast imaging varies from state to state and the new FDA recommendations don’t address coverage so it’s best to check with your insurance provider.  

Here are the Center for Disease Control and Prevention’s answers to frequently asked questions about dense breasts and implications for additional screening beyond a mammogram.

Video clips-Dr. Jessica Guingrich,  radiologist & medical director, OSF HealthCare Center for Breast Health  

Mammogram B-roll