(upbeat music) - Hi, I'm Jacqui Tricarico, Senior Correspondent for "One-on-One," and I am so pleased to be now joined by Dr. Michele Blackwood, Chief of Section Breast Surgery at Rutgers Cancer Institute of New Jersey, part of RWJBarnabas Health.

Thank you so much for joining us, Dr. Blackwood.

- Thanks, Jacqui.

Thanks for doing this segment on breast cancer.

It's so important.

- It really is.

And we ended up dedicating this whole half hour to breast cancer awareness and just how important that is.

The segment before this, we see Steve Adubato interviewing Sarah Roberts at the Connie Dwyer Breast Foundation, and I know you have a personal connection to the foundation as so does RWJBarnabas Health.

Can you describe that for us?

- Sure.

I started the Connie Dwyer Breast Center at St. Michael's Medical Center in Downtown Newark years ago.

I cold called Connie and Bob, and they were very, very generous in supporting our work.

- That's great.

And how have you seen the foundation really help with the overall mission in terms of making sure that mammograms, other screenings are available to women who wanna get them?

- So Connie Dwyer Breast Foundation that I know of now is a little bit different than what we had at St. Michael's.

They have switched their over to Trinitas Hospital, which is one of our hospitals for RWJBarnabas Health.

It's in Elizabeth.

As far as I know, they support women getting screened and to some degree access to healthcare when it comes to breast health and breast cancer.

- Well, this past year, the US Preventative Services Task actually lowered the recommended age to start screenings of 45 to 40 years old.

In your opinion, is 40 early enough because we have seen breast cancer on the rise, especially in younger people, younger women?

- That is absolutely true.

We're seeing a real increase in the number of breast cancer cases in women under age 45 right now.

And this is unusual, as most people think, they think of breast cancer as an older woman's illness or disease.

The reality is that we've doubled the number of women being diagnosed in earlier ages.

They have a very different way of being treated.

They have other concerns.

It's a very different world for breast cancer patients when they're that young.

We don't know why this is occurring, and it really started more than 10 years ago.

So some people wanna blame the pandemic, some people wanna blame other issues, but the reality is that something started happening more than 10 years ago for this kind of trend to continue.

- Well, why isn't there more data or studies on that to find out why this is happening more and more so that maybe we could try to tackle it in a better way?

- Well, there are more studies being done, thankfully, you've gotta remember, it takes a while to see these kind of trends.

We weren't sure what was going on.

And you also have to remember that we at RWJBarnabas Health really support women being screened at age 40 at least.

However, if you have a family history, if you have something else going on, screening means taking women and doing a mammogram plus possibly an ultrasound, plus possibly an MRI for nothing palpable in their breast or no problems.

Whereas the diagnosis of breast cancer may be accompanied by a lump or some changes to the breast tissue.

Certainly if that happens even at a younger age, these women need to be evaluated.

- You mentioned mammograms, but then ultrasounds, MRIs, there are so many different ways to look at the breast tissue today.

So are mammograms still the best and truest way to go, and why are we seeing different ways to examine and look for this cancerous breast tissue?

- Jacqui, that's a really good question.

The reality is that mammograms are a great screening tool for breast cancer.

They are a two vision X-ray looking through breast tissue to see if there's any cancerous growths or changes in there.

The issue is that in women with dense breast tissue, which young women tend to have, and even some older women, that mammograms just aren't enough.

We thankfully have the dense breast law here in New Jersey that allows for women to get other screening tools to look through that tissue, such as an ultrasound or an MRI.

Ultrasounds can find breast cancer sometimes in dense breasts, but they also help delineate if something is a cyst or a solid lesion in the breast.

MRIs are very good at really helping with women who have a high risk of breast cancer, very dense breast tissue, someone with a gene mutation, someone who's thought to possibly have what we call asymmetry on their mammogram.

So the mammogram is a first step, it's a first start, but the reality is that if we think something's there or if this patient is higher risk, we need to do more than that.

And that's where MRI and ultrasound come in.

- So we're talking about screenings, but now fast forward to something's found and can you tell us about what the advancements in treatment are right now for breast cancer?

Because I know, obviously, there are so many ways this could go in terms of what stage it's found in, When you hear stage zero too, I wanted to ask you about that because I've been hearing that more and more.

What does stage zero actually mean?

- So breast cancer can be in different stages, from stage zero, which is the earliest stage, to stage four, which is metastatic.

Stage zero is actually something called ductal carcinoma in situ.

This is a type of breast cancer that some people would call a pre breast cancer.

It's not invasive, it doesn't go to the lymph nodes, does not require chemotherapy, has almost 100% survival to it.

Many, many different ways to treat this, Jacqui.

It's a really important distinction to be made.

It can be made and the distinction can be such that you can literally go from almost no treatment to bilateral mastectomies and everything in between.

So for women with DCIS, it can be very, very difficult to decide how and how much to treat this.

The reality is that almost 100% of women with DCIS are gonna be absolutely fine.

The question is how much should one do to treat that?

- And I'm sure it's just patient to patient, but also in terms of preventative, women who have breast cancer history in their immediate family who also possibly have that BRCA gene that they carry, how important is it for them to seriously consider what their treatment plan should be, even if they don't have breast cancer at that moment?

- So when it comes to patients with breast cancer, when they first come in, we talk to 'em about everything, not just the cancer they have and how to treat it.

The good news is there are many options usually with breast cancer, they can be something as small as a lumpectomy where you just take out the breast tissue with the surrounding room of breast around it, and where the tumor is or the calcifications are.

Or some women choose the opposite extreme and have a mastectomy.

In between all of that is lumpectomy with or without radiation, mastectomy with or without reconstruction.

Women who have a high risk mutation, and by the way, it's not just BRCA1 anymore.

There's BRCA1, which we found in the 1990s, and we have at least four others that can be what we call more deadly type of mutations.

So there's something called BRCA2, PALB2, CHEK2, ATM gene, and all of these genes, if a patient is found to have them, can put her at higher risk for breast cancer.

So with these patients, we actually have a high risk program that we follow these patients many times with yearly mammos, MRIs, and exams.

We talk to 'em about prevention, we talk to 'em about treating this area and taking out the breast tissue with mastectomies, possibly, with reconstruction.

The other issue is when someone has a actual breast cancer, we can treat it in many different ways.

Breast cancer is usually treated completely with a team.

So they have the breast surgeon, someone like myself, and you also have a radiation oncologist, a medical oncologist, a plastic surgeon, a geneticist, nurse navigation, we have the gamut at RWJBarnabas Health in treating patients with breast cancer.

- Such important information.

And I think the end goal here is everybody go get your screening.

And if you feel something or you feel something's off, say something.

Don't let it wait, don't push it aside.

Dr. Blackwood, thank you so much for joining us.

- Thank you so much, Jacqui, appreciate it.

- [Narrator] One-On-One with Steve Adubato is a production of the Caucus Educational Corporation.

Celebrating 30 years in public broadcasting.

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