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(upbeat music) - Hi everyone, Steve Adubato with my colleague, Jacqui Tricarico a special correspondent here on One-on-One.

Jacqui, this entire half hour dedicated to breast cancer awareness, we're taping at the end of October, but it'll be seen many times.

Two very important interviews about breast cancer awareness.

First, why is this program so important?

Second, we'll talk about the guests.

- Like you mentioned, we're taping this in October, Steve, which is Breast Cancer Awareness Month.

And it's just so important, not even just this month, but like you said, this program will be aired several times to just get the information out there about how important it is for women to get their screenings done when they're supposed to for early detection of breast cancer.

We've seen breast cancer on the rise over the years, and especially now on the rise for younger women, women 45 and younger, which is such a big deal when it comes to screenings, early detection.

And if you have breast cancer, treating it and knowing that you have it early on in the stages, not when you find it at stage four, but finding it at stage zero.

And I talk a little bit about that with Dr. Michele Blackwood at RWJBarnabas Health.

- And also I interviewed Sarah Roberts, who's the executive director of the Connie Dwyer Breast Cancer Foundation, an important organization involved in this fight.

Jacqui, you and I are having a conversation about this.

And when we agreed to do this program, we talked about doing this intro together.

And anywhere you don't wanna go is your business.

But you take this, this isn't just journalism for you and broadcasting.

I mean, you just like every other woman, you're of a certain age, younger than most.

Oh, no, that's not an issue for me.

What has this programming and being involved in this done for your thinking about early detection and the whole issue of breast cancer?

- Well, the age for regular screenings, which is recommended, used to be 45.

They just changed that over the past year or so to age 40.

I'm just a few years- - 40?

- Yeah, I'm just a few years younger than that.

But recently, I felt something a little off and something concerning.

So I went to my doctor who took a look at everything and suggested that I get a mammogram and an ultrasound just to rule out anything.

And they did find a small cyst, but thank God it was benign.

I feel like one of the lucky ones because now where I am, almost 40, I hear about breast cancer so often.

Friends of friends, family members, friends of family members.

It comes up way more than I like to hear it.

And this programming is just so important because like I said, it's all about really making sure that women are putting themselves first so often, right?

Us moms and women in general, we're putting our health on the back burner to take care of everybody else.

But this is so important to get those screenings, to get that early detection, and just making sure that we're taking care of ourselves.

- And Jacqui's been the driving force along with our terrific team of producers of making this program possible.

So first, Jacqui, your interview is the second one, right?

- Yep.

So first up, we'll see Sarah Roberts.

- Sarah Roberts first and then Dr. Blackwood after that.

This program dedicated to the women we say we care about.

Well, let's show that we really do care by putting information out there and encouraging women to get tested, to get those mammograms.

Early detection does save lives.

I'm not a clinician, but we just know that to be true.

For Jacqui, myself, and our entire team, let's check out two compelling important conversations about breast cancer awareness.

- I think once a woman is diagnosed with breast cancer, depending on her circumstance, it is very hard to have hope.

You read so much of the negative.

You hear all the bad stories and there are many of them.

But there are...

There are stories of success.

It's been 25 years since I was first diagnosed.

And here I am 25 years later.

What a gift I've been given.

- Hi, everyone, Steve Adubato.

Welcome to a very special half hour.

Jacqui Tricarico and I teed this up.

This is our program on breast cancer awareness, and we kick it off with a leader in the field.

Sarah Roberts is executive director of the Connie Dwyer Breast Cancer Foundation.

Sarah, great to have you with us.

- Thank you so much for having me.

- The name, the Connie Dwyer Breast Cancer Foundation.

Put it in perspective.

- The Connie Dwyer Breast Cancer Foundation ensures that all women in New Jersey, the uninsured and underserved communities, have access to breast healthcare that includes screenings, treatment, follow-up care, and, most importantly, support while they're dealing with breast cancer and their families, so we're here to support them in any way we can.

- And Connie Dwyer?

- Connie Dwyer is our wonderful leader and founder, and we're celebrating our 20th anniversary, and since that 20 years, in the last two decades, we have opened two centers, and we currently have a center at Trinitas Regional Medical Center in Elizabeth, and recently launched a mobile mammography unit with University Hospital.

- So let me ask you something.

In terms of breast cancer awareness, how much better are we doing, Sarah, when it comes to early detection?

- Well, I believe that early detection is saving lives.

A lot of women are now dealing with breast cancer at a much younger age, but I think it's because there are more advanced technology and screenings, and women are taking it very seriously, scheduling their mammograms, and know the earlier they find breast cancer, the better chances they have of survival.

- Women of color.

Are they disproportionately impacted, affected, suffering because of dealing with breast cancer, so we can get into the whole question of social determinants of health, but African American and Latino women affected differently by breast cancer?

- I think we're finding that yes they are.

They're coming to the hospital in a much later stage of breast cancer, more likely stage four, and they're at a higher risk because for many reasons, whether they're underinsured, uninsured, they're in underserved communities, or they're just not likely to schedule their mammogram because it's hard to make time, it's hard to find transportation, childcare, to get time off of work to really take care of themselves, and they're taking care of other people all the time, so there are many barriers that they face that they are not seeing the success rates from early detection in coming to the hospitals, and they're being diagnosed at stage four instead of stage zero or one.

- And the difference is huge between, again, every case is different, every woman is different, but being diagnosed in stage one or two versus four, all the difference in the world?

- I believe so.

I mean, I would consult your doctor about your treatment options.

- So Dr. Blackwood's gonna be on, I'm sorry, Dr. Blackwood's on, and Jacqui Tricarico is doing that interview, so she'll put-- It's actually unfair to ask of you.

She'll put it in perspective clinically, but anecdotally, it matters when you are diagnosed.

- It does matter, and early detection saves lives, so the sooner you find breast cancer and it happens to be at a younger age or an earlier stage, your prognosis is much better.

The treatments are effective.

- Yeah, let's talk about treatments.

So much of what we've been talking about, we talk to so many healthcare professionals, and technology has had a huge impact on the world of healthcare and medicine.

The technology connected to mammograms, connected to diagnosis and treatment of breast cancer.

What do we know about that, Sarah?

- Well, we do know that the standard of care now is 3D mammography, and now women are being educated more about whether they have dense breasts, and that makes a difference because that usually means an MRI or ultrasound follow-up, and we are excited to announce that we just gave a grant to Overlook Foundation for Overlook Hospital for a technology that is doing dye contrast, and while you're getting the 3D mammo instead of having an MRI, some women can't have an MRI for certain reasons, and it's also cost effective to have a dye contrast MRI while you're having a 3D mammography, and that's gonna help save lives, and that's kind of the future of medicine where it's going now is they're finding new ways to detect the breast cancer earlier and this is gonna be one of them.

- So the Foundation is not a medical organization, meaning it's not a hospital, it's not a clinic, but you provide grants to what kind of organizations do and what kind of work around breast cancer?

- That's a great question.

So we have different vehicles.

So we have raised money to launch a mobile mammography unit with University Hospital, which is really exciting.

- In Newark.

I wanna be clear University Hospital in Newark.

Go ahead, please.

- Right, it's traveling around Essex County, mostly Newark, the Greater Newark area, and parts of Union County, where it's serving underserved communities coming into those locations to help them get their mammographies, 3D mammography, right on the mammo unit, and they also have cervical examinations to detect cervical cancer, bilingual coordinators and follow-up care, and we open centers like that in the one at Trinitas, and then we have our Community Grants Program that helps many organizations like Sister-to-Sister or Crossroads for Hope, or the Connections and Pathways Program, and those help families with support and much-needed nutrition, food insecurities, and all of those things helping the whole family in that type of situation.

- So how did you get into this work?

- I've always worked in nonprofits in my whole career and really enjoyed working in women's health, and I started working at the Connie Dwyer Breast Cancer Foundation about five years ago, and I've loved every minute of it.

- It's a nonprofit, but the money matters, so if someone went on the website right now, not only could they find out about programs and initiatives and where grants go, we're not gonna turn this into a fundraiser, but if people wanted to be supportive, they could.

- They could.

They could go to our website, it's www.CDBCF.org, and you can learn all about our programs and our initiatives.

The most important thing we're trying to do is ensure that every woman in New Jersey has the access to breast screenings, treatment, follow-up care, and support.

- Sarah, this may be a question that's not really relevant in this time that we're living in, but not too long ago there were a fair number of anecdotal stories where women, and listen, this is true for men as well, there are certain tests that we avoid.

There was, "My doctor called and said, "you know, it's been a while since you had the PSA "and you gotta get--" Translation, I'm like, "Well, I don't want to go."

To what extent does that, I don't know if I call it reluctance, resistance, I don't know what I call it, avoidance, is that still there in a significant way, Sarah?

or are the vast majority of women saying, "No, it's not that I don't want to know or know, "but if I do have an issue, "the earlier it is detected, "the better chance I have of surviving "and living a quality life?"

Loaded question, I know.

Talk to us about that.

- I think it's a great question.

I think what you're doing here today, too, is helping spread that awareness because every October is Breast Cancer Awareness Month, and this message just gets out there over and over and over again to hope that women really take the time to stop, call their doctor, make their appointment for their mammography, it's annually starting at 40, it's important that you go every year so you can see the changes in your breast.

- Every year, every year.

- Every year.

- After 40.

- After 40 to get your mammography.

For some saying I'm waiting five years, bad idea.

- Bad idea 'cause things can change.

But you can also do self-examinations at home.

I mean, starting in your twenties, getting familiar with things, getting familiar with the signs, your own breasts, what they look like, what it should be like, what it should feel like.

If there's a lump or any other changes is really important.

That's when you should call your doctor.

- How about family members, support for family members of women dealing with breast cancer?

Talk about that.

- I glad you brought that up.

That's a great point.

I think it's really important to know your risk and to calculate your risk, and you can sit with your gynecologist or your doctor and really talk about your risk, your family history, whether your mother has it, maternal, paternal mother, grandmother, aunt, sister, and to know what the guidelines may change for you.

Your frequency of getting a mammogram may change, the age may change, so you really need to consult your doctor and talk about your risk.

- And along those lines, family history matters but may not be determinative, that's not the right word.

It may not determine whether you have breast cancer or not.

It matters but there are other factors, correct?

- Yeah, I think that is correct.

I think there are tests you can take like the BRCA test that some women may choose to take depending on if they've calculated that risk with their physician, so I think it's important to know all those tools are out there and that you have really done your homework and you've advocated for yourself to know like what your personal risk is and to make sure that you stay on top of your mammograms.

- Sarah Roberts.

And we are honored by you and the work that the Foundation is doing to join us, Jacqui Tricarico, myself, and our entire team, in this breast cancer awareness special.

Sarah Roberts is executive director of the Connie Dwyer-- Check out Connie Dwyer, a really important person.

Connie Dwyer Breast Cancer Foundation.

Sarah, thank you so much.

Keep up the important work.

- Thank you so much for having me.

I really appreciate it.

- You got it.

Stay with us, we'll be right back.

- [Narrator] To watch more One on One with Steve Adubato find us online and follow us on Social media.

- 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.

Funding has been provided by Valley Bank.

Robert Wood Johnson Foundation.

The New Jersey Education Association.

EJI, Excellence in Medicine Awards.

Horizon Blue Cross Blue Shield of New Jersey.

New Jersey Sharing Network.

The Healthcare Foundation of New Jersey.

Community FoodBank of New Jersey.

And by The Fidelco Group.

Promotional support provided by NJ.Com.

And by BestofNJ.com.

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