JoAnn Pushkin, in her home in the Town of Huntington on Wednesday,...

JoAnn Pushkin, in her home in the Town of Huntington on Wednesday, has successfully advocated for policy changes at the state and federal level. Credit: Newsday / Steve Pfost

Breast cancer survivor JoAnn Pushkin doesn’t back down from a challenge, no matter how daunting it may seem.

The Long Island resident, who battled two rounds of cancer, has successfully taken on both the New York State Legislature and the federal government in order to make sure women are better informed about their breast health.

After years of advocacy alongside doctors and medical experts, Pushkin celebrated a victory this month when the U.S. Food and Drug Administration updated its mammography regulations, requiring facilities to notify patients about the density of their breasts.

She said this change could help women all over the United States get additional breast cancer screenings that will help detect tumors not picked up by mammograms. It’s the information Pushkin wishes she knew before she was first diagnosed with breast cancer in 2005.

“Breast density is important for women to understand, because it's a double whammy,” said Pushkin, 63, who lives in the Town of Huntington. “It increases the risk of developing breast cancer, and it increases the risk that a cancer will be missed. And that's because dense tissue shows up white on a mammogram, but so does breast cancer. So a breast cancer, nestled in dense tissue, is like trying to find a snowball in a blizzard.”

Former State Sen. John Flanagan, who worked with Pushkin on getting a similar notification policy through the State Legislature as a law more than 10 years ago, praised her “perseverance” and “moxie.”

“This is the proverbial moving of the mountains,” Flanagan said of Pushkin’s successful fight to get the FDA mammogram guidelines updated. “She is saving lives.”

Dr. Wendie Berg, a professor of radiology at the University of Pittsburgh School of Medicine, said the implementation of the FDA rule will standardize the language used to inform women in all 50 states.

“Until now, there was a patchwork of differing laws in 38 states plus Washington, D.C., some of which did not even tell a woman if her own breasts were dense or not,” Berg told Newsday in an email.

Pushkin said she was always diligent when it came to her health. She ate well, exercised, was aware of her family’s medical history and got a yearly mammogram.

When she felt a lump in her breast in December 2005, she contacted her doctor, who sent her for a diagnostic mammogram and an ultrasound. While the mammogram yielded nothing unusual, the ultrasound confirmed there was indeed a mass in her right breast. A technician also explained her dense breasts made it tougher to see the tumor on a mammogram.

“I couldn’t even speak,” Pushkin remembered. “I found out I have breast cancer. I find out it was missed because of dense breasts and I find out I have dense breasts all within like 20 minutes of each other.”

What followed was a series of surgeries and therapies, including radiation and chemotherapy, which could have been minimized or maybe even avoided if her cancer had been detected earlier. As she recovered, Pushkin focused on sharing the information she had learned about the risk factors associated with dense breasts. She was undaunted, even after the cancer returned in 2011 and she underwent more treatments.

She reached out to Flanagan and Assemb. Ellen Jaffee (D-Suffern) to draft a bill that would let women’s mammogram reports include the information about dense breasts and suggest they speak with their doctors about further screening.

Pushkin said that between 2011 and 2012, she called, wrote to or visited each of the 130-plus members of the State Legislature to support the bill. 

Despite opposition from some medical groups and insurance companies, the law passed unanimously in 2012 and went into effect in early 2013.

Pushkin realized similar efforts were needed at the federal level, so she reached out to members of Congress and the FDA.

At the same time, she worked with experts, including Berg, to create an educational website, densebreast-info.org.

“My aunt died of breast cancer. My mother’s breast cancer had spread to lymph nodes by the time it was found due to symptoms, and she required chemotherapy,” Berg said. “Because I knew enough to seek a screening MRI, my own breast cancer was found early, when it was easily treated. All women should have the chance to find it early if they have breast cancer.”

Dr. Michelle Price, medical director at the Fortunato Breast Health Center at Mather Hospital in Port Jefferson and a radiologist specializing in breast imaging, said her facility recommends that women with dense breasts receive an ultrasound exam in addition to their mammogram.

There is no nationally approved approach, even though the addition of breast ultrasound to annual mammography has been shown to increase detection of small, early, treatable breast cancers, she said.

“[Pushkin] has been such an unbelievable advocate for women,” Price said. “I’m so proud of what she has been able to accomplish … this is really so empowering for women.”

Pushkin said her next goal is a federal law that would require health insurance plans to cover screening and diagnostic breast imaging with no out-of-pocket costs for women with dense breasts or at higher risk of breast cancer.

“None of what I am doing will prevent these women from getting breast cancer,” Pushkin said. “But what this does is move the needle back on when we're going to find it because cancer found early has a much greater survival rate.”

Breast cancer survivor JoAnn Pushkin doesn’t back down from a challenge, no matter how daunting it may seem.

The Long Island resident, who battled two rounds of cancer, has successfully taken on both the New York State Legislature and the federal government in order to make sure women are better informed about their breast health.

After years of advocacy alongside doctors and medical experts, Pushkin celebrated a victory this month when the U.S. Food and Drug Administration updated its mammography regulations, requiring facilities to notify patients about the density of their breasts.

She said this change could help women all over the United States get additional breast cancer screenings that will help detect tumors not picked up by mammograms. It’s the information Pushkin wishes she knew before she was first diagnosed with breast cancer in 2005.

WHAT TO KNOW

  • JoAnn Pushkin, a breast cancer survivor from Long Island, has successfully lobbied for regulations at the state and federal level that inform women if they have dense breasts and recommend they speak with their doctors about next steps.

  • Breast cancer is more difficult to find on mammograms if a woman has dense breasts. For these women, additional screenings with an MRI or an ultrasound may detect cancers not visible on a mammogram.

  • Additional screening has been shown to increase detection of small, early, treatable breast cancers.

“Breast density is important for women to understand, because it's a double whammy,” said Pushkin, 63, who lives in the Town of Huntington. “It increases the risk of developing breast cancer, and it increases the risk that a cancer will be missed. And that's because dense tissue shows up white on a mammogram, but so does breast cancer. So a breast cancer, nestled in dense tissue, is like trying to find a snowball in a blizzard.”

Former State Sen. John Flanagan, who worked with Pushkin on getting a similar notification policy through the State Legislature as a law more than 10 years ago, praised her “perseverance” and “moxie.”

“This is the proverbial moving of the mountains,” Flanagan said of Pushkin’s successful fight to get the FDA mammogram guidelines updated. “She is saving lives.”

Dr. Wendie Berg, a professor of radiology at the University of Pittsburgh School of Medicine, said the implementation of the FDA rule will standardize the language used to inform women in all 50 states.

“Until now, there was a patchwork of differing laws in 38 states plus Washington, D.C., some of which did not even tell a woman if her own breasts were dense or not,” Berg told Newsday in an email.

'I couldn’t even speak'

Pushkin said she was always diligent when it came to her health. She ate well, exercised, was aware of her family’s medical history and got a yearly mammogram.

When she felt a lump in her breast in December 2005, she contacted her doctor, who sent her for a diagnostic mammogram and an ultrasound. While the mammogram yielded nothing unusual, the ultrasound confirmed there was indeed a mass in her right breast. A technician also explained her dense breasts made it tougher to see the tumor on a mammogram.

“I couldn’t even speak,” Pushkin remembered. “I found out I have breast cancer. I find out it was missed because of dense breasts and I find out I have dense breasts all within like 20 minutes of each other.”

What followed was a series of surgeries and therapies, including radiation and chemotherapy, which could have been minimized or maybe even avoided if her cancer had been detected earlier. As she recovered, Pushkin focused on sharing the information she had learned about the risk factors associated with dense breasts. She was undaunted, even after the cancer returned in 2011 and she underwent more treatments.

She reached out to Flanagan and Assemb. Ellen Jaffee (D-Suffern) to draft a bill that would let women’s mammogram reports include the information about dense breasts and suggest they speak with their doctors about further screening.

Pushkin said that between 2011 and 2012, she called, wrote to or visited each of the 130-plus members of the State Legislature to support the bill. 

Despite opposition from some medical groups and insurance companies, the law passed unanimously in 2012 and went into effect in early 2013.

Health insurance coverage next

Pushkin realized similar efforts were needed at the federal level, so she reached out to members of Congress and the FDA.

At the same time, she worked with experts, including Berg, to create an educational website, densebreast-info.org.

“My aunt died of breast cancer. My mother’s breast cancer had spread to lymph nodes by the time it was found due to symptoms, and she required chemotherapy,” Berg said. “Because I knew enough to seek a screening MRI, my own breast cancer was found early, when it was easily treated. All women should have the chance to find it early if they have breast cancer.”

Dr. Michelle Price, medical director at the Fortunato Breast Health Center at Mather Hospital in Port Jefferson and a radiologist specializing in breast imaging, said her facility recommends that women with dense breasts receive an ultrasound exam in addition to their mammogram.

There is no nationally approved approach, even though the addition of breast ultrasound to annual mammography has been shown to increase detection of small, early, treatable breast cancers, she said.

“[Pushkin] has been such an unbelievable advocate for women,” Price said. “I’m so proud of what she has been able to accomplish … this is really so empowering for women.”

Pushkin said her next goal is a federal law that would require health insurance plans to cover screening and diagnostic breast imaging with no out-of-pocket costs for women with dense breasts or at higher risk of breast cancer.

“None of what I am doing will prevent these women from getting breast cancer,” Pushkin said. “But what this does is move the needle back on when we're going to find it because cancer found early has a much greater survival rate.”

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