Lisa Fortier Reveals Breast Cancer Diagnosis

Yesterday, Lisa Fortier announced on twitter that she was diagnosed with breast cancer earlier this year.

This post indicates that Coach was diagnosed February 6th and at that time was “Stage 2 or 3 breast cancer that’s spread to [the] lymph nodes”. This news would have been delivered to Lisa and her family only four days before the Zags’ breast cancer awareness game against Loyola Marymount.

I work in medicine as a family medicine physician. It’s one of the reasons why I write under a pseudonym rather than use my real name because I don’t want people questioning my medical advice after reading my basketball takes. As part of my position, cancer is an ubiquitous part of my job with regards to discussing recommended screenings, evaluating conditions suspicious for cancer, explaining what a diagnosis means, and assisting with a person’s care, both emotionally and physically, during and after treatment. Additionally, I have multiple family members actively with or with a history cancer including my father, mother, grandmother, and more.

And yet, with all of that experience, I still can’t help but feel intense emotions when I learn of new cancer diagnoses for reasons that I could write a thesis on, as I’m sure you could too. In this situation, I’m struck by how Lisa had to take this life-changing information in, learn about her treatment plan, which likely involved a lot of alien-like words that can be very disorienting, and stay centered enough to throw her full weight into the Team.

That takes a level of personal discipline and strength that is unimaginable to most of us, but also one that can be incredibly isolating. While it’s not clear when Lisa updated members of this past year’s Zags players and coaches, I’d imagine this occurred after the season and, if that’s the case, I hate thinking about how alone she might have felt having to keep such information away from others. While it’s possible none of the above is how it played out, I want to highlight how important those of us around patients with cancer can be with regards to their treatment as studies have shown that “social support has an impact on physical health, well-being and adjustment to cancer of cancer patients”. Heck, even in my role, I see this as an important aspect of care for any number of conditions like diabetes, heart failure, and so many others.

As such, I’m so glad that Lisa has shared this information to us in the public. While the likelihood that any one of us will have some life-changing benefit to her will be low, as a collective, we can share our support directly to Lisa in so many ways. Maybe that’s sharing uplifting messages, honoring her at games, or even utilizing this news to spur our interest in our individual health, our families’ health, and our communities’ health.

One way that I want to do my part is to share information about breast cancer and recommendations for breast, and other types, cancer screening. So if you’re wanting a basketball article, you’re SOL because you’re getting a medicine article, something I actually writing about so any feedback about how I’ve delivered the information would be super awesome to hear.

At current time, the United States Preventative Services Task Force recommends screening for 4 cancers in the general public, breast, cervical, prostate, and colorectal, and 1 for those with a history of smoking, lung cancer.

The USPSTF was created in 1984 and describes themselves as “an independent, volunteer panel of 16 national experts in prevention and evidence-based medicine”. They are transparent in their methods relating to their recommendations and will modify their recommendations based on newer evidence and generally align with the guidance provided by specialty organizations with some exceptions. I’m highlighting the USPSTF because it’s a great starting point for all sorts of health screenings before one might jump to a specific organizations recommendations, which are sometimes behind paywalls (boo!).

Cancer screening means that medical professionals will order a test in patient’s without symptoms. For example, in someone without a family history of colon cancer, organizations like the USPSTF would recommend screening to start at 45 years old, but if you were experiencing rectal bleeding, it may be deemed necessary to do something like a colonoscopy to explore why that symptom is occurring prior to that age.

The USPSTF recommends breast cancer screening in individuals assigned female at birth (AFAB) starting at 40 years old and ending at 74 years old via mammography. This falls in-line with the recommendation from American College of Obstetrics and Gynecology (ACOG). With regards to self-breast examinations, ACOG states “… self-examination is not recommended in average-risk women because there is a risk of harm from false-positive test results and a lack of evidence of benefit.”

Additionally, the USPSTF recommends that those AFAB with (1) a personal or family history of breast, ovarian, tubal, or peritoneal cancer or (2) who have an ancestry associated with BRCA-1/2 gene mutations with an appropriate brief familial risk assessment tool. If such screening yields a positive result, the patient should speak with a genetic counselor. It should be noted that, per ACOG, “although most cases of breast cancer and ovarian cancer in the United States occur sporadically, pathogenic BRCA1 and BRCA2 mutations are present in 5–15% of cases of these types of cancer.” There are other types of genetic cancer syndromes that are associated with a higher risk for breast cancer so be sure to talk with your family about members’ medical history and share this with your medical provider who should be able to estimate your risk and provide a management plan.

With regards to breast cancer, after seeing the lowest observed rate of 122-124 new cases per 100K women per year (NIH’s language) from 2003 to 2006 on record, we have unfortunately seen a steady uptick in the rate of new breast cancer diagnoses ever since. The most recent observed data available, which is from 2021, revealed 137 new cases per 100K woman and it’s estimated that in 2024, we will see about 310,000 new cases, which represents 15.5% of all new cancer diagnoses and is the leading new cancer diagnosis among women being almost double to that of lung/bronchus cancer.

Thankfully during this time period, we have seen a drop in mortality with the death rate reported as 31.6 per 100K women in 1992 compared to 19.1 per 100K women in 2021. The current estimates for the 5-year survival rate of breast cancer from 2014-2020 data currently sits at 91.2%. When breaking down this survival rate based on cancer stage at the time of initial diagnosis, localized breast cancer carries a 99.6% survival rate whereas regional, which is what i believe Lisa’s cancer would be staged at given her one comment in this area, slots in at 86.7%, while those staged as distant carry a 31.6% 5-year survival rate.

As you can see, getting screened early and regular helps immensely with a person’s outcome relating to breast cancer so I can’t stress enough: TALK WITH YOUR MEDICAL TEAM ABOUT CANCER SCREENING!

While I’ve spent the majority of this article on breast cancer, I don’t want to forget the other types of cancers that we screen for so I will list those below. Please recognize that I am not providing personalized medical advice, but rather sharing open-access medical recommendations to this audience and the information below may not apply very well to you based on personal, familial, and other factors.

• Cervical Cancer Screening: A-grade – person’s AFAB 21-65 years old
• Prostate Cancer Screening: C-grade – person’s AMAB 55-69 years old (note that this recommendation is currently in the midst of a update so this may change and this current recommendation varies notably to the American Urology Associate’s recommendation)
• Lung Cancer Screening: B-grade – adults 50-80 years who have a 20 pack-year smoking history (ie. 1 pack per day for 20 years) and currently smoke or have quit in the past 15 years
• Colorectal Cancer Screening: B-grade – 45-49 years old AND A-grade – 50-75 years old.

That’s all I’ve got. Thanks for coming to my TED article.