Opinion: The Couric Effect May Be Just What the Breast Cancer Community Needs

Debi Fischer, MSW, BSN, BA, LCSW, RN

In the middle of Breast Cancer Awareness month, First Lady Jill Biden visited Miami, Florida, where I am based, to spotlight President Biden’s Cancer Moonshot initiative, which is designed to combat and end cancer. Biden and US Senator Debbie Wasserman Schulz, who is a breast cancer survivor, visited Sylvester Comprehensive Cancer Center for an event to spotlight the Moonshot initiative, Breast Cancer Awareness Month, and National Mammography week.¹

This month has been a revelation in terms of breast cancer awareness. Katie Couric, noted broadcast journalist, has once again shone the spotlight on a potentially lethal cancer. The University of Michigan coined the term “the Couric Effect” in the year 2000 when she advocated for colonoscopy screening after her husband from colon cancer in his 40s.² There was a national jump in colonoscopy screening rates that year by approximately 20%. The same phenomena may be in the process of happening again.

Couric was in the middle of filming her 3D mammogram and ultrasound when her physician spotted a suspicious area. The camera was turned off. Katie found out that she needed a biopsy and then was given the diagnosis of stage IA HER2-negative breast cancer. She had a lumpectomy and 15 radiation therapy treatments this past summer. She received her diagnosis on June 21; on July 14 she had surgery, and on September 7, she began her first of 15 sessions of radiotion. Couric has shared that for the next 5 years she will be taking an oral aromataste inhibitor in order to decrease her estrogen level.²

In addition to sharing various detrails about her diagnosis and treatment plan, Couric has also shared that she has dense breasts and that her diagnosis required a breast ultrasound. On TV, she has stressed the importance of this 2-step process. During an appearance at the TODAY show where she was a co-anchor for many years, Couric noted that only 70% of women who meet criteria for breast cancer screening complete this important step. The COVID-19 pandemic had an impact on women going for screening as well. Couric herself did not go for these annual tests since December 2020. In her personal blog, she wrote that the pandemic may have skewed her sense of time.²

In addition to advocating for annual mammograms, Couric is educating the public about dense breasts and the importance of ultrasounds. Approximately 40% to 50% of women between the ages of 40 years to 74 years have dense breasts.³ Couric, at 65, also falls into this category.4 Patients with dense breasts may be at increased risk of developing breast cancer and it is recommended that they get routine mammaorgrams similar to other individuals. However, women with dense breasts may also benefit or a 3D mmammogram, or an ultrasound, as these screening devices may be able to better detect tumors in this population. There is also a new modality called SoftVue, which is a new form of ultrasound. It has received FDA approval and, when coupled with mammography, increases detection accuracy by approximately 20%.

Currently, 38 states, including Florida, New York, California, and New Jersey, as well as the District of Columbia have a requirement for “some level of breast density notification after a mammogram.”⁵ A federal national standard for reporting dense breast findings to women does not exist at the present time. Since 2019, there have been efforts for legislation on a federal level. In addition, the FDA has been trying to push for a standard covering reporting these findings.

I personally believe that there is a benefit to additional screenings for this patient population. I hope standard guidelines emerge in the coming years, and I believe that Katie Couric’s advocacy may be the incentive needed to get us there.

References

1. Last call for 10.11.22-A prime-time read of what's going down in Florida politics. Florida Politics. October 11, 2022.October 14, 2022. https://bit.ly/3EQ0AeS
2. Berman M. Katie Couric's Breast Cancer. MEDPAGE today. October 6, 2022. Accessed October 12, 2022. https://bit.ly/3EUKdxz
3. Weisholtz, D. TODAY. Exclusive; Katie Couric on telling daughters she has breast cancer: 'Hard to deliver that news'. October 3, 2022. Accessed October 12, 2022. https://on.today.com/3MOpyx1
4. Uda, R. Do you have dense breasts? Here's how to find out-and what to know about the cancer risks. Katie Couric Media. October 14, 2022. October 11, 2022. https://bit.ly/3So4ezS
5. State legislation map. Dense Breast Info. Accessed October 13, 2022. https://bit.ly/3Daxy8j