Jill Martin and Chris Evert’s Surgeon Shares Her ‘Breast Advice' About Cancer (Exclusive)

Dr. Elisa Port draws on patient stories like Martin's and Evert's and 25 years of experience for a new book on breast care

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Key Takeaways

• Breast surgeon Dr. Elisa Port has treated celebrities like Jill Martin, Chris Evert and Hannah Storm
• She shares insights from her patients, and her 25 years as a surgeon, in her new book The Breast Advice
• Port emphasizes early detection, self-advocacy, and optimism as breast cancer survival rates exceed 90% with advances in treatment

Celebs like Today show's Jill Martin, tennis star Chris Evert and sportscaster Hannah Storm have turned to her for care and advice, but breast surgeon Dr. Elisa Port says she's learned a lot from all of her patients, high-profile or otherwise.

Now Port, who is chief of breast surgery at the Mount Sinai Health System, is sharing their wisdom — and her own 25 years of experience — in a new book, The Breast Advice: All You Need to Know About Breast Health, Screening and Treatment.

Just over a decade ago, Port, who performed Martin's double mastectomy after the Today show contributor learned she had stage 2 breast cancer, wrote The New Generation Breast Cancer Book to combat information overload and negative messaging online that didn't match the reality of breast cancer treatment.

"The survival rate from breast cancer was getting better and better, and yet women were coming into my office with more doom and gloom than ever before," she says, "Prior to coming to see me, patients were Googling breast cancer, and I understood loud and clear that the Internet, when it came to breast cancer, was full of doom."

When thinking about writing her new book, she says she noticed women were increasingly getting information from other women's cancer experiences, in real life and online. "The experiential part of going through breast cancer is the most invaluable, incredible resource that patients can get from each other, but the problem is that no two cases are exactly the same," she says. "There's a limit to what patients can learn from each other."

In her new book, she says she's taking the best of those real-life lessons (including sections written by Martin, Evert, who underwent a mastectomy after genetic testing showed she carried the BRCA gene, and Storm, who had a lumpectomy after being diagnosed with non-invasive, stage zero breast cancer called ductal carcinoma in situ) and combining them with research and practice expertise for a comprehensive handbook.

"It's called The Breast Advice, but it's not only my advice, it's their advice, too," Port says. "Usually there's medical advice in one silo and experiences from others in another — they need to be combined and married." And, she adds, while half of the book deals with cancer treatment, the first half addresses breast health: "This is the book that every woman, starting at age 25, needs to read now."

Port says that she hopes to spread the message that while more than 320,000 women are still diagnosed with breast cancer annually, and rates are rising for younger women, the overall survival rate is above 90% due to advances in treatment. "In some cases, when you pick it up earlier, stage 0, it's 99%," she says. "So it's extremely treatable and curable. There's lots of room for optimism. Getting a cancer diagnosis is scary. To say it's not is just not humane. It's really scary, but the outlook is amazing."

What should people know about their risks for breast cancer?

"Most women who get breast cancer, with 90% of them, we don't really know what caused it. They had no family history. One of the things that always makes me incredibly sad is when a woman comes into my office with more advanced stage breast cancer. She's 62. She hasn't gotten a mammogram in 10 or 20 years, or ever. She goes, "I don't understand how I got this. I wasn't at risk. I have no family history." It's myth that only those with breast cancer in their family should be aware of the risk, Port says: "If you have breasts, you're at risk."

Incidence rates are rising, especially among women under 50. What do we know about why?

"We don't know the things that cause it in older women, so we certainly don't have an answer yet on why we're seeing an increased risk in younger women. We think maybe it has to do with rising obesity rates in this country, and especially in our young people. Being overweight, or obese, increases your risk of getting breast cancer. Everyone thinks fat stores are just these passive blobs of tissue that hang off your body. They're not—fat stores are very metabolically active. They create a lot of things that they secrete into your bloodstream, things like pro-inflammatory agents, things like hormones. Fat stores are one of the biggest sources, other than the ovaries, of hormone production. In the 12 to 19-year-old age group, somewhere between 10% and 20% of our kids are obese or overweight. Maybe that is related, but we don't have the answers yet."

Is it important for younger women to check their own breasts?

"If you feel something, say something. Younger women in their 20s and early 30s, are not typically being screened, nor do we think they should be. But if you're a young woman and you feel a lump or anything abnormal in your breast, don't let anyone tell you, 'You are too young to get breast cancer.' Advocate for yourself, see a breast specialist, get tested, get imaging, get a mammogram, get an ultrasound, get a biopsy. Do whatever it takes to prove you either do or do not have cancer. Know what's normal for you so that if something changes, you pick it up early and bring it to a doctor's attention. Let's get over this idea of 'Women are histrionic and they'll overreact, and they'll be in their doctor's office every month.' Let's move past that."

Who should be getting genetic testing?

"Genetic testing used to be recommended for an extremely narrow group — if you had a family history of breast cancer at a young age in a young relative, ovarian cancer, if you had a certain kind of cancer called triple-negative breast cancer. Thankfully, over the years, we've expanded the guidelines for testing. And there's a huge misconception that you can't inherit breast cancer or ovarian cancer, from a father's side. Knowledge is power and you should dig deep on your father's side too. Another misconception is that if you test positive, people are going to whisk you off for surgery and pressure you to do extremely extensive, aggressive interventions. That's not true."

What do you tell patients facing breast cancer treatment who are scared?

"There's this conspiratorial idea that 'Doctors just want to slash, burn, and poison you: The surgeons are slashing you. The radiation doctors are burning you. The chemotherapy doctors are poisoning you. That's what they're in it for and that lines their pockets.' Nothing could be further from the truth. A lot of research has been devoted to, 'How can we do less without compromising results?' Surgeons are the biggest advocates for lumpectomy instead of mastectomy, or single mastectomy instead of bilateral mastectomy. Oncologists now have incredible tools to know who does not need chemotherapy. We are giving 30% less chemotherapy than we did 10 years ago. There's no one-size-fits-all approach, but we've gotten better and better at figuring out when we can dial down treatment."

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