Dear Dr. Nancy Snyderman:

August 28, 2012

I was very disappointed with your story last night on NBC News about an obesity study and breast cancer recurrence. (

Most people do not understand risk factors and I would have expected you, as a journalist and doctor, to put it into context. The American Cancer Society says: “Risk factors don’t tell us everything. Having a risk factor, or even several, does not mean that you will get the disease. Most women who have one or more breast cancer risk factors never develop the disease, while many women with breast cancer have no apparent risk factors (other than being a woman and growing older). Even when a woman with risk factors develops breast cancer, it is hard to know just how much these factors might have contributed.”

So this study showed a 25% increase in risk of recurrence if you are obese. That means in laymen terms, that if the recurrence rate is 30%, then obesity will increase your rate to 37.5% (which is a 25% increase in the rate)  So instead of 3 chances in 10 of having a recurrence, an obese woman has 3.7 chances in 10. How many times now will we hear people say–she was fat, so that’s why the cancer recurred—or much more often: she wasn’t fat, so why?

Too much emphasis and story time is spent on risk factors. Most people would be surprised to know that only 15% of those with breast cancer have a family history and less than 10% have the BRCA mutations. Isn’t the real story to be reported this: The vast majority of early stage breast cancer cases and later metastatic recurrences, (which are deadly), happen without researchers knowing why?

We in the metastatic breast cancer community are bracing for October which is a grueling experience for us, with the media concentrating on prevention and early detection, placing the burden on patients to prevent their disease, and, once they get it, to be happy, proud, fighting ‘survivors.’ How about an honest story of those of us living with metastatic breast cancer who had their mammograms, ate well, exercised and had positive thoughts and still got metastatic disease?  Or an honest story about research (or lack thereof) into metastasis, (cancer spreading or metastasizing to vital organs), which is the cause of breast cancer deaths.

We’d be happy to talk to you if you’re interested.


Ginny Knackmuhs
Metastatic Breast Cancer Network (MBCN)