MCC’s Breast Cancer Summit at Walter Reed focuses on risks, prevention, care

By Bernard S. Little Walter Reed National Military Medical Center Hospital Communications

Focused on topics that included risks, prevention, screening, genetics, imaging, and disease management, the John P. Murtha Cancer Center (MCC) hosted Breast Cancer Summit 2026 on Oct. 21 at Walter Reed National Military Medical Center (WRNMMC).

The Department of War’s (DOW) sole designated Cancer Center of Excellence, the MCC annually hosts the breast cancer summit every October. The event brings together military and civilian oncologists, surgeons, researchers, survivors and others to discuss clinical developments, patient support and breakthroughs in breast cancer research and care.

According to MCC doctors, researchers and other Military Health System (MHS) providers, research, breast cancer is the most common cancer in active-duty service (ADS) women. They added that it may have a significant effect on troop readiness with lengthy absence during treatment and the possibility of an inability to return to duty after the treatment.

The MCC research program falls under the Uniformed Services University of the Health Sciences (USU), and retired U.S. Army Col. (Dr.) Craig D. Shriver serves as director of the MCC and MCCRP. He coauthored the study Cancer Previvors in an Active Duty Service Women Population: An Opportunity for Prevention and Increased Force Readiness. It concluded that “The identification of previvors and concomitant use of risk-reducing strategies may improve the health of ADS population and optimize readiness of the U.S. military by decreasing future cancer burden.”

“Breast cancer affects our active duty ranks slightly higher than other [populations],” stated U.S. Navy Capt. (Dr.) Lanny Littlejohn, WRNMMC director. He said that while the average median age for diagnosis in the general population is around 62, it’s typically younger for military members. This may be due to a combination of occupational, environmental, lifestyle and demographic factors. In addition to that, the MHS and Department of Veterans Affairs (VA) more structured healthcare systems and regular medical evaluations for its members can also lead to earlier detection of tumors in younger women.

Littlejohn said that 66% of breast cancer diagnoses come at the localized stage. That’s when the disease is confined entirely within the breast tissue and has not spread to nearby lymph nodes or distant parts of the body. “This is when treatment tends to work better,” he added. “This is why regular screening is important to ensure the best outcome for our members.”

“Survivorship is most important if we can diagnose breast cancer early in its most treatable stages,” agreed U.S. Navy Cmdr. (Dr.) Jenny Held, director of the MCC’s Breast Care and Research Center at Walter Reed. “To do that we need a better understanding of how we screen for it, who to screen, how to identify who is high-risk, and then what we do with that information.”

Risk Factors

Dr. Celia Byrne, from USU’s Preventive Medicine and Biostatistics Department, discussed breast cancer risk factor and prevention. “Breast cancer rates for all racial groups now increase with age until the 70s and then decrease.” Black women have the highest rates for women less than 40, and White women the highest rates from ages 65 to 84. Hispanic women have the lowest rates for ages 30 to 50, and Asian American and Pacific Islander women the lowest 60 plus.”

In addition to age, Byrne discussed several other contributing risk factors including genetics (inherited gene mutations), family history (having a first-degree relative (mother, sister or daughter) with breast or ovarian cancer, personal medical history, reproductive timeline (menstruation before 12 or going through menopause after 55), dense breast tissue and chest radiation.

Lifestyle risk factors for breast cancer include alcohol consumption, body weight, physical inactivity, hormone replacement therapy, reproductive choices (having first full-term pregnancy after 30, never having a full-term pregnancy, or not breastfeeding), and smoking, Byrne explained.

She recommended several lifestyle changes to help decrease breast cancer risk. These include maintaining a healthy weight, regular exercise, limiting or avoiding alcohol, not smoking, eating a balanced diet and breastfeeding, along with screening for breast cancer are prevention measures.

Management

Dr. David Weintritt, a breast surgeon, and Kristin Lupton, a physician assistant, both with Virginia Cancer Specialists, discussed management of high-risk patients. They explained that this involves a personalized, multi-layered approach centering on lifetime risk assessment, enhanced surveillance, risk-reducing medications and surgery, and lifestyle modifications.

Lupton added that the goals in care should also include relieving anxiety with a plan, empowering the patient by encouraging their active participation in treatment choices and open communication, and reinforcing their healthy habits that they may already be doing.

Cancer Screening

One in eight women, or roughly 13% of women in the United States will develop invasive breast cancer at some point during their lifetime, said Dr. Erin Crane, breast radiologist at MedStar Georgetown University Hospital. She discussed breast imaging in average and high-risk patients.

“Screening finds cancers earlier,” said Crane, who compared patient-detected cancer to screen-detected cancer. She listed the primary differences between patient-detected discovery of breast cancer and screen-detected discovery.

With patient-detected discovery, a lump or other symptoms have already developed. With screen-detected discovery, there are generally no symptoms, tumors are smaller and the cancer is at an earlier and better treatable stage, Crane shared.

She also explained that with patient-detected discovery, the cancer has a more likelihood of having spread and node-positive, whereas screen-detected discovery is more often node-negative.

With patient-detected discovery there is also a greater chance for a mastectomy and axillary surgery, said Crane. With screen-detected discovery, the chances for breast conservation are greater.

Patient-detected discovery generally comes with more chemotherapy and at a higher cost than screen-detected discovery, Crane added.

The MCC certified genetic counselor, J. Fitzpatrick Doyle, explained that the primary purpose of genetics testing for breast cancer is to identify inherited or germline gene mutations to assess disease risk and guide medical decisions for prevention and treatment. He recommended people who should see cancer genetics include those diagnosed at a young age, such as 50 and younger; with rare tumors like triple-negative breast cancer; male breast cancer patients at any age; with multiple or recurrent cancers; with a family history of breast cancer; with ancestry in high-risk populations, particularly if you are Ashkenazi Jewish descent, which carries a high risk for mutations; and tested before 2013.

Dense Breast Tissue

U.S. Army Col. (Dr.) Danielle Holt, an associate professor of surgery at USU, also discussed screening for women with dense breasts.

“Women who present for routine breast cancer screening trust that recommended imaging will detect cancers at an early, treatable stage. Nearly half of screening-eligible women have dense breast tissue, a biologic characteristic that increases breast cancer risk and reduces the sensitivity of mammography because dense tissue and cancers appear similarly radiopaque. Current guidance no longer recommends patient-performed breast self-examinations; instead, encouraging breast awareness with prompt evaluation of new changes [is the recommendation],” states Holt in her article titled Breast Density Masking and the Need for Precision Screening published in March’s Journal of the American Medical Association.

Holt’s editorial calls attention to challenges in breast cancer screening that may disproportionately affect active duty women and have implications for military readiness. She also highlights the limitations of current screening coverage policies and urges insurers to expand access to supplemental imaging when physicians recommend it Since dense breast tissue makes it difficult to capture tumors on mammograms, it can result in detecting cancers at a later stage in these patients, potentially affecting their treatment outcomes and readiness.

Holt spoke from personal experience about the need for improved screening. “My cancer was missed on my screening mammogram because of dense breast tissue. I found a breast lump. Younger women are more frequently being diagnosed with breast cancer. This is an even more pressing issue for women in the military with breast cancer being the #1 cancer in servicewomen with higher rates in younger women,” she shared in an Instagram post during her treatment.

Holt added that this is why supplemental imaging like an MRI is a critical next step for detection, especially for those at higher risk. “With new federal rules requiring mammogram reports to disclose breast density, you have the information you need to self-advocate.

“If your report says you have dense breasts, don't stop at the mammogram. Talk to your doctor to see if supplemental screening is right for you,” Holt urged.

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