At the 54th Commencement of the Icahn School of Medicine at Mount Sinai, held at David Geffen Hall at Lincoln Center on Thursday, May 11, Valentin Fuster, MD, PhD, President of Mount Sinai Heart and Physician-in-Chief of The Mount Sinai Hospital, had the honor of bestowing wisdom upon a new cohort of physicians and researchers.
“I have the awesome responsibility of providing you with wise and inspiring words, but with the comfort that you might not retain them for more than 24 hours,” began Dr. Fuster with a chuckle. But beyond the humor, Dr. Fuster called on graduates and all present in the hall to reflect on the concept of progress, especially in medicine.
What Does It Mean to Progress?
Society has moved through time, but we can’t take progress for granted, said Dr. Fuster.
At present, and sadly not new in the history of humanity, the concept of progress appears to be challenged, he said. One, by an ongoing abandonment of traditional ethical and moral values, and two, by radical groups threatening one of the most basic principles of human dignity, which is the right to live.
New perspectives of progress can only be advanced by youth with innovative training, and the graduating class at Icahn Mount Sinai represents a group key to that goal, Dr. Fuster noted.
Challenges to Progress
Scientific innovations have forged ahead at a rapid pace, and have created gaps—between digital and cognitive creativity, and between treating disease and preventing it.
In the first category, Dr. Fuster spoke of acceptable uses of recent technologies, such as the artificial intelligence tool ChatGPT, for preparing research manuscripts. However, the definition of acceptable uses should be questioned by the younger generation, he said. “Young people—you—are generally those with the highest exposure to digital technologies, and as such you are uniquely equipped for positive decision-making.”
Furthermore, while advanced technologies have become part of daily lives, clinicians need to realize that the digitization of body data can only be useful to the well-being of the patient when integrated thoroughly with a complete clinical and social history and physical examination—a reality that is being diluted in medical educational systems that are mainly focused on digital technology, Dr. Fuster said.
In the latter category, there remains a gap in thinking about where the line between treatment and prevention should lie. Experts have agreed on the importance of prevention, not just treatment, but there remain questions about when medical practitioners should intervene, Dr. Fuster said, exhorting the young graduates to continue contributing toward prevention efforts.
Contributing to Progress
Being an active participant toward progress can be fulfilling, but the journey will be fraught, said Dr. Fuster. There are three principles that can help during dark moments, he noted.
Resilience is key, as the road to personal fulfillment is long and often marked by frustration. Mentorship is next, as people often spend excessive energy pursuing ambitions before they are ready and tutors can help discover talent. The last is to give back to society, as generosity and empathy are always the basis of happiness.
Finally, Dr. Fuster called on the graduates to live in the moment. “In this special and unique day, please stop your clock and celebrate your achievement,” he said. “And turn the clock back to give thanks to all of those who helped you on this journey, in a sense, to make you ready to engage in progress.”
The honor of delivering the Commencement address is reserved for individuals who have made a big impact in the health and sciences field. Dr. Fuster has a long and illustrious career as a physician and researcher, and in recognition of his achievements, he was conferred an honorary Doctor of Science degree at the 54th Commencement. Here’s a look at his storied career over the decades:
1974-1982
Professorships, including in Medicine and Cardiovascular Diseases, and Pediatrics, at Mayo Medical School, Rochester, Minnesota
1982-1991
Arthur M. and Hilda A. Master Professor of Medicine, Mount Sinai School of Medicine
1991-1994
Mallinckrodt Professor of Medicine, Harvard Medical School, Boston
1994
Dean for Academic Affairs, Mount Sinai School of Medicine
1994-1997
Arthur M. and Hilda A. Master Professor of Medicine, Mount Sinai School of Medicine
1997-present
Richard Gorlin, MD/Heart Research Foundation Professor of Cardiology, Mount Sinai School of Medicine/Icahn School of Medicine at Mount Sinai
2002-present
Director, the Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, The Mount Sinai Hospital
2006-2022
Founding Director, Mount Sinai Heart
2007-2009
Scientific Director, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
2009-present
General Director, Centro Nacional de Investigaciones Cardiovasculares, Madrid, Spain
2011-present
Physician-in-Chief, The Mount Sinai Hospital
2023-present
President, Mount Sinai Heart
Through work with Mount Sinai Heart, Dr. Fuster has also led initiatives and programs that have had a global impact.
Hypertension management in rural Kenya: Using a multidisciplinary approach to address the challenge of linking and retaining hypertensive individuals to a hypertension-management program, community health workers use a behavioral communication strategy and smartphone-based tools to reduce blood pressure and manage their health.
Sesame Street education project: In 2006, Dr. Fuster joined as an advisor for Sesame Workshop’s Healthy Habits for Life initiative, launched in 2005 to promote healthy lifestyles and diet among young children. In 2012, he collaborated on Sesame Workshop’s Global Health Initiative, and helped create a mini-series Barrio Sésamo:Monstruos Supersanos, or Super Healthy Monsters, which aired on Spain’s co-production of Sesame Street. Segments have since been incorporated into local versions of Sesame Street in Colombia, Germany, Netherlands, United States, and other countries.
Did you know: Dr. Fuster has a Muppet, named Dr. Valentin Ruster, modeled after him? The Muppet doctor is featured in Super Healthy Monsters, and he teaches fellow Muppets about the heart, and even hosts a game show about balanced diets with Cookie Monster as a contestant.
Polypill initiative: Mount Sinai Heart launched a program to combine aspirin, a statin, and an angiotensin-converting enzyme inhibitor into one pill to prevent heart disease. The program was not only launched in the United States, but made available to developing nations, with accompanying studies to determine whether the polypill is effective in reducing cardiovascular disease and improves adherence and accessibility to health care.
Cardiovascular disease prevention in children worldwide project: Dr. Fuster is pursuing a project that helps children acquire a healthy lifestyle and sustain it long-term through early education and intervention, preventing cardiovascular and other diseases later on in life. This project, presently reaching about 50,000 children worldwide, is rooted in the understanding that given greater brain plasticity in early years of life, what is learned and experienced in those ages will be enduring.
“Tonight, we celebrate Mount Sinai’s ability to provide the highest-quality health care, educate the next generation of great clinicians and researchers, and generate scientific breakthroughs that advance the capabilities of modern medicine,” Dennis S. Charney, MD, said in his opening remarks.
For the first time since the COVID-19 pandemic, the Mount Sinai Health System Crystal Party tent was up and abuzz in Central Park’s Conservatory Garden. Beneath its rainbow big top, nearly 800 physicians, faculty, staff, trustees, supporters, and friends of the Mount Sinai Health System collected to celebrate the past year’s research and health care advances, achieved under extraordinary conditions. The event, held Thursday, May 4, raised $3 million in support of the Health System.
The 38th annual celebration kicked off with remarks from Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean, Icahn School of Medicine at Mount Sinai. “Tonight, we celebrate Mount Sinai’s ability to provide the highest-quality health care, educate the next generation of great clinicians and researchers, and generate scientific breakthroughs that advance the capabilities of modern medicine,” he said.
Dr. Charney made a special effort to highlight some of Mount Sinai’s proudest, current research achievements.
“Our scientists have begun human clinical trials of a diabetes drug they discovered that has the potential to be transformative,” he said. “A drug that can regenerate the pancreatic cells that produce insulin. This could be nothing less than a cure for type 2 diabetes. In recent months, Mount Sinai researchers have also identified an immune cell that helps kill bladder cancer tumors, identified genes strongly linked to autism, and conducted an unprecedented analysis of immune cells in the brain that appear to play a key role in the genetic risk and development of Alzheimer’s disease.”
Turning his attention to the leading patient care enabled by the generosity of Mount Sinai’s donors, Dr. Charney said, “Today, Mount Sinai is serving more patients, with more advanced services than ever before, as we’ve significantly expanded our ambulatory footprint across the five boroughs and Long Island. After performing the world’s first human tracheal transplant, Mount Sinai established the Institute for Airway Sciences to advance new therapies for patients with diseases of the trachea, lung, and sinuses.”
Looking to the future, he shared news of a number of capital improvement projects under consideration, to further enhance patient care.
“The next phase of the expansion and modernization of the Saul Family Emergency Department at The Mount Sinai Hospital will be finished in July. It will include a new acute care zone, an observation unit, and a separate Geriatrics Emergency Department to complement our new Children’s Emergency Department,” he said. “Early next year, we will open new offices at Mount Sinai West for the Bonnie and Tom Strauss Movement Disorders Center and the Nash Family Center for Advanced Circuit Therapeutics. And our next great project—the Tisch Cancer Hospital—will begin construction next month.”
Dr. Charney thanked the donors in the audience for their partnership and closed by saying, “It is no exaggeration to say that the return on your investment can be measured in diseases cured and lives saved.”
As these moving stories of patient successes came to a close, Richard A. Friedman, Co-Chair of Mount Sinai Health System Boards of Trustees, came to the podium.
“Mount Sinai’s work over the past three years in our hospitals, clinics, classrooms, and labs has burnished their reputation as one of the truly great academic medical centers, not only in this country but in the world,” Richard A. Friedman, Co-Chair of Mount Sinai Health System Boards of Trustees, said in his concluding remarks.
“Three years ago,” he observed, “you would not have found a single soul in this beautiful garden in this area. New York City was in lockdown and the only tents in Central Park were those of Samaritans First, where our doctors were caring for COVID-19 patients for whom there were no hospital beds. That was a moment of crisis when Mount Sinai was busy saving thousands of lives. Tonight, years later, it’s finally time to toast all that the Mount Sinai Health System does for our community and for humanity through the advancement of biomedicine.”
As he concluded, reminding everyone in attendance of the importance of their philanthropy to saving lives, Mr. Friedman stated, “Mount Sinai’s work over the past three years in our hospitals, clinics, classrooms, and labs has burnished their reputation as one of the truly great academic medical centers, not only in this country but in the world. So, my tribute is to all the doctors, the faculty, the researchers, and everyone at Mount Sinai.”
A 13-year-old living with a painful autoimmune disorder. A father who required constant oxygen to breathe due to lung scarring that occurred when he worked as a volunteer at Ground Zero after the September 11 attacks. A teenager who fled Ukraine with her family hoping to find treatment for a rare heart condition.
All three received life-changing care at Mount Sinai.
The stories of these three patients, which highlighted a year of accomplishments at Mount Sinai, were spotlighted during the annual Crystal Party fundraising event. The event, held Thursday, May 4, raised $3 million in support of the Health System. Their stories were presented in a video shown during the event.
The emotional story of 13-year-old eighth-grader Lauren Calvo, brought to the fore the particular demand for creativity when caring for pediatric patients who must endure frequent doctor visits under trying conditions. In 2020, Lauren was diagnosed with chronic recurrent multifocal osteomyelitis, an autoimmune disease that causes pain in the bones.
“Her case is quite complex and has required [the involvement of] different medical teams,” said Cemre Robinson, MD, an Assistant Professor, Pediatrics, Icahn School of Medicine at Mount Sinai. “I thought it would be great if all of us at Mount Sinai—the medical team, nurses, Child Life—could come together to create an experience for her that removed the fear from her visits. She should look forward to these visits, which requires building a personal connection.”
The Child Life and Creative Arts Therapy Department was engaged to help Loren in her journey. “What lies at the heart of Child Life is transforming the child’s experience at the hospital,” says Bethany Pincus, MA, MT-BC, LCAT-LP, Creative Arts Therapy Coordinator at The Mount Sinai Hospital. “There are so many different things that music can bring to the table. I love to song-write with patients to help them just process their emotions and allow for distraction. It allows for pain management, a feeling of freedom, and autonomy.”
Lauren’s case also benefitted from Mount Sinai’s interdisciplinary methodologies. “One of our jobs as a physician,” said David Dunkin, MD, Associate Professor, Pediatrics, “is to instill hope. Loren was fortuitous in ending up at Mount Sinai because we have experts in bone metabolism, pediatric inflammatory bowel disease, and rheumatology. We bring all those disciplines together to come up with the best care for Loren, to get her to thrive.”
“I’m eternally grateful for giving Loren her life back,” said her mother, Kim Calvo.
Next, those present heard the dramatic story of Chef James Kelly and his family, who recounted receiving the 1 am call from his Mount Sinai team, alerting him that lifesaving transplant organs had been found. After volunteering to prepare meals for first responders on 9/11, James developed fibrosis, or scarring of the lungs, thought to have resulted from his time at Ground Zero. Over time, breathing became difficult and then severe, requiring the use of oxygen 24 hours a day.
James’s son, James Patrick Jr., described his father’s predicament. “I watched him deteriorate to the point where he could barely get out of bed. It was so hard.”
“The pulmonologist told me, ‘You have the lungs of an 85-year-old man who smoked six packs of cigarettes a day,’ James recalled.”
“It’s hard to understand that the patient can’t breathe,” said Scott Scheinin, MD, Professor, Thoracic Surgery. “They’re slowly suffocating. It’s a horrible existence.” He would need a double lung transplant.
After the early morning call, the family arrived at Mount Sinai. After a seven-hour lung transplant surgery, Mount Sinai’s first, the procedure was pronounced a success.
“Twelve hours later, they were getting me out of bed,” James said. “When I took that first breath, it felt like such a clean, new breath of life. I walked and I couldn’t believe it. In certain ways, it was my first breath of life. When you’re on your second chance and you’ve gotten a second chance, it puts a new light on everything that you do.”
“It’s a huge endeavor to open up a transplant program from scratch,” explained Pamela Phillipsborn, NP-C. “James was our very first. The hospital will never forget. It’s an honor to have taken care of him.”
Of particular resonance was the story of 17-year-old Sofiia Baturina, who had never heard of Mount Sinai Kravis Children’s Hospital thousands of miles away, when Russian forces invaded her hometown in Ukraine. Born with a rare heart condition that requires life-long care and repeat surgeries, she was scheduled for her fourth in Kiev when the war broke out. The stress of the war and being a refugee put additional stress on her. She was having chest pains and shortness of breath, and time was running out.
“We were sitting in the basement, seven hours, 11 hours a day, without enough food,” Sofiia recalled. “We needed to make a plan.” The family endured a harrowing escape from Ukraine to Germany as Sofiia’s older sister in New York, Anna, made contact with the Staten Island-based Global Medical Relief Fund, seeking help. The nonprofit foundation arranged for flights out of Germany, and with one email quickly connected the family to doctors at Mount Sinai, who immediately offered to help.
Based on Sophia’s history, Barry A. Love, MD, Assistant Professor, Pediatrics, Medicine (Cardiology), determined she could be treated with a minimally invasive catheterization procedure rather than full open-heart surgery, which comes with a much longer and harder recovery. This would have been unobtainable for her in Ukraine, but Dr. Love performed a two-hour procedure from a small incision in the groin.
Today, her right heart pressure is nearly normal. Sofiia was discharged from the hospital the next day. A week later, she was walking without symptoms. Before the team at Mount Sinai intervened, Sofiia’s right heart pressure was dangerously high.
“In a week, she was her old self again,” said her sister. “It is truly life-changing what she had to go through here at Mount Sinai.”
“I’m so happy that we were able to do our little part in the middle of what is a very sad moment in world history,” said Robert H. Pass, MD, Chief of the Division of Cardiology at Icahn Mount Sinai and Co-Director of the Mount Sinai Kravis Children’s Heart Center.
“Sophia’s condition is rare, but rare is one of the things that Mount Sinai specializes in,” said Dr. Love, bringing it home. “We specialize in rare. We are able to look after patients that have the most complex and most difficult problems and do so in large part because of the generosity of our donors.”
A workshop held by the simulation lab at the Selikoff Centers for Occupational Health demonstrates best practices for moving and handling patients.
Providers at Mount Sinai’s Emergency Medical Service (EMS) treat, transfer, and move patients—some in extreme situations. They work through small spaces, up and down stairs, and even extricate patients from under subway trains while providing medical care throughout a call. It can be hazardous.
Nationwide, injury rates among EMS responders are increasing as they dedicate themselves to helping patients with urgent medical needs. In 2020, for example, 24 percent of EMS practitioner work-related emergency room visits were for strains and sprains, according to the National Institute for Occupational Safety and Health. EMS providers have reported injuries related to the physical nature of their jobs, which can leave them with permanent disabilities, forcing them to leave the field.
In response to the increase in injuries throughout the United States, and with concern for the EMS providers, a partnership program between the Selikoff Centers for Occupational Health and Mount Sinai Health Systems Emergency Medical Services was launched to help reduce the incidence of work-related strains and sprains.
“When the EMS department asked us to develop an injury prevention training program, we were clear that this was an integral part of our mission at the Selikoff Centers for Occupational Health,” said Arlette Loeser, MA, Program Director of the Ergonomics and Injury Prevention Program at the Selikoff Centers. “We worked closely with them to provide education and support to our EMS responders. We aimed to fill the void of injury prevention programs, leading to the development of an effective program of interactive training and teaching tools for our responders who are risking injury on a daily basis.”
Ms. Loeser, an ergonomist and educator for more than 25 years, said she was pleased to learn that workers had expressed gratitude for the new program and for Mount Sinai’s commitment to supporting a safe work environment.
Khalid Kazi, Senior Manager of EMS Training and Safety, said EMS sought the advice of the occupational medicine experts at the Selikoff Centers when confronted with a rising numbers of staff injuries. The Selikoff team consisted of experts in ergonomics, nursing, medicine, and a volunteer firefighter emergency medical technician.
“They developed a unique model for an injury prevention workshop with a simulation segment and downloadable safety posters to help our department’s responders develop best practices in understanding how to effectively move patients safely,” he said. “We hope to create an environment where any EMS provider may be able to safely operate while providing the high standard of care expected by Mount Sinai.”
At the Awards Ceremony Dinner, from left: Back Row: Dennis Charney, MD; Leo Keegan, MD; Christopher Bellaire, MD; Hashem Emad Zikry, MD; Daniel J. Weiss, MD, PhD; Basil Hanss, PhD; David R. Friedland, MD, PhD; Alberto Paniz-Mondolfi, MD, PhD; Robert O. Wright, MD, MPH; Cardinale Smith, MD, PhD; Alexis Colvin, MD. Seated: Silvia Chavez, MSN; Leif Holgersen, MD; Meg A. Rosenblatt, MD; Bret P. Nelson, MD; James C. Tsai, MD, MBA; Carl W. Braun, MD; Katherine A. Hawkins, MD, JD; and Vesna Najfeld, PhD
More than 225 alumni, faculty, and honored guests gathered for the 2023 Alumni Reunion Awards Ceremony Dinner held at the New York Academy of Medicine. This was the first time in four years that the event was held in person to celebrate the recipients of the Mount Sinai Alumni Awards and the St. Luke’s-Roosevelt Alumni Awards, as well as milestone graduation years: the classes of 1978, 1983, and 1998.
This year’s event, held Wednesday, May 10, was particularly special for another reason: It was the first reunion to honor the first four graduating classes from the original Mount Sinai School of Medicine. The classes of 1970, 1971, 1972, and 1973 jointly celebrated their 50th anniversaries, which is a signifier of the extraordinary trajectory taken since the School of Medicine’s founding.
Guests were welcomed with opening remarks from Alexis Colvin, MD, Associate Dean for Alumni Affairs, Dennis S. Charney, MD, Anne and Joel Ehrenkranz Dean of the Icahn School of Medicine at Mount Sinai, and Kenneth L. Davis, MD, Chief Executive Office of the Mount Sinai Health System, who is also an alumnus of the class of 1973. Leo Keegan, MD, Vice President of the Mount Sinai Alumni Association, and Carl Braun, MD, President of the St. Luke’s-Roosevelt Alumni Association, presented the awards. A special welcome video with Talia Swartz, MD, PhD, President of the Mount Sinai Alumni Association, was also shown.
The Alumni Award recipients are:
The Mount Sinai Alumni Leadership Award: Christopher Bellaire, MD Candidate ’23, Hashem Emad Zikry, MD, ISMMS ’18
St. Luke’s-Roosevelt Distinguished Young Physician of the Year: Alberto Paniz-Mondolfi, MD, PhD, SLR ’11
The Jeffrey T. Laitman, PhD Award for Achievement in Medical Education: Bret P. Nelson, MD
The Mount Sinai Graduate School Alumni Award: Basil Hanss, PhD, Cardinale Smith, MD, PhD, MSSM ’15, MSH ’10
The Mount Sinai Master Clinician Award: Meg A. Rosenblatt, MD, MSH ’89
The Mount Sinai Alumni Special Recognition Award: Silvia Chavez, MSN, ANP-BC, Vesna Najfeld, PhD
The Terry Ann Krulwich Physician-Scientist Alumni Award: Daniel J. Weiss, MD, PhD, MSSM ’88
The Dr. Sidney Grossman Distinguished Humanitarian Award: James C. Tsai, MD, MBA
The J. Lester Gabrilove Award: Robert O. Wright, MD, MPH
St. Luke’s-Roosevelt Distinguished Alumni Award: Katherine A. Hawkins, MD, JD, SLR ’77, Leif Holgersen, MD, FACS, SLR ’70
The Saul Horowitz, Jr. Memorial Award: David R. Friedland, MD, PhD, MSSM ’95, MSH ’00
The Alumni Association also held a series of events from Wednesday, May 10, to Friday, May 12. The event series included a symposium with two panel conversations and a discussion with Dr. Charney, and an Open House for the new Alumni Office and Wisch Physician Lounge. Members of the 50th anniversary classes participated in the 2023 Commencement Ceremony.
To view the digital Reunion Dinner Program Book, see event photos, watch the welcome video, and listen to the Alumni Podcast from the graduating class of 1972, click here.
At the 2023 Commencement Ceremony, from left: Ernst Schaefer, MD; Jacob Rispler, MD; Steven C. Port, MD; Naomi LC Luban, MD; Katherine Teets Grimm, MD; Arthur L. Frank, MD; Kenneth L. Edelson, MD; and Michael S. Balkin, MD.
Mammograms have been in the news lately, and it can sometimes be a bit confusing. But the guidance from Mount Sinai doctors remains unchanged and simple: You should start getting mammograms at age 40 and continue yearly.
In this Q&A, Elisa Port, MD, FACS, Chief of Breast Surgery and Co-Director of the Dubin Breast Center, explains why changing guidelines from groups such as the U.S. Preventive Services Task Force have not altered the recommendations of doctors like herself to urge women to start mammograms at age 40 and have them every year. She also explains why this longstanding recommendation for annual mammograms starting at age 40, based on extensive data, is critical for Black women, who are more susceptible to an aggressive form of breast cancer, and why new regulations from the Food and Drug Administration on breast density are also important.
Elisa Port, MD, FACS
What is the latest advice on the age that people should start getting regular mammograms?
The age that women should start getting mammograms has never changed from the perspective of health care professionals. There is tons of data and research that has shown that starting at age 40 and yearly thereafter is the best way to detect breast cancer early and gives women of all those age groups the best chance of survival if they do develop breast cancer that is found through early detection. What has not been consistent is that, starting in 2009, and then again in 2016, a number of groups, such as the American Cancer Society and the U.S. Preventive Services Task Force, started putting out guidelines that differed from that. These were basically prioritizing different factors, and taking into account such things as the anxiety of patients, false positives, and cost. But doctors have known all along that the optimal way to screen women for breast cancer, with the highest chance of survival, is starting at age 40 and continuing yearly thereafter.
What is the U.S. Preventive Services Task Force?
The task force is an independent, volunteer panel of experts on prevention and evidence-based medicine that provides guidance to primary care physicians about preventive services such as screenings and counseling services. It is one of several leading sources of guidance to physicians.
What are the reasons for the new guidance from the task force to start mammograms at age 40?
One of the reasons for the change in its guidance on mammograms was newer data, very disturbing, showing that Black women—who we know can develop cancers younger—are more at risk for developing a particularly aggressive kind of cancer called triple negative breast cancer that can grow more rapidly. The death rate in Black women who get breast cancer is substantively and unacceptably higher. So this change in recommendation is a limited response to that data, saying one thing we can do to address that is revert back to starting screening at a younger age. But they did not go far enough.
How is the risk for Black women different?
One of the biggest issues specific to Black women is that breast cancer is not just one disease. Breast cancer involves multiple different subtypes. Each of these different subtypes is treated differently, has a different pathway, and behaves differently. One of these subtypes, called triple negative breast cancer, is the most aggressive kind of breast cancer and also one of the most difficult to treat. We know that of all breast cancers, triple negative makes up only about 15 percent. However, there are certain groups that have a higher chance of developing triple negative breast cancer and are at high risk for developing that subtype. Black women are one of those groups. When they develop breast cancer, there is a 30 percent chance it will be triple negative, not 15 percent. So it is much higher. As a result, they may need to be screened earlier, and with greater frequency.
Should people be concerned if they cannot afford a mammogram?
At Mount Sinai, we feel very strongly that women should keep to our guidelines, and we accept all insurance. We will do everything within our power to make sure that all women, even those without insurance, regardless of their ability to pay, get the care they need.
Are there any exceptions for the guidance that mammograms should start at age 40?
One of the things that we have made so much progress on, and that I’m so proud of, is there is not a one-size-fits-all approach. There are groups where we might even start screening earlier. Women with a family history of breast cancer, particularly at a young age, may start screening earlier and add other adjunctive tests like ultrasound or MRI—these are all considered in our high-risk populations. For example, if your mother was diagnosed with breast cancer at age 45, we typically advise starting screening about 10 years younger than the youngest family member diagnosed with breast cancer. Doctors might recommend starting at age 35, and recommend that you seek personalized advice and guidance regarding screening.
The FDA recently updated its regulations to require mammography facilities to notify patients about the density of their breasts. What does this mean for patients?
The density notification is a very important step because it tells women and their providers if they might be at higher risk for having a cancer missed, and potentially should be adding screening tests, like ultrasound and MRI, to close the gap in case mammograms are missing something. What is most important is that knowledge is power—women should be empowered to know more about their bodies. It does not automatically mean everyone needs an ultrasound or an MRI. It is a very nuanced discussion with one’s doctor, but it is a data point that can factor heavily into making these decisions. Breast density can only be determined one way, and that is based on a mammogram. We cannot tell breast density from the physical exam, or age, or family history. Based on that mammogram, one can then have an educated conversation regarding whether any additional imaging is appropriate
Will this new regulation produce any changes for Mount Sinai patients?
Many states, including New York, already had laws regarding breast density notification before the FDA’s action. So here at Mount Sinai, patients are already learning about their breast density, without the new FDA notification. Now all states, including New York, will need to do this in a uniform way. So there may be some small change for us in the notification language we send to patients.
What should I do if I have any questions or concerns about mammograms?
Primary care providers and gynecologist are the ones who order most of these tests. Their role is to customize and personalize any kind of cancer screening based on the individual, her family history, age, and other medical issues. That is what a good doctor does: takes all these considerations and puts it all together in a thoughtful approach for the individual.
