The bad news is that more and more women are being diagnosed with breast cancer. The good news is that the death rate among them is going down. And one reason for the good news is people like Dr. Elisabeth A. McKeen.
McKeen is a board-certified oncologist with the Palm Beach Cancer Institute, and also has served as co-chair of the Breast Committee at Duke Comprehensive Cancer Center. For more than 20 years she has been practicing medicine, and for the past decade has been specializing in breast cancer patients and genetics.
The 54-year-old McKeen became interested in medicine at a young age. “I knew I wanted to become a doctor by the time I was in sixth grade,” she said. “I had read a book about the first woman doctor (Elizabeth Blackwell) and I liked it, and I liked her because she had Elizabeth as a first name. And I also liked science.”
McKeen received a B.S. in Biology from Renssalaer Polytechnic Institute, and then earned her M.D. at The Albany Medical College. She served as an Intern at Emory University Affiliated Hospitals in Atlanta, which is where she met Jim Harris. “We worked together during our internship,” she explained. “He’s from here, he was born in West Palm Beach, and when he started a practice he needed a partner. So I came down to Florida.” And she has stayed for 22 years.
Born in Pennsylvania and reared in Tennessee, McKeen remembers the move to Palm Beach County well. “I came on Valentine’s Day in 1982. My son was three months old and my daughter was almost two. She hadn’t been outside for months (because of the cold). She thought she had gone to heaven because she could be warm again.”
Over the years, McKeen came to a point where she began to focus her practice on breast cancer. “I thought that as the science of oncology got more sophisticated, I could better serve patients if I concentrated in just one area,” she said. “So I started limiting my practice, and I enjoy seeing women patients.” McKeen added that cancer genetics, which she has studied since 1976, takes up about 10 percent of her time.
She talked about how the success in treating breast cancer has changed since she first entered the profession. “When I was a medical student, only 35 percent (of women diagnosed) were expected to live for five years. Now, for mammogram-detected cancer, the number is more than 90 percent. That’s a dramatic improvement. Now, 90 percent have a chance of it never coming back.”
Unfortunately, one of the problems is that many women still do not have mammograms. “The statistics are shocking,” she said. “Mammograms are paid for but women don’t get them. Their doctors may not encourage themthat’s the first step. Physicians are getting better about that but not all women go to a doctor. In the minority community, the rate of mammograms tends to be worse.” McKeen pointed out that studies show that when women are able to get a good mammogram diagnosis at an earlier stage, the cancer is easier to treat.
She talked about how the number of women being diagnosed with it has increased. One reason is that women live longer, and some have children later in life or don’t have them at all. But the major cause, according to McKeen, is “hormone replacement therapy. A second cause is radiation exposure. A lot of women received radiation treatment for acne when they were young. And there are the social factorsbeing overweight, not getting enough exercise, smoking, having more than five alcoholic drinks in a week. But if you look at the community as a whole, hormone replacement is the major contributor.”
Genetics is also a component. “I do quite a bit of genetic counseling,” she said. “A woman has an abnormal breast-cancer gene, and those are the ones I see a lot. A blood test will tell if you have a mutation.”
McKeen said a woman with an abnormality could have her ovaries out and reduce the chance of cancer by 50 percent. But doctors are working on less drastic measures. “In the future we may be able to correct abnormalities,” she said. “We’ll be able to study which genes are changed and develop new ways to treat them. We’re having targeted therapy for genes. That’s the way of the future.”
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