BCRF investigator Dr. Lisa Newman talks about the personal experiences that have shaped her research and career
As the chief of breast surgery at the Weill Cornell Medicine/New York-Presbyterian Hospital Network, Dr. Lisa Newman routinely operates on patients diagnosed with breast cancer. She also spends part of her always-busy days counseling women who are at a high risk of the disease.
Though these patients don’t have cancer, they do face tough choices about how aggressive they want to be in lowering that risk—and many of them ask Dr. Newman what she would do if she were in their situation. But she doesn’t have to imagine: More than a decade ago, she underwent a double mastectomy after learning she was at a high risk of breast cancer herself.
Back then, a routine mammogram and biopsy revealed Dr. Newman had lobular carcinoma in situ (LCIS), a condition in which cells that resemble cancer cells grow in the lining of the milk-producing glands (lobules) of the breast. While LCIS is not considered cancer and doesn’t require treatment, Dr. Newman knew it wasn’t inconsequential either. Women diagnosed with LCIS have a seven to 12 times higher risk of developing invasive breast cancer.
“I was completely stunned to learn that I had an elevated risk of breast cancer,” Dr. Newman said. “It was bizarre to be on the other side of this conversation, and I actually surprised myself with the decision that I made.”
Fortunately, she had several options. Most women with LCIS elect to undergo more advanced screening — including yearly mammograms, ultrasounds, and MRIs — to more closely monitor for signs of breast cancer. Others choose to take hormone-blocking medication such as tamoxifen to lower their risk of developing the disease. But Dr. Newman decided that the most aggressive approach to prevention, a double mastectomy, was the best option for her.
“When I learned that I had LCIS, there was no doubt about what I wanted to do,” she says. “I absolutely do not advocate in favor of mastectomy being the answer for every patient. But it was the right answer for me.”
Part of Dr. Newman’s motivation for choosing to have her breasts removed came from her longstanding expertise in breast cancer racial disparities. Black women like herself have a nearly 40 percent higher death rate from breast cancer. They’re also more likely to develop very aggressive forms of the disease, such as triple-negative breast cancer (TNBC) and inflammatory breast cancer (IBC). Plus, black women are more often diagnosed at younger ages and at more advanced stages of the disease than white women.
When Dr. Newman began her career as a general surgeon in the diverse New York City borough of Brooklyn, less was known about the interplay between race, ethnicity, and breast cancer. She didn’t have to look any further than her own practice to see dramatic differences in how Black women experienced breast cancer compared to white women.
“My African American patients tended to be younger than my white patients, and they were diagnosed at more advanced stages of the disease,” Dr. Newman said. “Also, their cancers seemed to be more resistant to the treatments that were available at the time.”
She was deeply troubled by these observations and the questions they prompted. Many of the differences could be explained by social and economic factors, but what about biology and genetics? Did African ancestry shape Black women’s predisposition for more aggressive forms of breast cancer? Associations between Ashkenazi Jewish heritage and hereditary predisposition for breast cancer have been well-documented; perhaps African ancestry had a comparable correlation?
It was clear then that more research was needed, and Dr. Newman wanted to be part of it. So, she pursued additional surgical oncology fellowship training at the University of Texas M.D. Anderson Cancer Center and returned to her undergraduate alma mater, Harvard University, to obtain a master’s degree in public health. These experiences helped develop the focus of her research: understanding how African ancestry impacts a woman’s risk of developing TNBC.
In 2004, she founded the group that is now called the International Center for the Study of Breast Cancer Subtypes (ICSBCS). Dr. Newman oversees a multidisciplinary team of physicians and researchers investigating breast tumor biology associated with the genetics of diverse racial and ethnic groups. The program also invests in capacity-building health services in under-resourced areas of Africa.
For two decades, Dr. Newman has traveled to Africa several times every year with a team of researchers and surgeons to work side by side with her African colleagues in the clinic and operating room while also conducting research. Their efforts have yielded many critical discoveries, including that TNBC risk is indeed associated with genetic African ancestry—especially Western Sub-Saharan African ancestry.
Dr. Newman became a BCRF investigator in 2022, and with the Foundation’s support, she’s expanding the ICSBCS’ biobank, which houses thousands of primary breast tumor samples as well as blood and saliva specimens from patients in the U.S. and East and West Africa. Her BCRF grant is supported by The Estée Lauder Companies’ Award in honor of employees. Dr. Newman also serves on the steering committee of BCRF’s Health Equity Initiative made possible by The Estée Lauder Companies Charitable Foundation.
“Research is critical,” Dr. Newman said. “Funding it is the only way we’ll be able to identify prevention strategies, provide patients with less-toxic treatments, and ultimately find a cure for the disease. I believe we are close to accomplishing these goals.”
Today, Dr. Newman is grateful that she has remained free of breast cancer. Devastatingly, her sister Debbie, who was by her side throughout her preventive mastectomy, was not so fortunate. The day before Thanksgiving in 2021, Dr. Newman, Debbie, and other family members were on a phone call discussing the upcoming celebration when Debbie suddenly began slurring her words.
Dr. Newman helped get her to the emergency department quickly, thinking Debbie was having a cerebrovascular event. It was a reasonable assumption considering that their mother had died from complications of a stroke several years before. But the results of a brain CAT scan revealed that the slurred speech was caused by brain metastasis. Debbie had metastatic breast cancer that had spread to her brain.
Additional testing revealed that Debbie had an extremely aggressive inflammatory form of TNBC. Dr. Newman’s beloved sister—a highly accomplished lawyer and teacher who held degrees from Princeton and Georgetown and had access to excellent healthcare—died of the disease in a matter of months.
“Her death was shocking and heartbreaking, and it so intensely drove home the message that when it comes to breast cancer disparities, they are not completely explained by socioeconomic disadvantages,” said Dr. Newman. “We absolutely have an obligation to look at tumor biology and genetics.”
While her career has evolved in ways she hadn’t anticipated, the one thing she truly never expected was that her work would become so intensely personal.
“Debbie’s experience is an extremely powerful and constant reminder to me and my team that we must continue our work more robustly and more rapidly than ever,” Dr. Newman said.
Read more stories from BCRF’s Research Is the Reason storytelling initiative here.
