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Johns Hopkins Health - Personal Best

Fall 2009
Issue No. 6

Personal Best

Date: September 24, 2009

Dorothy Hamill
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Legendary figure skater Dorothy Hamill opens up about her toughest competition yet: breast cancer

Legendary figure skater Dorothy Hamill opens up about her toughest competition yet: breast cancer

In January 2008, 51-year-old skating icon Dorothy Hamill pondered cutting short her starring role in the nationwide tour of Broadway on Ice.

“I was tired and preoccupied,” she recalls. “I just wasn’t performing at my best.”

And no wonder. Weeks earlier, Hamill had been diagnosed with breast cancer and had begun treatment at Johns Hopkins.

“I kept wondering,” she says, “is this going to come back?”

Despite her worries, she continued with the demanding show schedule.

“It’s hard to just stop when you’ve been doing it for so long,” she says. “I’m a people pleaser; I couldn’t let anyone down by quitting.”

For anyone, a breast cancer diagnosis is beyond unnerving, but for Hamill—a three-time U.S. figure-skating champion, world title holder and winner of the 1976 Olympic gold—it seemed especially daunting.

Among her first thoughts was of her own mother, who was diagnosed with breast cancer in 1980. While a 23-year-old Hamill was touring, her mother was having a radical mastectomy and undergoing chemotherapy.

“That was difficult,” she says. “My mom kept very quiet about her breast cancer. It was different back then.”

Then there was Hamill’s own daughter, who had just started college when Hamill was diagnosed. Although she didn’t want to burden her daughter, Hamill also didn’t want to keep her in the dark, as her own mother was compelled to do at first.

“So much goes through your head. So many emotions and fears,” she says. “But I felt like I wanted to be open about this, with my daughter and all women who might face breast cancer.”

First, she had to get past the shock of her diagnosis.

What Next?
Because of her family history, Hamill had been vigilant about having mammograms for years. Yet, even when an ultrasound revealed something unusual, she didn’t think the worst. When the breast biopsy came back showing breast cancer, her world changed.

“I suddenly felt like I needed to become an expert on breast cancer, and do it very quickly,” she recalls. At the insistence of family members, Hamill came to Johns Hopkins for a second opinion.

That’s when everything shifted into high gear.

“It was an altogether different experience,” she says. “I felt like I had more eyes and ears than I knew what to do with, and they had answers to questions I hadn’t even thought of asking.”

Answers for questions like: What are the side effects of chemotherapy and tamoxifen? What is Herceptin therapy and what are the risks? How can you participate in clinical trials? What are margins in relation to breast cancer? How long is it until you’re considered cancer-free?

Breast Cancer Experts
For Hamill and breast cancer patients who find their way to Johns Hopkins, help and support come in the figures of leading medical and surgical oncologists and other dedicated breast cancer specialists.

“We live and breathe our specialty,” says breast surgeon Theodore Tsangaris, M.D. “But we never forget we’re here to care for people.”

Along with Tsangaris, another of those specialists is Lillie Shockney, R.N., M.A.S., administrative director of the Johns Hopkins Avon Foundation Breast Center, whose own breast cancer experience inspires her patients.

“Lillie was an angel from heaven,” Hamill says. “She’s your best friend, your biggest comfort, someone who gives you her undivided attention.”

Shockney says her role is to make sure every breast cancer patient feels as if Johns Hopkins is extended family. “We’re here to navigate and advocate,” she says, “but also to empower.”

Hamill had two surgeries—first a lumpectomy, then removal of additional nodes—followed by radiation treatment.

“Our goal is breast conservation,” Tsangaris says, “and we do that in about 90 percent of cases.” And, though not the course of treatment for Hamill, when mastectomy—or complete removal of a breast—is the decision, Tsangaris adds that skin and nipple-sparing procedures have become so technically proficient, it’s hard to see a difference.

Where differences are seen, Hamill hopes they will be identified in breast cancer clinical trials. When she learned of one at Johns Hopkins for an aromatase inhibitor, a type of breast cancer drug that blocks estrogen production for tumors that are considered estrogen-sensitive, it took little to persuade her to participate.

“Being part of a clinical trial, that’s been very meaningful,” she says. “It’s a duty for me, to further the study of breast cancer treatments to help others. How can you not do that?”

Now, Back to the Action
It’s been more than a year since Hamill’s diagnosis and surgeries, and she’s as busy as ever. Has her diagnosis changed her? Absolutely, she says. Physically, Hamill tires easily and she often has achy joints—but you’d never know that if you met her in person. And although she’s always been close to her daughter, she’s even closer now. She’s also an advocate for breast cancer screenings, talking to other women about her experience.

Mentally, Hamill is ever the performer who gets back up after she falls.

“You can’t worry about what’s happened,” she says. “You have to move forward.”?

Not All Breast Centers Are the Same
Whether you’re facing treatment for breast cancer or getting a second opinion, ask the right questions when choosing where to go. Breast cancer experts at Johns Hopkins recommend that you:

  • Find out how many breast cancer surgeries the facility does annually, not including breast biopsies. A single surgeon should do a minimum of 100 a year.
  • Ask whether the facility is using digital or analog imaging. Seventy-five percent of U.S. centers use analog, but digital imaging is nearly 30 percent more accurate.
  • Make sure there are breast reconstructive surgeons who are performing the latest microvascular flap procedures.
  • Ask if there are dedicated breast pathologists. Only a handful of centers have experts who are specifically focused on breast cancer.

These are important questions to ask. National studies show that breast cancer survival rates are significantly higher when patients are treated by specialists at experienced, high-volume centers.

Did You Know?
Johns Hopkins is the only hospital in the country to offer immediate, on-site readings of screening mammograms. Most centers call you in a few days or send a postcard, notes breast specialist Lillie Shockney.

“Doing this goes a long way toward reducing fear and anxiety,” she says, “plus patients can pursue treatment faster.”

The Johns Hopkins Difference
Seventy percent of women undergoing mastectomy in the U.S. are not offered advice by their surgical team on breast reconstruction.

“That doesn’t do anyone any favors,” says breast specialist Lillie Shockney. “We do it differently at Johns Hopkins. We make sure we’re counseling our patients about all options—no matter what the treatment—every step of the way.”

Detection Checklist
The earlier breast cancer is found, the better the chances are for treatment. The American Cancer Society recommends that you:

  • Have a digital mammogram annually starting at age 40.
  • Have a clinical breast exam every three years in your 20s and 30s, and annually after age 40.
  • Know how your breasts normally feel and report changes promptly to your doctor. Breast self-exams are an option for you beginning in your 20s.
  • Consider MRI if you have at least a 20 to 25 percent lifetime risk of breast cancer, including a strong family history of breast or ovarian cancer or treatment for Hodgkin’s disease.

Ask the Expert
Do you have a question about breast cancer? Ask it online or search the archives of questions and answers at

For more information about breast cancer prevention, diagnosis or treatment, visit Johns Hopkins online at For appointments and consultations, call 877-546-1872.

Watch Dorothy Hamill talk about her personal breast cancer story at