Janet Vittone

In 2002 Julann (upper left), Janet (upper right) and Jill (bottom left) were all treated for breast cancer at Mayo Clinic along with their mother, Charlotte. Jean (bottom right) opted for a preventive mastectomy.

ABC News and Prevention magazine announced on Monday, May 7 on Good Morning America that they had selected Dr. Vittone as one of five finalists in their "Picture of Health" contest for women over age 40. For more information click here (opens in new window.)

Janet Vittone doesn't have to look any further than her family portrait to know about breast cancer. After all, four of the five women — Vittone, her mother and two of her sisters — have the disease. Sobering, yes, but what's truly breathtaking about this picture is that they were all diagnosed within one year.

Just as Vittone, a Mayo Clinic internist, was finishing her own post-chemotherapy radiation in 2002, her younger sister, Jill, and then her mother, Charlotte, learned that they too had breast cancer. If that wasn't enough, by the end of the year, her oldest sister, Julann, would hear the same news.

One-by-one, at Vittone's insistence, they traveled from their home turf in Michigan to Rochester where she knew they'd benefit from the integrated services of Mayo Clinic's Breast Diagnostic Center. That included genetic counseling. But they'd also receive the same swift attention she had experienced after first spotting a left-breast dimpling on Thanksgiving eve, 2001.

From testing to treatment, Mayo physicians attempt to expedite every aspect of care so patients are spared the anxiety that comes with any breast condition. Vittone underwent a mammogram and biopsy on Friday, met with the surgeon and radiation oncologist on Monday, and scheduled her procedure for Tuesday. Not only did she know the diagnosis immediately, but learned beforehand that she needed a mastectomy. "That knowledge was very helpful," she says.

Likewise, within days of arriving separately the following summer, Vittone's younger sister and mother had a myriad of diagnostic tests to confirm the suspicious mammograms and biopsies they saw back home. At Mayo, surgeons were prepared to follow up immediately with a mastectomy on Jill and lumpectomy on Charlotte. "If there's one message for patients," Vittone says, "it's that you can get things done very quickly here."

But does that help the prognosis? Obviously, "the earlier, the better" applies to any cancer diagnosis. When Julann underwent a double preventive mastectomy in December, little did she suspect that Mayo surgeons would find a previously undetected lobular cancer. Since this type of malignancy is notoriously harder to pinpoint than more common ductal carcinomas, finding and removing it was a lucky stroke. They caught it at stage one.

Such timely action can do much for a woman's peace of mind. But so can having proximity to important ancillary services. In time, the Vittones tapped Mayo's genetic counselors to assess their individual risks. The sisters had no clues as to their mother's family health history since she was adopted. But they were able to determine — from Vittone's index blood sample — that none carried BRCA1 or BRCA2 — the only abnormal genes known to significantly increase the risk for breast and ovarian cancers.

Even so, Vittone and her older sister underwent preventive hysterectomies. In addition, like Julann, Jill and their only cancer-free sibling, Jean, she opted for a preventive mastectomy on her remaining breast, a step she suggests to others. "It was hard to consider that decision initially, but after going through this with everyone, I thought, "Why did I keep it this long?"

What final advice does this clinician and cancer survivor have for others? Be diligent with monthly breast self-exams and undergo screening mammograms. Since Vittone found her lump at age 38, she knows you're never too young to be proactive. In fact, 25 percent of breast cancer occurs in women under 40, regardless of familial connections. Vittone regularly corrals such sobering facts, along with her personal story, to motivate women. "When I bring up my family, some of my patients even start to cry," she says. "I just say, It's OK, we're all fine.' Then I use the experience to educate them about their own breasts."