Her breakthrough in imaging finds breast cancers earlier
Published: September 4, 2006
If Dr. Etta Pisano could function better without sleep, you might not be reading this article.
As a young medical student, Pisano yearned to be an obstetrician and gynecologist. But nights on call left her feeling wrecked the next day, and she realized she’d never survive a life of delivering babies at all hours of the night.
But with typical resourcefulness she found a different way to achieve her aim of practicing in women’s health. Instead of serving women by delivering their babies, Pisano dedicated her career to saving their lives by finding breast cancers earlier.
Pisano, now a UNC-Chapel Hill radiologist, is widely regarded as the mother of digital mammography. She is recognized in this month’s issue of Ladies’ Home Journal for her groundbreaking work in the technology.
Pisano helped design the first digital mammography device, then led tests needed to win Food and Drug Administration approval. Last year, she published the initial findings of a $26.5 million study she led to establish the device’s clinical value. The results: Doctors were four times as likely to recognize invasive cancers in women under 50 who had digital scans and twice as likely to spot tumors when they are small and easier to treat.
“It’s really practice-altering,” Pisano says. “Those women will now get digital mammography. I really believe that.”
Pisano, whose shoulder-length curtain of dark hair makes her seem younger than her 49 years, says it was a surprise and an honor to receive Ladies’ Home Journal’s new Health Breakthrough Award. She was one of seven doctors selected from a list of 100 candidates to receive the honor.
“It was really nice to have my work recognized,” Pisano says. “It’s very unusual for scientists.”
Attention from national media may be a rarity. But around Chapel Hill, Pisano is something of a superstar whose fans include UNC-Chapel Hill Chancellor James Moeser and the dean of UNC’s School of Medicine, Dr. William L. Roper. Roper recently tapped Pisano to be vice dean of academic affairs — a role in which she does much of the hands-on work of running the medical school.
It’s just the latest responsibility Pisano balances on her slim shoulders. She is a professor of medicine and biomedical engineering, a clinician who still reads patients’ mammograms, and director of UNC’s Biomedical Research Imaging Center. She also maintains her own research lab, which has one of the highest levels of grant funding in the university.
“She does it all well but she seems to do it all without effort,” Moeser says. Pisano was elected by her peers to serve on a UNC faculty committee that advises the chancellor. “People give her jobs to do,” Moeser says, “because they know if Etta says she’ll do it, it’s going to get done.”
Pisano is also admired for her ability to do all she does while still making time for a rich personal life that includes a 25-year marriage to her college sweetheart, Dr. Jan Kylstra, and four children, as well as a cat, a dog and a guinea pig.
Juggling work, life
Pisano’s ability to balance work and life has made her counsel and example especially valuable to Nadia Charguia, a fourth-year medical student at UNC whom Pisano mentors through the UNC chapter of the American Medical Women’s Association. Pisano chose Charguia from the list of students seeking mentors because she noticed that Charguia, like her, had been an undergraduate philosophy major.
“I was very appreciative when I learned Dr. Pisano was going to be my mentor,” says Charguia, 27. “She’s doing breakthrough research, she’s a vice dean. But she also has a happy, successful marriage and she raises her children. She has all the attributes I hope to have one day.”
Despite her heavy workload, Pisano has logged scores of hours watching her kids’ soccer matches — though she considers the sport dull for its lack of scoring — and band concerts. She’s also a former chairwoman of the Chapel Hill area PTA and was named the school district’s volunteer of the year in 2004.
Kylstra, an ophthalmologist, says people who don’t know his wife well are often surprised by how deeply involved she is with her children’s lives.
“People look at her and think she’s a workaholic and that she must not pay any attention, but she knows everything that’s going on with the kids,” he says. “She’s pretty much a normal person, but in overdrive.”
Pisano was forced from an early age to learn to juggle multiple responsibilities.
She was just 15, and the oldest of seven siblings, when her mother died at the age of 44. Overnight, Pisano found herself the de facto matriarch of a very busy household. The moment she got her driver’s license, for example, Pisano was immediately responsible for all the driving. She had to keep track of seven different schedules and ferry brothers and sisters to scout meetings and other extracurricular activities.
“It really required a lot of administrative ability,” Pisano says. “I kind of know how to do this like people know how to breathe.”
Loss ignites passion
The death of Pisano’s mother, for whom she is named, also influenced her career path. Pisano, whose father is also a radiologist, decided she wanted to be a doctor by age 12. But her mother’s sudden death — from a tumor that caused bleeding in the brain — ignited a passion to serve women and to make medicine better.
“She was never diagnosed,” Pisano says, noting that the imaging capabilities we have today simply didn’t exist back then. “She had started having headaches, and then one morning she didn’t wake up.”
Pisano got interested in radiology as a medical student at Duke, but didn’t begin focusing on breast imaging until she completed her residency. Once again, she was handed tremendous responsibility despite her youth and lack of experience. Her first job out of residency was chief of breast imaging at Beth Israel Hospital in Boston — a Harvard-affiliated teaching facility where she had trained as a resident.
“The chairman of the [radiology department] told me, ‘You’re going to be a breast imaging radiologist — this is your future,’ ” Pisano recalls. “He was so insistent I felt I really couldn’t say no.”
She remained in the position for only a year. But when she and Kylstra began looking for positions in the Triangle in the late 1980s, the title caught the attention of recruiters at UNC. UNC did not have a breast imaging section at the time and was keen to start one.
It was at UNC that Pisano started her 14-year quest to improve the quality of breast imaging.
As proud as she is of helping shepherd digital mammography along, Pisano is still looking for ways to improve medicine.
“I feel like it should not have taken 14 years,” she said.
As an administrator at UNC’s medical school she hopes to effect change that can help researchers get advances to the patient’s bedside sooner. She wants to try setting up clinics to gather certain research data in real time, bypassing some steps in the long clinical trial process.
“We have to find ways to make it better and faster,” Pisano says.
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