(gentle music) - [Michelle] Tonight, an often unknown condition that increases the risk of breast cancer.

- Why haven't I been getting an ultrasound all this time if my doctor recommends it now?

- [Pamela] Then, a former inmate's story of redemption.

- Someone such as myself can be redeemed, it could be done for anybody.

- [Pamela] And the 2026 Rhode Island governor's race heats up with Ted Nesi.

(bright music) - Good evening and welcome to "Rhode Island PBS Weekly."

I'm Michelle San Miguel.

- And I'm Pamela Watts.

We begin with a story about breast cancer.

According to the CDC, it's the second leading cause of cancer death among women in the United States.

- And many women who are at greater risk of developing the disease are often the same women for whom detection through a mammogram is more difficult.

And, as we first reported last October, if additional screening is not conducted, the consequences for some can be life-threatening.

Tonight we take another look at how a new Rhode Island law is helping uncover this hidden risk.

- I could tell by the look on her face there was something, but she couldn't say, and then they brought somebody in and said they had to do a biopsy.

- [Michelle] Michele Winn was recently diagnosed with breast cancer for the second time.

Her first diagnosis was eight years ago.

- They found something back when I was 50, and they immediately took me in for an ultrasound.

They just saw a shadow, but they couldn't, they had to make sure with the ultrasound and that's when that all got sent into motion and it was definitely there.

- [Michelle] Winn went through treatment and was grateful her cancer was found in stage one.

She's been diligent about getting her mammogram every year.

She was surprised to learn this year that she once again had breast cancer, this time on her other breast.

Winn did not realize having dense breasts increased her risk of breast cancer.

- They did tell me they were dense, but again, I heard everybody had dense, so I didn't really take too much stock in it, but it's real.

- [Michelle] The breasts are made up of fatty tissue and dense tissue, which includes the milk glands, milk ducks, and supportive tissue.

A person with dense breasts has more dense tissue than fatty tissue.

- We can't change our breast density.

- Dr. Jennifer Gass is the Director of the Breast Health Center for Care New England.

She's also a professor of surgery at Brown University.

- How do you go about detecting if you have dense breasts?

Can you do a self exam or you really need a professional to do that mammogram to find out?

- It's a mammographic finding, and so a breast self exam won't tell you.

- [Michelle] About half of women 40 and older have dense breasts, which can make mammograms harder to read.

- The fatty tissue is helpful in the breast because on x-ray, mammogram, the fatty tissue is very translucent, and so when the mammogram is translucent, then the density pops out like a light bulb.

But when the mammogram is dense, the brilliance of that light bulb is masked by all of that density.

- [Michelle] Dr. Gass pointed to an image from the CDC website.

On the left, it shows a mostly fatty breast, compared to the one on the right, which is a dense breast.

- The white tissue is the dense tissue, and the challenge here is that any one of these little white nodules could be the beginning of a cancer, but when it's masked in the background of all of this patchy density, you can't pick it up as a cancer.

- [Michelle] According to the Susan G Komen Breast Cancer Foundation, women with very dense breasts are four to five times more likely to get breast cancer than those with fatty breasts.

It's a sobering statistic for Charles Kelley.

His wife, Ann, died of breast cancer in 2019.

- It was quite a shock to her and all of us when she found a lump in her breast.

She said, "Well, it can't be anything serious because I've just got a clean bill of health from a mammogram."

- [Michelle] Ann Kelley's doctor recommended she get an ultrasound, which found a tumor in her breast.

When the mother of two asked why the tumor did not show up on a mammogram, the doctor said it was because she had dense breasts.

- She, being a very logical CPA and business person, said, "Well, why hasn't someone told me this years ago that I should have had some alternative procedures?"

We talked about it and that set her off on not only fighting her own fight with cancer, but also fighting to make the public, and particularly women, aware that they needed to be an advocate for themselves.

- [Michelle] And Kelley helped write and pass a law in Rhode Island that requires healthcare facilities that perform mammograms to notify patients if they have dense breasts.

It took effect in 2014.

- Patients receive a letter about their mammogram result, and on that mammogram result letter was an additional paragraph about your breast density, and that if you were dense, that you should be asking your provider for additional imaging such as ultrasound or MRI.

- [Michelle] We asked Care New England for a sample of what a mammography report in Rhode Island looks like for patients with dense breasts.

It includes a notice that, quote, "In some people with dense tissue, other imaging tests, in addition to a mammogram, may help find cancers."

A state law took effect this year that requires insurance companies to cover additional screening needed for patients with dense breasts.

- Before this legislation, my office spent some time working to ensure there would be coverage, so there was unnecessary work effort to ensure that the patient could get the test that she needed, so now hopefully with this legislation, it'll be more streamlined, and really, the woman should be able to advocate for herself.

- [Michelle] Michele Winn says she's learned how important it is to advocate for your health.

Her cancer was found early and she says her prognosis looks good, but she says she did not know she could have benefited from additional screening over the years because she has dense breasts.

- That's why this time when I went in and they said there was something there, I was angry.

I was like, "Why haven't I been getting an ultrasound all this time if my doctor recommends it now?"

There were two schools of thought with whether or not an ultrasound was necessary with every mammogram.

Again, they might find something with every ultrasound and go in unnecessarily, but in this case, I'm glad they did.

- [Michelle] Doctors say ultrasounds and MRIs can lead to false alarms and involve unnecessary biopsies.

It's a concern Kelley heard when his late wife was working to pass the legislation, but he believes it's worth it.

- I grew up around strong women.

My wife was a strong woman.

They wanna know what's going on with their body and their health and it's a lot more anxiety prone to be dealing with surgery and radiation and chemotherapy than just finding out that you maybe should get a little biopsy.

- [Michelle] Kelley has no doubt that Ann has saved lives and continues to make an impact.

- Many people have said to me, "I never knew that I needed these additional procedures."

Couple of people have actually said, "We found a tumor early, stage one."

And if they hadn't found it, it could have developed and metastasized and been a real problem for that person, so there's nothing more rewarding or heartening or a greater tribute to Ann's efforts than those women.

- Now the FDA has followed the lead of Rhode Island and several other states.

Its regulations now require that all mammogram facilities notify women of their breast density.

Up next, we revisit a story that first aired back in January of 2024.

Senior producer Justin Kenny introduced us to a man whose search for redemption began when he took a life.

This is part of our continuing "Turning Point" series.

- My name is Keith Nunes and I'm here to tell you about a second chance that I received that changed my life.

When I was a young man, I came up in the '80s and '90s, the height of the crack epidemic and violence epidemic, inner city poverty, which is a story that's pretty common.

There's plenty of other individuals that came up in them circumstances, but when I was in them circumstances, you know, I didn't necessarily make the right decisions and I started down the road of selling drugs to try to get money and to try to get out of the poverty I was in, and when you're in that world, one thing leads to another.

It's a lot of physical toughness that's portrayed in that world and you feel like you have to defend yourself in that type of environment, so it was those circumstances that led me to being out at a nightclub and getting into an altercation with some older, bigger gentlemen.

One thing led to another and it ended with me wrongly and unnecessarily taking the life of another man.

So at 18 years old, I was arrested and charged with a first degree murder and another attempted murder.

I received a mandatory life sentence for a first degree murder, and an additional 10 years to run consecutive with a life sentence.

I knew that I deserved to be held accountable for my actions and prison should definitely be a part of that with that serious of a crime.

Now, the length of time one should receive for that ultimate act, it's debatable.

I know some people believe that if you take a life wrongly, you should forfeit your life, whether that's with life imprisonment or with death penalty, and I would be hard pressed to argue against that logic, you know, on the one hand.

But on the other hand, having lived it, I know that people come from tough circumstances and at young ages are forced to make tough decisions on what they think will keep them alive or keep them maintaining in a rough environment, and I think people should be given a second chance in many of those circumstances.

(reflective music) Education for me, both informal and formal, was one of the major components of my story of redemption.

I believe my story is a redemption story above all else.

It's a cliche, but when you know better, you do better, and a lot of decisions are made out of ignorance.

So when you learn certain things about yourself, about society, about, you know, moral or ethical matters, you start making different decisions.

(reflective music continues) (reflective music continues) In receiving a life sentence at 18 years old is difficult to describe.

Being released from that situation when you didn't necessarily expect to is equally, if not more difficult to describe.

There's just a flux of different emotions hitting you at once.

You're happy, you're overjoyed, of course, you're excited.

There's a little bit of survivor's guilt there.

There's other individuals that you grew up with in that situation that, you know, they come from the same circumstances as you, made the same decisions for the same reasons in the same type of situation and they're not coming home, they're not getting the opportunity.

You also feel, you know, you're trying to make up for some lost time.

I was 41 when I was released.

As a 40-year-old man, I knew I had to come out here and try to rebuild my life and that was gonna be challenging.

You're a little bit fearful because of that.

You wonder if you're gonna make good or if you're gonna fail and you just feel the seriousness, you feel the gravity of it knowing that, you know, you've been given this second chance at life, literally, and it's on you to make the best of it and to show everybody involved, you know, people that might have been hurt by your bad decisions, and people that were faithful enough to support you through 23 years of incarceration.

You wanna prove to everybody that it wasn't for naught.

Something occurred and you're here to make good, and it could be a little bit of pressure.

(reflective music continues) (reflective music continues) If someone such as myself can be redeemed, if someone such as myself could go from serving a life sentence that began at 18 years old, to applying for a master's degree and helping others, it could be done for anybody, anybody could do it.

First and foremost, it takes a look at self.

It takes some serious introspection.

It takes a willingness and a desire to change.

It's definitely gonna take good people to help you along the way 'cause no one could do it themselves, but the change is possible and it's a very powerful thing when it occurs.

I personally believe that the tougher circumstances that a person comes from, the stronger they are when they make the change, the better position they're in to help others when the change occurs, and it's a very powerful thing.

I want everybody to know that redemption is possible for everybody.

- Finally tonight, the election for Rhode Island's next governor is more than a year away, but this year will shape how that race unfolds.

Michelle and WPRI 12's politics editor Ted Nesi explain what's playing out behind the scenes.

- Ted, welcome back.

It's good to see you.

The latest campaign finance reports were recently filed and it's already prompting all kinds of speculation about the race for governor.

Now, viewers might be saying, "That race is more than a year and a half away.

Why are you talking about that?"

But I know that you feel passionately about why we should be discussing this right now.

- Yeah, and not just my innate love of politics all year round, right Michelle?

- Which you do.

- I do, I do, I'm not gonna deny it, but there's this great concept in political science and it's called the Invisible Primary and it's the idea that in the year before the actual election year, there's all this stuff happening behind the scenes that sets the table for the choices voters eventually face when the big public campaign happens, so that's things like who are influential people in organizations supporting?

What kind of money are the potential candidates raising?

Who decides to get in, who decides to get out?

All those kind of things, so that stuff's happening right now and it's something to watch leading into the election year itself.

- You mentioned fundraising, so let's get into those numbers.

The latest reports show Governor Dan McKee finished last year with about $550,000 in his campaign account.

Meanwhile, his likely challenger, the former CVS Executive Helena Foulkes, had almost twice as much, just over $1 million.

What do those numbers say to you at this point?

- Well, it tells me Foulkes is 90, 95% certain to run again in the Democratic primary and people should remember that Foulkes nearly defeated Dan McKee in the 2022 Democratic primary after a late surge she had after some good debate performances.

I think McKee's team is well aware of that.

They know that certainly if Foulkes is running again, she's gonna have a lot of money and that's something we need to be prepared for, but we've already seen them in a sign, I think of how seriously they're taking her, criticizing her, for example, for that CVS lawsuit the feds have brought over how they handled opioids, and at the same time, Michelle, McKee's team is, there's another thing happening in this invisible primary, which is McKee's team trying to convince insiders in Rhode Island politics that he is definitely running.

There's still this undercurrent of people wondering, you know, is he really going through it?

Is he really gonna seek another term?

And that's part of why you hear the name Joe Shekarchi come up frequently because people think if McKee were to not run, the House Speaker would jump into the race.

- So you mentioned that lawsuit against CVS.

Arguably that is the biggest vulnerability that Helena Foulkes faces.

Now you and your colleague Tim White recently had Attorney General Peter Neronha on Channel 12's "Newsmakers."

We should remind viewers that Neronha is very much an ally of Helena Foulkes, so it was telling what he had to say about her.

Let's take a listen to a portion of that.

- [Ted] Helena Foulkes was the head of CVS retail starting in 2014.

How much responsibility does she bear in your view?

- Yeah, it's hard for me to assign responsibility to individual CVS leadership, but Helena Foulkes has to answer that question.

Look, when I read the federal complaint, as I have, because obviously I'm concerned about those allegations, I think we're gonna have to wait and see how the evidence comes out in that lawsuit, but I think Helena knows she has to answer those questions and convince the public that she did what she could.

- And Ted, if Helena Foulkes' own allies are saying that, I would imagine that's problematic for her this early into the election cycle.

- Yes, I mean, it reinforces why McKee's team is already so early in the process speaking out about to draw attention to that lawsuit.

We also don't know, I mean, the process of that suit is just getting started.

It was only announced in December, so we don't know what documents will come out, emails, will she be deposed?

It could be that it's something she can get through, but I think there's a lot of uncertainty needed there and everyone thinks that it could be a vulnerability.

- Just to go back to Neronha, he is another name that we keep hearing, potentially running for governor, lieutenant governor, he hasn't said.

Yay or nay?

- Yeah, and I think it's fascinating because Neronha, what he really wants, Michelle, is to run for a third term as Attorney General, but he's not allowed to do that because of term limits so I think he's trying to figure out, "Do I wanna go for a different job?"

I think he's basically made clear what he doesn't want is for McKee to be reelected, so if that means supporting Helena Foulkes, he's gonna do that.

If it means supporting someone else, if it means running himself, but I don't see him running in a crowded field with others 'cause he thinks that would help McKee, which is why it's so interesting this idea he might try to run for lieutenant governor against incumbent Democrats.

Sabina Matos may be on a quasi ticket with Helena Foulkes or even maybe Shekarchi, depending on how things roll out, so Neronha is definitely somebody to keep watching.

- And as you mentioned, Neronha is the only state general officer who is barred by term limits from seeking another, from seeking office as attorney general, so that race will be interesting to watch to see who runs for AG.

- Yes, that'll be an open seat for attorney general next year, Michelle, and people should remember, Neronha was such a strong candidate when he first ran in 2018.

He cleared the field, it really wasn't competitive, so this could be the first competitive race for attorney general we have in Rhode Island since all the way back in 2010, so that's another one I'm watching pretty closely.

- A lot to watch.

- I'm excited.

- You sleep.

- Yeah, I don't sleep, I just do politics.

(laughing) - Thanks so much, Ted.

- Thanks, Michelle.

- And that's our broadcast this evening.

Thank you for joining us.

I'm Pamela Watts.

- And I'm Michelle San Miguel.

We'll be back next week with another edition of "Rhode Island PBS Weekly."

Until then, please follow us on Facebook and YouTube and you can visit us online to see all of our stories and past episodes at RIPBS.org/weekly, or listen to our podcast on your favorite streaming platform.

Goodnight.

(bright music) (bright music continues) (bright music continues)