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I Choose...Breast Cancer Awareness · I Choose Me with Jennie Garth

• 0:01
  Speaker 1: You're listening to I Choose Me with Jenny Garth. Hi, everyone,
• 0:09
  Speaker 1: welcome to I Choose Me. This podcast is all about
• 0:12
  Speaker 1: the choices we make and where they lead us. October
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  Speaker 1: is Breast Cancer Awareness Month, and I know that many
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  Speaker 1: of us have been affected by breast cancer, and as women,
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  Speaker 1: I think it's something that has crossed all of our
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  Speaker 1: minds at some point. Breast cancer is something that I
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  Speaker 1: believe every woman thinks about at some point in our life.
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  Speaker 1: I know it has personally touched my life, and because
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  Speaker 1: of Breast Cancer Awareness Month, I wanted to make sure
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  Speaker 1: that we had this conversation because if we can get
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  Speaker 1: one woman listening today to go out and get a
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  Speaker 1: mammogram or ask for a mammogram, then this episode has
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  Speaker 1: served its purpose. My guest today is the medical director
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  Speaker 1: of Surgical Breast Oncology at Christas Saint Vincent in New Mexico.
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  Speaker 1: Please welcome doctor Amani John Bacar to the I Choose
• 1:08
  Speaker 1: Me Podcast.
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  Speaker 2: What a pleasure it is to meet you. It's so
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  Speaker 2: nice to meet you too. Who knew we'd be here together? Yeah?
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  Speaker 3: I never imagined I would meet Jenny Gorth ever, so
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  Speaker 3: that is amazing.
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  Speaker 1: Oh my gosh, it's so funny that you say that
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  Speaker 1: you'd never imagine that we would meet. But here we are,
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  Speaker 1: and we're talking about something so so important, and I'm
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  Speaker 1: really grateful that you're here because we're going to just
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  Speaker 1: break all of these myths down. We want to know
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  Speaker 1: all the details, all the things that we need to know.
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  Speaker 1: I think a lot of women don't get mammograms because
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  Speaker 1: maybe they think they're too young, or they're concerned that
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  Speaker 1: it's going to hurt, or they just don't want to
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  Speaker 1: think about it. But for someone listening today who's never
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  Speaker 1: had a mammogram before, let's talk about the process. I mean,
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  Speaker 1: I've had many mammograms at my age, I can I
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  Speaker 1: can speak to the level of uncomfortability. But from your perspective,
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  Speaker 1: does that scare women away?
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  Speaker 2: And what is it like?
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  Speaker 3: So full disclosure, I'm thirty seven, so I haven't yet
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  Speaker 3: gotten a mammogram myself.
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  Speaker 1: Amazing to know. But wait, wait, that brings me to
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  Speaker 1: this question. What is the age where where women I've
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  Speaker 1: forgotten it's been so long.
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  Speaker 2: It's forty.
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  Speaker 3: It's forty, and so for someone who is of average risk,
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  Speaker 3: forty is the age that's when you should definitely start
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  Speaker 3: getting your mammograms. Someone who is high risk, who has
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  Speaker 3: a high rist family history should come see someone like me,
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  Speaker 3: a breast specialist and get established in a high risk
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  Speaker 3: breast clinic and potentially start imaging sooner in the twenties
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  Speaker 3: even or thirties.
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  Speaker 1: Okay, that's funny because I was just talking to someone
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  Speaker 1: who is thirty seven today and she said she hadn't
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  Speaker 1: gotten a mammogram, and I was concerned. But now I
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  Speaker 1: know that we don't start this process until we're forty,
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  Speaker 1: so that is already I've learned something, and I'm very,
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  Speaker 1: very grateful. But I can sort of speak to the
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  Speaker 1: comfortability of it. I mean, it's not like I want
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  Speaker 1: to go get a mammogram. It's not leasant, but it's
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  Speaker 1: not the worst thing ever either, And it's so quick
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  Speaker 1: like when they do, yeah, they do put your boob
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  Speaker 1: in a machine and flatten it down like a pancake.
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  Speaker 2: Yep.
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  Speaker 1: But it's momentary, and we women have endured way worse.
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  Speaker 1: So even if you're uncomfortable for you know, five seconds
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  Speaker 1: while they're taking the image, it's invaluable the information that
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  Speaker 1: you are going to get and the peace of mind
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  Speaker 1: that you're hopefully going to get knowing that you're all clear. Okay,
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  Speaker 1: so we learned already something super super big. How long
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  Speaker 1: does it take to get results? Like for in my experience,
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  Speaker 1: it's taken about a week maybe.
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  Speaker 2: Yeah, usually a week.
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  Speaker 3: So I'm here in San Fe, New Mexico, and oftentimes
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  Speaker 3: if patients need a biopsy, the radiologists or one of
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  Speaker 3: the texts will tell them right then and there, like, hey,
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  Speaker 3: we see something on your mammogram, you need a biopsy,
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  Speaker 3: or hey see something on your mammogram, you need another mammogram,
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  Speaker 3: or maybe an ultrasound, And so usually the.
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  Speaker 2: Turnaround is pretty quick.
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  Speaker 3: If it's a normal result, then they may get like
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  Speaker 3: a letter or a notification through their phones, you know,
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  Speaker 3: their chart on their phone that everything's normal, within like a.
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  Speaker 2: Week or so. Yeah.
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  Speaker 1: I've never had that moment where they say, oh, yeah,
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  Speaker 1: we need to take this again, or I need to
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  Speaker 1: call somebody and have them come look at this.
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  Speaker 2: Well that's great, that's awesome news. Yeah, that would be
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  Speaker 2: a little scarier.
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  Speaker 1: I want to talk to you about the b r
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  Speaker 1: C A one and b r C A two genes.
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  Speaker 2: Yeah, how do we test for those?
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  Speaker 3: That is a great question, because that's something that I'm
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  Speaker 3: extremely passionate about.
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  Speaker 2: Good.
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  Speaker 3: So we have a blood test that looks at eighty
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  Speaker 3: one different genes BRACO one in two, as well as
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  Speaker 3: other genes like CHECK two, PALB two, other genes that
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  Speaker 3: really increase the risk for breast cancer, but also other
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  Speaker 3: types of cancers like ovarian cancer, pancreatic cancer, prostate cancer,
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  Speaker 3: colon cancer. And that's a blood test that can only
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  Speaker 3: be ordered by a physician. It's not the same thing
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  Speaker 3: as a medical you know, twenty three and me or
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  Speaker 3: something like that that has to be ordered by oftentimes
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  Speaker 3: a genetic counselor, or it can be ordered by an
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  Speaker 3: oncologist like myself, a surgical oncologist or a medical oncologist.
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  Speaker 3: And I see patients for that in the office all
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  Speaker 3: the time. And people who have a high risk family
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  Speaker 3: history should talk to their primary care doctors about it
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  Speaker 3: and say, hey, I have a high risk family history,
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  Speaker 3: I have someone in my family diagnosed with none of
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  Speaker 3: those cancers, especially one of those cancers under the age
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  Speaker 3: of fifty. Where do I go next for testing? And
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  Speaker 3: it may be different in every community and a lot
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  Speaker 3: of places. They might say you need to see a
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  Speaker 3: genetic counselor. But here in Santa Fe, I do a
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  Speaker 3: lot of that and I moved to Santa Fe about
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  Speaker 3: nine months ago and I've probably done genetic testing for
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  Speaker 3: over one hundred and twenty patients so far.
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  Speaker 2: Amazing. Yeah, Yeah, I think it's so important because you
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  Speaker 2: need to know what your risks are. You need to
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  Speaker 2: know what you're what you're starting with, I.
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  Speaker 3: Mean exactly, and what you're inheriting from people.
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  Speaker 2: You know.
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  Speaker 3: I spoke to a patient in the clinic today who
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  Speaker 3: didn't really have a very convincing family history but then
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  Speaker 3: ended up having a Braco one mutation, and so it's
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  Speaker 3: a scenario where we can't guess, and so the only
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  Speaker 3: way to know for sure is to do the genetic testing.
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  Speaker 3: And it does get approved by insurance for people who
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  Speaker 3: meet the NCCN criteria to get tested, and so I
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  Speaker 3: don't see a lot of problems with insurance coverage not
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  Speaker 3: being there for that kind of testing. And if you
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  Speaker 3: do find out you have a mutation like Braco one
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  Speaker 3: or two, then you could be eligible for things like
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  Speaker 3: breast MRIs to do more screening and just to make
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  Speaker 3: sure that if you do develop something that we do
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  Speaker 3: in fact, catch it early.
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  Speaker 2: Oh thank god, the insurance is taking care of us
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  Speaker 2: in this respect. Okay, So, but if you test positive.
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  Speaker 1: For the BRCA gene, right, what does that mean in
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  Speaker 1: terms of your risk of getting breast cancer?
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  Speaker 3: So that risk depends on which Braco gene that you inherit,
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  Speaker 3: and kind of also on your family history. But in general,
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  Speaker 3: for the Braco one and two genes, the risk for
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  Speaker 3: a future breast cancer it can be anywhere between forty
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  Speaker 3: and eighty percent. And so that's a pretty high level
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  Speaker 3: of risk. And as you know, you probably know Angelina
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  Speaker 3: and Joelee had a braco one mutation as well. And
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  Speaker 3: sometimes people do choose to remove both breasts prophylactically or
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  Speaker 3: before they develop any kind of cancer. Sometimes they choose
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  Speaker 3: to remove the ovaries for similar reasons, to reduce that
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  Speaker 3: risk as much as possible. And like you said, those
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  Speaker 3: options are only really available to you if you know
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  Speaker 3: that you have one of those mutations, if you know
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  Speaker 3: your risk.
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  Speaker 2: I mean, that's the key. Education. Awareness, advocacy for yourself
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  Speaker 2: is the.
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  Speaker 3: Key, absolutely one hundred percent, because it's it's hard enough
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  Speaker 3: as women right to get get our complaints taken seriously
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  Speaker 3: and to get heard, and you know, going back to
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  Speaker 3: your earlier point about mammograms, I know that they're uncomfortable
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  Speaker 3: and for patients who have had medical trauma, they may
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  Speaker 3: even be traumatic. And if that was the way that
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  Speaker 3: we screened for testicular cancer for men, we would have
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  Speaker 3: something better by now.
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  Speaker 4: Right, Oh right, that's a good point, it is, And
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  Speaker 4: so we you know, we have this kind of squishing
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  Speaker 4: the breast, sort of archaic technology.
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  Speaker 3: We have mammograms because it's something that mostly women need
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  Speaker 3: to get done and people women are very strong, and
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  Speaker 3: so we sort of just we deal with it.
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  Speaker 1: Do you think there's anything and yeah, do you think
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  Speaker 1: there's anything in the pipeline of experience better for us?
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  Speaker 2: Absolutely?
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  Speaker 3: So I can see that there are some studies being
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  Speaker 3: done of some new technologies that can work as well
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  Speaker 3: as mammograms, and then also of things that are a
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  Speaker 3: little bit more curved, like the human breast, so it's
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  Speaker 3: a little less of the squishing involved. And so some
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  Speaker 3: of those technologies are being trialed right now and I
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  Speaker 3: think are going to come out in the future. Not
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  Speaker 3: quite there yet. So right now, the a mammogram is
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  Speaker 3: still the standard of care.
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  Speaker 2: And it is uncomfortable, you know. It sucks.
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  Speaker 3: It's not a fun thing to do. No one looks
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  Speaker 3: forward to it, that's for sure. But you're right, like
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  Speaker 3: the information it gives you in just like a few
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  Speaker 3: minutes of discomfort or even pain is so invaluable. And
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  Speaker 3: it's peace of mind or figuring out what's next and
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  Speaker 3: if you need some kind of surgery.
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  Speaker 2: What you need to do, what you need action you
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  Speaker 2: need to take. I just want to be clear.
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  Speaker 1: If you test negative for the BRCI gene, does that
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  Speaker 1: mean that you won't get breast cancer?
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  Speaker 2: So that's a great question.
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  Speaker 3: It It doesn't mean that you'll never get a future
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  Speaker 3: breast cancer. It just means that your risk is average,
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  Speaker 3: like along with the rest of the population. It's not
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  Speaker 3: elevated because of a bad gene that you inherited from
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  Speaker 3: one of your parents. And something else that I hear
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  Speaker 3: oftentimes about the BRACA mutation is that like women are
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  Speaker 3: the only ones who can inherit it, and that is
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  Speaker 3: totally not true.
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  Speaker 2: You can get that mutation from your dad as well. Really,
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  Speaker 2: what happens with men when they have it? Same thing men,
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  Speaker 2: So the men can get breast cancer. Actually, BRACA one
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  Speaker 2: does increase the risk for male breast cancer. For men,
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  Speaker 2: we worry a little bit more about aggressive prostate cancers.
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  Speaker 2: Prostate cancer is typically not a very aggressive thing in men,
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  Speaker 2: but in people who are Braca mutation carriers it can be.
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  Speaker 3: And we also still worry about the pancreas as well,
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  Speaker 3: and as well as like skin cancers like melanomas, and
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  Speaker 3: so men who have the Braca mutation also need to
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  Speaker 3: be watched carefully in you know, cancer specific screening clinics,
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  Speaker 3: so that way an oncologist can keep a closer eye
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  Speaker 3: on them as well.
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  Speaker 1: So you heard it here. Men and women are both
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  Speaker 1: affected by the barca meat and need both men and
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  Speaker 1: women should get tested.
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  Speaker 2: Absolutely. Wow, I didn't know that. Thank you.
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  Speaker 1: I'm going to go to a question from one of
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  Speaker 1: our listeners. This is from re West five to two four.
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  Speaker 1: Why has there been such a huge increase in breast
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  Speaker 1: cancer cases in the past twenty or so years.
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  Speaker 3: That is a great question that I get all the
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  Speaker 3: time and clinic and I will say, there's a lot
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  Speaker 3: of different resource that's being done about it. Some of
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  Speaker 3: it may relate to environmental exposure, some of it may
• 11:40
  Speaker 3: relate to microplastics, some of it may relate to more
• 11:43
  Speaker 3: processed food because it's not just breast cancer that we're seeing.
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  Speaker 3: We're seeing it in like colon cancer as well.
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  Speaker 2: We don't have a really.
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  Speaker 3: Great answer for it right now. We're still trying to
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  Speaker 3: figure that out.
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  Speaker 1: Yeah, I mean, I've heard a lot of discussion about
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  Speaker 1: microplastics lately, and then you start thinking about moment to
• 12:02
  Speaker 1: moment in your life and how much you're exposed to plastics,
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  Speaker 1: like all day long. I just literally yesterday throughout my
• 12:10
  Speaker 1: plastic cutting boards that I've had for a minute because
• 12:13
  Speaker 1: I saw that when you chop into it, it releases
• 12:16
  Speaker 1: little microplastics and then you cook that up with your
• 12:18
  Speaker 1: sautee vegetables.
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  Speaker 3: Yeah, it's I mean, I think the research on the
• 12:22
  Speaker 3: microplastics is pretty compelling, and there's a lot.
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  Speaker 2: Of things that we need to do to be.
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  Speaker 3: A little bit more environmentally sound that I think will
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  Speaker 3: help our health as humans, not just with not developing
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  Speaker 3: cancer and especially cancer at younger ages, but also in
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  Speaker 3: a lot of other disorders as well. And so I
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  Speaker 3: think that research is going to pan out and show
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  Speaker 3: that being climate conscious will help our health in the
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  Speaker 3: long run.
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  Speaker 1: I just heard Katie Couric talking about breast density I
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  Speaker 1: have a question from a listener here, Ashley Holliback. Where
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  Speaker 1: can women get an ultrasound if they have dense breaths,
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  Speaker 1: since you now need one when a mammogram isn't enough.
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  Speaker 3: So this is the question I get a lot in
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  Speaker 3: the clinic now, as I'm sure you've heard, when you
• 13:09
  Speaker 3: get your mammogram results, they have to report on how
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  Speaker 3: dense your breasts are, and that just happened in the
• 13:15
  Speaker 3: last month or so.
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  Speaker 1: Wow.
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  Speaker 3: So people who do have dense breasts or category C
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  Speaker 3: or D breasts, they are recommended to also have an ultrasound.
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  Speaker 3: Sometimes they may even be recommended to have an MRI
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  Speaker 3: for screening. Usually the same mammography place that does the
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  Speaker 3: mammogram can also do an ultrasound. It just depends on
• 13:37
  Speaker 3: your regional location on if they can also do the MRI.
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  Speaker 3: The tricky part is getting the insurance to approve it,
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  Speaker 3: because insurances haven't one hundred percent caught up with those
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  Speaker 3: recommendations yet, and so a lot of times I see
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  Speaker 3: patients like this who do have dense breasts, and then
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  Speaker 3: I order the ultrasound with the mammogram, and I order
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  Speaker 3: both of them going forward, so that way they can
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  Speaker 3: just get both done in one visit, but typically the
• 14:02
  Speaker 3: same place where you got the mammogram can do the ultrasound.
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  Speaker 3: You may still need to have a doctor like your
• 14:08
  Speaker 3: primary care doctor or your obi juyan order it and
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  Speaker 3: write that dense breast is the reason.
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  Speaker 1: Why I have a question going back to the age
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  Speaker 1: that we should start getting mammograms. You said it was forty,
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  Speaker 1: but what if breast cancer runs in your family, maybe
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  Speaker 1: it runs in both sides of your family, should you
• 14:33
  Speaker 1: start getting screened earlier?
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  Speaker 2: Yeah, absolutely so.
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  Speaker 3: I have seen many patients who have a risk of
• 14:42
  Speaker 3: breast cancer because they have you know, their mom, for example,
• 14:45
  Speaker 3: passed away of breast cancer when she was thirty six,
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  Speaker 3: So that kind of patient doesn't need to wait until
• 14:52
  Speaker 3: they're forty to start getting imaging. Usually we don't start
• 14:56
  Speaker 3: doing breast MRIs for someone who's higher risked for breast
• 15:00
  Speaker 3: cancer until the age of twenty five. That's the earliest
• 15:03
  Speaker 3: we typically do those, but sometimes we'll do a clinical
• 15:07
  Speaker 3: breast exam with an oncologist like myself earlier than that,
• 15:12
  Speaker 3: depending on what the family history is. So if you
• 15:16
  Speaker 3: do have young people in your family in their thirties
• 15:19
  Speaker 3: and forties who have been diagnosed with breast cancer. My
• 15:22
  Speaker 3: recommendation is to check out a high risk breast clinic
• 15:26
  Speaker 3: in your area and talk to them about when you
• 15:29
  Speaker 3: should start that screening, because you're right, Jenny, it could
• 15:32
  Speaker 3: be earlier than forty, and waiting until forty may be
• 15:35
  Speaker 3: too late for some people.
• 15:38
  Speaker 1: Yeah, I mean they say that with heart disease too.
• 15:41
  Speaker 1: If you're genetically dispositioned to it correct, you need to
• 15:45
  Speaker 1: start having checks more frequently. Earlier on you said you
• 15:50
  Speaker 1: said twenty five was the age that you usually start.
• 15:54
  Speaker 3: Yeah, so twenty five is the earliest recommendation I've seen
• 15:57
  Speaker 3: for any kind of breast imaging, even for some one
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  Speaker 3: with a known BRACA mutation. Usually they'll say start MRIs
• 16:04
  Speaker 3: at twenty five, no earlier than twenty five.
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  Speaker 2: Rarely. I would say.
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  Speaker 3: There probably are people out there who have had mothers
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  Speaker 3: and sisters who have had breast cancer in their twenties,
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  Speaker 3: and for that, I think that we would have to
• 16:18
  Speaker 3: take on a case by case basis.
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  Speaker 1: Yeah, I mean, the statistics are crazy that, you know,
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  Speaker 1: breast cancer is affecting women much younger today.
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  Speaker 3: It is, and it is too absolutely and it's it
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  Speaker 3: is surprising, you know, the youngest patient that I've heard of,
• 16:39
  Speaker 3: not that I've personally seen, but that one of my
• 16:41
  Speaker 3: colleagues has seen with breast cancer was nineteen. Yeah, and
• 16:48
  Speaker 3: it's especially hard at that age because you know, you
• 16:51
  Speaker 3: go and see a doctor at nineteen, you may not
• 16:54
  Speaker 3: have a primary care doctor. So you go see someone
• 16:56
  Speaker 3: at an urgent care and they say you're too young
• 16:58
  Speaker 3: for breast cancer.
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  Speaker 2: This is a cyst.
• 17:00
  Speaker 3: And so my recommendation for anyone, really any age, if
• 17:05
  Speaker 3: you feel a lump in the breast, no one's physical
• 17:08
  Speaker 3: exam is good enough. I'm a surgical oncologist who primarily
• 17:13
  Speaker 3: examines patients with breast cancer all day long, every day,
• 17:16
  Speaker 3: and even I can't tell the difference between something that
• 17:19
  Speaker 3: is a cyst or something that's a cancer, or something
• 17:21
  Speaker 3: that's some other type of lump in the breast. And
• 17:23
  Speaker 3: so no doctor, no nurse practitioner, no PA, no one's
• 17:28
  Speaker 3: physical exam is enough. So if you feel a lump,
• 17:31
  Speaker 3: ask them to order some kind of imaging, a mammogram.
• 17:34
  Speaker 3: If you're too young for a mammogram, typically they won't
• 17:36
  Speaker 3: do a mammogram for somebody who's under thirty, ask for
• 17:40
  Speaker 3: an ultrasound, but some sort of breast imaging is needed
• 17:43
  Speaker 3: to look at that lump in more detail.
• 17:46
  Speaker 2: Don't let anyone.
• 17:47
  Speaker 3: Reassure you that by physical exam a lump is nothing.
• 17:50
  Speaker 1: Absolutely, such good advice, Such good advice. And listen to
• 17:55
  Speaker 1: your instincts too, I.
• 17:57
  Speaker 3: Mean absolutely absolutely. And I see it with my young patients.
• 18:01
  Speaker 3: I see this really awesome where they are bounced around,
• 18:05
  Speaker 3: you know, they see someone at some urgent care. Then
• 18:08
  Speaker 3: they go somewhere else and that person says, you're too
• 18:11
  Speaker 3: young for breast cancer. This might be an infection, and
• 18:13
  Speaker 3: they put them on some me inabiotics. Then this whole
• 18:15
  Speaker 3: time things are progressing, the lump is growing, and then
• 18:18
  Speaker 3: they finally get established with a primary care doctor and
• 18:21
  Speaker 3: the primary care doctor says, oh, and then they get
• 18:24
  Speaker 3: sent to me.
• 18:27
  Speaker 1: If you have no history with family breast cancer none,
• 18:34
  Speaker 1: m h. I have very very little family history of
• 18:38
  Speaker 1: breast cancer. And I don't remember what age I must
• 18:40
  Speaker 1: I may I must have been forty when they ordered
• 18:43
  Speaker 1: me to get my first manmigram. And you're saying that's
• 18:46
  Speaker 1: the age if you if you're not worried that you
• 18:49
  Speaker 1: have in your family.
• 18:50
  Speaker 2: Yeah, forty is the age.
• 18:52
  Speaker 3: And they there were kind of differing recommendations on that
• 18:55
  Speaker 3: as well. Like one governing body in the US said fifty,
• 18:59
  Speaker 3: and one said forty. And now everybody says forty because
• 19:02
  Speaker 3: we are seeing, as you commented, the incidents in young
• 19:05
  Speaker 3: women rising, and so it's really worth it to start
• 19:09
  Speaker 3: it at forty. It's a pretty safe test to do
• 19:12
  Speaker 3: very very very small radiation dose that is totally worth
• 19:16
  Speaker 3: it for the benefit.
• 19:16
  Speaker 1: Yeah, I was going to ask you that, Like what
• 19:18
  Speaker 1: I get concerned about my exposure to so much radiation.
• 19:23
  Speaker 1: One because I travel a lot, so I always get
• 19:25
  Speaker 1: worried going through those machines.
• 19:28
  Speaker 2: Yeah, And everybody says, oh, it's.
• 19:30
  Speaker 1: Fine and don't worry, but I do worry. And so
• 19:34
  Speaker 1: getting some sort of a screening can can cause concern
• 19:38
  Speaker 1: for people that they're going to get too much radiation
• 19:41
  Speaker 1: for sure.
• 19:42
  Speaker 3: And I get told that often. You know, people are like,
• 19:44
  Speaker 3: what about the radiation and risk with a mammogram. So
• 19:48
  Speaker 3: here in Santa Fe, New Mexico, we are at seven
• 19:51
  Speaker 3: thousand feet, so we're at pretty significant We have a
• 19:54
  Speaker 3: higher radiation risk anyways, because we're a little bit closer
• 19:57
  Speaker 3: to the sun.
• 19:58
  Speaker 2: Okay, But in.
• 20:00
  Speaker 3: Order to actually see a problem from the radiation that
• 20:04
  Speaker 3: you get from doing a mammogram, you'd have to get
• 20:07
  Speaker 3: a mammogram every single day for an entire really actually
• 20:11
  Speaker 3: every day for the rest of your life, and then
• 20:13
  Speaker 3: you might might have a slight increase in the risk
• 20:17
  Speaker 3: of developing a future cancer due to that radiation. But
• 20:21
  Speaker 3: as long as you're not getting a mammogram every day,
• 20:23
  Speaker 3: which no one is, it's pretty safe. The scanners in
• 20:27
  Speaker 3: the airport are even less radiation than a mammogram, so
• 20:30
  Speaker 3: totally safe.
• 20:31
  Speaker 2: I mean, okay, thank you, you're making totally safe like those.
• 20:35
  Speaker 3: I mean you could get like probably I would say
• 20:39
  Speaker 3: you could get like easily ten thousand of those, and
• 20:41
  Speaker 3: you'd be fine in terms of your annual radiation dose.
• 20:46
  Speaker 3: If you travel like thirteen thousand miles, you know, you
• 20:49
  Speaker 3: travel from la to Europe and back in a year,
• 20:54
  Speaker 3: then that's about the same amount of radiation that you're
• 20:56
  Speaker 3: getting from a mammogram, and mammogram is totally If you
• 21:01
  Speaker 3: live at sea level, the amount of radiation you get
• 21:03
  Speaker 3: from a mammogram is about the same amount you would
• 21:06
  Speaker 3: get from seven weeks of just background radiation just living
• 21:09
  Speaker 3: at sea level, So totally totally safe. Not really significantly
• 21:14
  Speaker 3: increasing your radiation exposure and worth doing despite that risk.
• 21:20
  Speaker 1: Yeah, what you're saying about this, what'd you just call
• 21:24
  Speaker 1: it background expiation?
• 21:26
  Speaker 2: Yeah, background exposure? Yeah, that is scary.
• 21:30
  Speaker 3: Well, it's just you know, it's we all get some
• 21:32
  Speaker 3: radiation from the sun, right if we're living at high
• 21:35
  Speaker 3: elevation like I am, or if we're living at sea level,
• 21:39
  Speaker 3: we also get radiation from minerals in our own body
• 21:43
  Speaker 3: breaking down. And that's totally normal, and Okay, it's a
• 21:47
  Speaker 3: really small dose. And so there's actually the EPA, the
• 21:52
  Speaker 3: Environmental Protection Agency, has a like radiation dose calculator that
• 21:56
  Speaker 3: you can use, which I recently used because I was
• 21:59
  Speaker 3: making a TikTok on the radiation exposure you get from
• 22:02
  Speaker 3: a mammogram, and you can calculate like how much radiation
• 22:06
  Speaker 3: exposure do you get in your home based on like
• 22:09
  Speaker 3: where you live and how many miles you travel a
• 22:11
  Speaker 3: year if you're an avid traveler, and if you have
• 22:14
  Speaker 3: veneers and if you have radon in your home and
• 22:17
  Speaker 3: things like that, and overall it's the amount of radiation
• 22:21
  Speaker 3: you get.
• 22:22
  Speaker 2: There are different sources.
• 22:23
  Speaker 3: You can get it from your right, but it's a really,
• 22:26
  Speaker 3: really really low dose that is not going to increase
• 22:29
  Speaker 3: anyone's risk of having problems from the radiation at all.
• 22:33
  Speaker 1: I recently decided that I didn't want any of my
• 22:37
  Speaker 1: do we have a microwave right that is under the
• 22:41
  Speaker 1: cab counter level, it's down below like right where ovaries are,
• 22:47
  Speaker 1: And so I recently put a big sign up on
• 22:50
  Speaker 1: the floor, nobody stand right here when the microwave is on.
• 22:54
  Speaker 2: Yeah, that's I mean, that's fair.
• 22:56
  Speaker 3: Although I will say in that calculator, how close you
• 22:59
  Speaker 3: stand to your micro is not in there.
• 23:01
  Speaker 2: So oh my gosh, I'm going crazy. I'm trying all
• 23:05
  Speaker 2: the things. Wow.
• 23:07
  Speaker 1: Another question I have for the women who are giving
• 23:09
  Speaker 1: them mammograms, the technicians, I know they go behind that
• 23:12
  Speaker 1: little wall, but they're still right there all day long,
• 23:16
  Speaker 1: every single day.
• 23:17
  Speaker 2: That is a great question too.
• 23:19
  Speaker 3: So they typically for those ladies, they have like it's
• 23:23
  Speaker 3: a little badge, a thing on their badge, and it's
• 23:26
  Speaker 3: something that their ID hangs from.
• 23:29
  Speaker 2: And what that does.
• 23:30
  Speaker 3: Is it actually like kind of measures the radiation dose
• 23:33
  Speaker 3: that they get exposed to. And that's something that they
• 23:36
  Speaker 3: have to like turn in and it gets counted so
• 23:39
  Speaker 3: that way we can.
• 23:40
  Speaker 2: Be sure that their radiation exposure is safe.
• 23:43
  Speaker 3: And then you know, any kind of job in the
• 23:45
  Speaker 3: hospital where you're giving X rays of any kind, they
• 23:48
  Speaker 3: wear those little badges that will actually help calculate that
• 23:52
  Speaker 3: dose and make sure that no one's getting to a
• 23:53
  Speaker 3: point where you know, they're getting too much radiation exposure.
• 23:58
  Speaker 3: And so it's that's pretty tight regulated by like hospital,
• 24:01
  Speaker 3: by memorgraphy centers, and so they are totally safe too,
• 24:04
  Speaker 3: don't worry.
• 24:05
  Speaker 1: Yeah, that's that's good to know. I was worried what
• 24:09
  Speaker 1: you were saying before. We were talking about before about
• 24:11
  Speaker 1: the the age being much younger. Now, Yeah, that women
• 24:16
  Speaker 1: are discovering that they have is so alarming. But and
• 24:19
  Speaker 1: in your right, they get shuffled around and they get discredited,
• 24:23
  Speaker 1: and they people don't believe them or want to do anything.
• 24:28
  Speaker 1: How and you said that advocating for yourself, But what
• 24:31
  Speaker 1: if you're a young girl and you're in you know,
• 24:35
  Speaker 1: wanting to know more about your health, even if you
• 24:39
  Speaker 1: you know, don't have breast cancer in your family genes
• 24:43
  Speaker 1: that you know of, how do I get my voice
• 24:46
  Speaker 1: heard as a young woman in a doctor's office?
• 24:49
  Speaker 2: Also an excellent question.
• 24:51
  Speaker 3: So it is harder for women, right, the things that
• 24:56
  Speaker 3: get diagnosed mostly in women, get longer to be diagnosed
• 25:02
  Speaker 3: because they get diagnosed mostly in women. So things like
• 25:05
  Speaker 3: endometriosis that I'm sure you've heard of, it's basically can
• 25:10
  Speaker 3: cause pretty debilitating pain, abdominal pain. It takes an average
• 25:13
  Speaker 3: of eight years to get diagnosed in women. Why because
• 25:19
  Speaker 3: people will discredit women like what you're saying. They'll say, oh,
• 25:22
  Speaker 3: you're just anxious. Oh that pain is just in your head,
• 25:25
  Speaker 3: and that we see it all the time with many
• 25:29
  Speaker 3: different diagnoses. Breast pain, that's one that I get asked
• 25:32
  Speaker 3: about a lot as well. We don't have great answers
• 25:34
  Speaker 3: for what causes breath pain or how to stop it
• 25:37
  Speaker 3: because it's something that almost exclusively impacts women, and seventy
• 25:42
  Speaker 3: percent of women in their lifetime will experience breast pain
• 25:45
  Speaker 3: at some point.
• 25:46
  Speaker 2: So it's hard.
• 25:48
  Speaker 3: It's a really challenging thing. Even for me as a
• 25:51
  Speaker 3: female surgeon, going to the doctor and having the doctor
• 25:55
  Speaker 3: listen to my concerns as a healthcare professional can be challenging.
• 25:59
  Speaker 2: So I think it goes.
• 26:00
  Speaker 3: Back to what you said earlier, Jenny, trust your gut,
• 26:03
  Speaker 3: listen to your instincts. If you feel like something's wrong
• 26:06
  Speaker 3: and no one's listening to you, then find another physician
• 26:09
  Speaker 3: that will and right, And studies have shown that like
• 26:14
  Speaker 3: patients who are women tend to be heard better by
• 26:18
  Speaker 3: physicians who are women. So finding a physician who is
• 26:21
  Speaker 3: a woman who is going to take the time and
• 26:23
  Speaker 3: listen to you. Studies have also shown that women physicians
• 26:26
  Speaker 3: spend longer listening to their patients and are more empathetic.
• 26:29
  Speaker 3: I think that will make a huge difference as well,
• 26:31
  Speaker 3: if you're able to choose to see women physicians, because
• 26:35
  Speaker 3: it will help you be heard.
• 26:37
  Speaker 2: It will also help us be heard.
• 26:38
  Speaker 1: Oh my gosh, I know, no one really ever talked
• 26:41
  Speaker 1: about that, about choosing a female physician that you know,
• 26:46
  Speaker 1: that wasn't really a conversation.
• 26:47
  Speaker 2: It was just go to the doctor, and it was
• 26:49
  Speaker 2: usually a man.
• 26:50
  Speaker 1: And yeah, it was even more uncomfortable because it was
• 26:54
  Speaker 1: a man and you're talking about sensitive things and it
• 26:57
  Speaker 1: exactly what it feels.
• 26:58
  Speaker 2: Right.
• 27:00
  Speaker 3: Nowadays, we have those options though, because like more than
• 27:03
  Speaker 3: fifty percent of medical students are women, and so there
• 27:06
  Speaker 3: are more and more women in a lot of different specialties.
• 27:10
  Speaker 3: Now surgery is not one of them. Still overwhelming majority
• 27:13
  Speaker 3: are men, but more there are more coming up through
• 27:17
  Speaker 3: the ranks now, and so I think we'll see those
• 27:20
  Speaker 3: those numbers shift soon. And so choosing women physicians or
• 27:24
  Speaker 3: you know, women wear nurse practitioners. Women who are PAS,
• 27:28
  Speaker 3: like women are more likely to listen to other women
• 27:31
  Speaker 3: when it comes to symptoms like a lump in the
• 27:34
  Speaker 3: breast that just won't go away.
• 27:38
  Speaker 1: That's also very valuable information. So how does eating a
• 27:41
  Speaker 1: healthy diet and not drinking alcohol and exercising, does that
• 27:47
  Speaker 1: actually decrease the risks of getting breast cancer? Because we
• 27:51
  Speaker 1: talk so much about being healthy and eating healthy and
• 27:54
  Speaker 1: getting exercise, and I know that all of those things
• 27:58
  Speaker 1: directly affect heart disease, But what about breast cancer.
• 28:04
  Speaker 2: It's kind of a mixed bag.
• 28:06
  Speaker 3: So have I seen patients who follow a you know, vegan,
• 28:12
  Speaker 3: plant based, completely organic diet, exercise every day? You know,
• 28:16
  Speaker 3: I'm here in New Mexico, as I mentioned, so everyone
• 28:18
  Speaker 3: here is in amazing shape because they live at high
• 28:21
  Speaker 3: elevation and they're also very outdoorsy. Have I seen lots
• 28:24
  Speaker 3: of those patients who do end up with a breast cancer?
• 28:26
  Speaker 2: Yes, I have.
• 28:28
  Speaker 3: And I've also seen patients who, you know, who didn't
• 28:33
  Speaker 3: live a healthy lifestyle at all, who also end up
• 28:36
  Speaker 3: with breast cancer. I think living a healthy lifestyle is
• 28:39
  Speaker 3: important for as you mentioned, things like heart disease and
• 28:42
  Speaker 3: not having a heart attack or a stroke. I think
• 28:44
  Speaker 3: it can slightly decrease the risk of a future breast cancer.
• 28:48
  Speaker 3: But there's no one diet that can prevent breast cancer,
• 28:52
  Speaker 3: because if there was, then we would all be on
• 28:54
  Speaker 3: it right and we would have studies that definitively show
• 28:57
  Speaker 3: beyond this diet and you'll never develop breast cancer or
• 29:00
  Speaker 3: some other type of cancer.
• 29:01
  Speaker 2: And I think moderation is really important.
• 29:04
  Speaker 3: You know, not drinking alcohol or drinking it in small
• 29:07
  Speaker 3: quantities when you do is important.
• 29:09
  Speaker 1: Yeah, I was going to ask you about alcohol, like,
• 29:11
  Speaker 1: does drinking alcohol put you in a higher risk?
• 29:14
  Speaker 3: Lightly but not a lot. You know, it's I think
• 29:16
  Speaker 3: it puts you at higher risk for things like pancreatic cancer,
• 29:19
  Speaker 3: for example, but not as much for breast So I
• 29:22
  Speaker 3: mean that's not saying that you go out and drink
• 29:24
  Speaker 3: whatever you want. I think it's moderation is key to
• 29:28
  Speaker 3: having a good long life.
• 29:31
  Speaker 2: With a good quality of life.
• 29:33
  Speaker 3: But I don't think that, you know, living the healthiest
• 29:36
  Speaker 3: lifestyle is something that can definitively prevent breast cancer. And
• 29:40
  Speaker 3: so something I talk about often with my patients and
• 29:43
  Speaker 3: the clinic is sugar. You know, I hear the myth
• 29:46
  Speaker 3: all the time that sugar feeds cancer, and so some
• 29:49
  Speaker 3: multile get diagnosed.
• 29:50
  Speaker 2: Oh it's a myth.
• 29:51
  Speaker 3: Yeah, there's no definitive study that, like, you know, if
• 29:54
  Speaker 3: you cut out sugar, it will help diminish the size
• 29:57
  Speaker 3: of your breast cancer, help shrink it, help treat it,
• 30:00
  Speaker 3: anything like that.
• 30:00
  Speaker 2: And so there's some studies that have been.
• 30:03
  Speaker 3: Done that will show some kind of association, but it's
• 30:06
  Speaker 3: not a very strong one. And so I see patients
• 30:09
  Speaker 3: all the time that have been diagnosed with a breast
• 30:11
  Speaker 3: cancer and their family members will say, well, you have
• 30:13
  Speaker 3: to cut out all sugar right now, Like that's it.
• 30:15
  Speaker 3: You know, you're you have to be done with it
• 30:17
  Speaker 3: because it's going to feed your cancer and then your
• 30:19
  Speaker 3: cancer is going to grow. And that's that's really that's
• 30:22
  Speaker 3: it's that's a very simplistic way of looking at it,
• 30:25
  Speaker 3: and that's not it. There's no definitive causal uh causal
• 30:30
  Speaker 3: relationship where if you eat a lot of sugar, then
• 30:32
  Speaker 3: you're definitely going to get cancer, because otherwise then you
• 30:35
  Speaker 3: would see a higher incidence of cancer and people who
• 30:38
  Speaker 3: are diabetic, for example, And that's we don't see that.
• 30:42
  Speaker 3: And so if I have a patient who's asking me like, hey,
• 30:44
  Speaker 3: how should I change my diet after getting diagnosed with
• 30:47
  Speaker 3: breast cancer, I say, a healthy diet is important. But
• 30:49
  Speaker 3: you know, if you have something that you really love eating,
• 30:52
  Speaker 3: you know, you love ice cream, you love flawing, whatever,
• 30:54
  Speaker 3: I'm never going to say don't eat that. Don't eat
• 30:57
  Speaker 3: the things that are going to bring you joy while
• 30:59
  Speaker 3: you're going through treatment, because treatment is hard enough as
• 31:01
  Speaker 3: it is.
• 31:03
  Speaker 2: First of all, who would ever say I love flawn? Sorry, I.
• 31:11
  Speaker 3: Love it that giggly texture. I am right, Okay, yeah
• 31:16
  Speaker 3: it's great.
• 31:16
  Speaker 2: And in New Mexico here we have like really really
• 31:19
  Speaker 2: authentic flawn.
• 31:19
  Speaker 1: So okay, maybe I just need to go to New
• 31:21
  Speaker 1: Mexico and try the good stuff.
• 31:23
  Speaker 2: What about soy? What about soy?
• 31:25
  Speaker 1: Because I've always heard I mean, I fed my babies
• 31:30
  Speaker 1: once they were off breast milk. I gave them the
• 31:33
  Speaker 1: only option back then was to give them a soy formula, right,
• 31:38
  Speaker 1: and I wasn't sure if I was doing the right thing.
• 31:42
  Speaker 3: Also a great point. I hear that one too, Like
• 31:44
  Speaker 3: soy and the estrogen link is there. You know, people
• 31:47
  Speaker 3: will say, well, if you eat a lot of soy,
• 31:50
  Speaker 3: then it might increase your risk for an estrogen related
• 31:53
  Speaker 3: breast cancer, and really the studies are not definitive about
• 31:57
  Speaker 3: that either.
• 31:58
  Speaker 2: So I don't tell I don't advise you to cut
• 32:00
  Speaker 2: out soy.
• 32:00
  Speaker 3: I think if you like soy, great, enjoy SOI I
• 32:04
  Speaker 3: don't think that there's a real reason to cut anything
• 32:07
  Speaker 3: specific out of your diet if you've been diagnosed with
• 32:09
  Speaker 3: the breast cancer to keep it from growing or spreading,
• 32:13
  Speaker 3: or you know, to keep to prevent breast cancer. I
• 32:15
  Speaker 3: think if you want to prevent breast cancer or catch
• 32:18
  Speaker 3: it early, really the most important thing to do is
• 32:21
  Speaker 3: to get your mammogram once a year.
• 32:23
  Speaker 1: Okay, So speaking of estrogen, let's talk about hormone replacement
• 32:28
  Speaker 1: therapy HRT. Yeah, does it increase your chances of breast cancer?
• 32:32
  Speaker 1: And what do we need to know associated with that?
• 32:37
  Speaker 3: It does increase the chance very slightly, based on pretty
• 32:41
  Speaker 3: large studies that have been conducted. So when I'm talking
• 32:45
  Speaker 3: to patients, I have patients who are even in my
• 32:49
  Speaker 3: high risk clinic because they have a family history that
• 32:52
  Speaker 3: I do think that HRT is worth trying for them.
• 32:55
  Speaker 3: I think that menopausal symptoms are like many other things
• 33:00
  Speaker 3: that are almost exclusive to women, not talked about enough,
• 33:03
  Speaker 3: and sometimes they can be extremely miserable and really alter
• 33:07
  Speaker 3: the quality of your life, right, And so it's a
• 33:10
  Speaker 3: risk versus benefit situation, like, Okay, the risk of breast
• 33:14
  Speaker 3: cancer is slightly higher, but the benefit is that, you know,
• 33:19
  Speaker 3: I'll get to sleep at night, I won't have these
• 33:21
  Speaker 3: terrible night sweats. You know, I won't wake up in
• 33:24
  Speaker 3: the middle of the night and wonder what it is
• 33:26
  Speaker 3: I'm doing. I won't have menopause brain those kinds of things.
• 33:29
  Speaker 3: And so oftentimes I think that the benefit.
• 33:32
  Speaker 2: Of HRT really outweighs the risk.
• 33:35
  Speaker 3: The only patients that I really say should not be
• 33:38
  Speaker 3: on HRT are the patients who have already been diagnosed
• 33:42
  Speaker 3: with breast cancer, and it is a breast cancer that
• 33:44
  Speaker 3: responds to estrogen. In that case, not a good idea
• 33:47
  Speaker 3: to be on hormone replacement therapy. But for others, I
• 33:50
  Speaker 3: do feel that in general, the benefits outweigh the risks,
• 33:53
  Speaker 3: and I think that it's something that more women should
• 33:55
  Speaker 3: be on. Mm HM.
• 33:57
  Speaker 2: I agree.
• 34:05
  Speaker 1: Breast implant illness has been getting talked about more openly.
• 34:10
  Speaker 1: More and more women are having their implants removed. Are
• 34:13
  Speaker 1: there any correlations between breast implant illness and breast cancer?
• 34:18
  Speaker 2: Not that I know of.
• 34:19
  Speaker 3: I have not seen any correlation between breast implant associated
• 34:23
  Speaker 3: illness and breast cancer. Breast implant associated illness is kind
• 34:27
  Speaker 3: of You're right, it's getting a lot more traction in
• 34:29
  Speaker 3: these last few years, but it's still a diagnosis that
• 34:33
  Speaker 3: they will do a full work up and make sure
• 34:36
  Speaker 3: that there's not something else that's causing these symptoms before
• 34:38
  Speaker 3: removing implants. But I think there's a growing body of
• 34:41
  Speaker 3: evidence that it's its own thing and should be considered earlier,
• 34:45
  Speaker 3: you know, before doing the whole million dollar workup in
• 34:48
  Speaker 3: women who have implants.
• 34:50
  Speaker 2: I can't believe. I was told.
• 34:51
  Speaker 1: I would remember hearing messaging when I was younger that said,
• 34:55
  Speaker 1: if you get breast implants, it reduces your chances of
• 34:59
  Speaker 1: get breast cancer.
• 35:01
  Speaker 2: Yeah.
• 35:02
  Speaker 3: I I've heard that as well from a few patients.
• 35:05
  Speaker 3: It really it doesn't change.
• 35:06
  Speaker 2: The risk at all.
• 35:07
  Speaker 3: Yeah, I think you know it doesn't, right, And when
• 35:10
  Speaker 3: someone has an implant and then they get a mammogram,
• 35:13
  Speaker 3: they sort of move the implant out of the way
• 35:16
  Speaker 3: and then get the native breast tissue in for the
• 35:18
  Speaker 3: mammogram and they're still able to see what's going on.
• 35:22
  Speaker 3: Sometimes having an implant, you know, that was placed for
• 35:24
  Speaker 3: an augmentation purpose, can change the treatment options that are
• 35:29
  Speaker 3: available to you if you do get diagnosed with breast cancer.
• 35:31
  Speaker 3: But it's not that's not a reason not to get
• 35:34
  Speaker 3: an implant for someone who wants one.
• 35:38
  Speaker 1: Speaking of moving the implant around, if someone's considering or
• 35:43
  Speaker 1: having to face being considering a mass sectomy or a
• 35:47
  Speaker 1: double mass ectomy, can you walk us through that process
• 35:53
  Speaker 1: and what that entails and the recovery. I mean that
• 35:57
  Speaker 1: sounds very scary.
• 35:59
  Speaker 2: Yeah, sure, I'm happy to do that.
• 36:01
  Speaker 3: So I do see a lot of patients who have
• 36:05
  Speaker 3: chosen to remove one breast or both breasts, and that
• 36:08
  Speaker 3: decision is really a very personal decision, you know it.
• 36:12
  Speaker 3: I think that there's some patients that have a larger
• 36:14
  Speaker 3: cancer for which it would be a good idea, But
• 36:17
  Speaker 3: there's some who have small cancers that just, you know,
• 36:21
  Speaker 3: they don't want to get a mammogram on that side again,
• 36:23
  Speaker 3: or they don't want to get mamogram on either side,
• 36:25
  Speaker 3: and they just want to, you know, for their own
• 36:27
  Speaker 3: peace of mind. They tell me, you know, doctor Jambacar,
• 36:29
  Speaker 3: I'm going to be awake at night thinking about potentially
• 36:33
  Speaker 3: having to get another biopsy sometime in the future, and
• 36:36
  Speaker 3: I want to remove both breasts. And if that's the case,
• 36:38
  Speaker 3: then you know, that's your decision now, you know.
• 36:41
  Speaker 2: For me, I have a lot.
• 36:43
  Speaker 3: Of different tools to help my patients have the best
• 36:46
  Speaker 3: recovery possible, and one of them is something called an
• 36:49
  Speaker 3: experal peck block, which is like a numbing injection that
• 36:52
  Speaker 3: gets done to the muscle, the peck muscle, which is
• 36:55
  Speaker 3: the muscle that's behind the breast, and that medication lasts
• 36:59
  Speaker 3: for like seven days, and so typically my patients go
• 37:03
  Speaker 3: home the same day after a two to three hour
• 37:05
  Speaker 3: surgery and they're able to do their normal activities shower,
• 37:09
  Speaker 3: wash their hair, et cetera. The next day, and most
• 37:12
  Speaker 3: of them take zero opioid pills at all because of
• 37:15
  Speaker 3: that medication.
• 37:16
  Speaker 2: It blocks the pain receptors.
• 37:19
  Speaker 3: It blocks the muscle, it numbs the whole muscle, and
• 37:21
  Speaker 3: so it numbs the breast tissue in front of the muscle.
• 37:25
  Speaker 3: And it's really something that's been used that most places
• 37:28
  Speaker 3: in the country, but not everywhere it should be used everywhere.
• 37:32
  Speaker 2: In New Mexico.
• 37:33
  Speaker 3: Mine is actually the only hospital and the only surgeon
• 37:36
  Speaker 3: who's doing it, and I'm hoping to spread that message so.
• 37:39
  Speaker 2: More people do it. I know in La quite a
• 37:41
  Speaker 2: few people are doing it, but I think.
• 37:44
  Speaker 3: That it is It's something that has been a huge
• 37:47
  Speaker 3: game changer, especially in the last couple of years since
• 37:51
  Speaker 3: the pandemic started, to make the recovery better for patients
• 37:56
  Speaker 3: who have breast cancer. And then you know, the next
• 37:59
  Speaker 3: day you could be walking around, showering, moving your arms,
• 38:02
  Speaker 3: doing all of your normal stuff. Usually you will feel
• 38:05
  Speaker 3: kind of sore for probably two or three weeks, but
• 38:08
  Speaker 3: this helps tremendously because it really takes the edge off
• 38:11
  Speaker 3: the first few days, and patients do sometimes need ice
• 38:15
  Speaker 3: pads or tilenyl and advil to kind of get them
• 38:17
  Speaker 3: through that.
• 38:20
  Speaker 2: And then the.
• 38:20
  Speaker 3: Reconstruction process, which sometimes can be started at the same
• 38:23
  Speaker 3: time as removing one or both breasts, sometimes needs to
• 38:28
  Speaker 3: be done in a separate surgery. It just sort of
• 38:30
  Speaker 3: depends on what type of reconstruction the patient chooses.
• 38:33
  Speaker 1: I see, so in some cases, if you have to
• 38:35
  Speaker 1: have your breast removed, you can have the reconstruction done
• 38:39
  Speaker 1: in that same operation.
• 38:40
  Speaker 2: You can.
• 38:42
  Speaker 3: But something I always counsel patients is, even if you're
• 38:44
  Speaker 3: able to start it at the same time, oftentimes there
• 38:47
  Speaker 3: is a second surgery or maybe in an office procedure
• 38:50
  Speaker 3: or something that's needed because remaking breasts is a work
• 38:54
  Speaker 3: of art and making sure everything's symmetric, either with the
• 38:58
  Speaker 3: side you still have left or making both sides of the
• 39:00
  Speaker 3: same like this not like this right, Like that's that's
• 39:04
  Speaker 3: a work of art, and it takes it takes a
• 39:07
  Speaker 3: very skilled plastic surgeon who's extremely dedicated to reconstruction to
• 39:11
  Speaker 3: do a good job.
• 39:13
  Speaker 2: And sometimes it can take.
• 39:14
  Speaker 3: You know, up to a year to do all the
• 39:16
  Speaker 3: procedures that are done to where the patient and the
• 39:21
  Speaker 3: plastic surgeon everyone's happy with how things are.
• 39:23
  Speaker 2: And so it's an art.
• 39:25
  Speaker 3: We don't want to rush that process, but sometimes it
• 39:28
  Speaker 3: can be started and most of it done, you know,
• 39:30
  Speaker 3: at the time of the mask stept tomy.
• 39:33
  Speaker 1: Wow, so interesting. Well, first of all, how often should
• 39:37
  Speaker 1: we be giving ourselves self exams, which means feeling around
• 39:41
  Speaker 1: the breast for any unusual lumps that are new.
• 39:46
  Speaker 3: Right, I'm kind of like, I'm not a huge proponent
• 39:50
  Speaker 3: for self breast exams. I think that it's important to
• 39:53
  Speaker 3: be kind of aware of what your breasts feel like,
• 39:56
  Speaker 3: you know, once every few months, kind of examine yourself
• 39:58
  Speaker 3: in the shower. But you know, I think that the
• 40:02
  Speaker 3: old teachings that you should be doing a self breast
• 40:05
  Speaker 3: exam once a month isn't really what we follow now
• 40:09
  Speaker 3: because self breast exams don't catch cancers very often, and
• 40:14
  Speaker 3: more often than not is the imaging that catches it.
• 40:18
  Speaker 3: So for me, you know, with my patients, I really
• 40:20
  Speaker 3: stress the importance of regular mammograms and if you are
• 40:25
  Speaker 3: high risk, getting enrolled in a high risk breast clinic
• 40:27
  Speaker 3: where they can watch you more often. But just in general,
• 40:30
  Speaker 3: having an awareness of what your breasts feel like, you know,
• 40:33
  Speaker 3: once every few months, I think is totally okay. And
• 40:37
  Speaker 3: I also often have patients that come seeing me after
• 40:40
  Speaker 3: having being dinosed so the breast cancer say, you know, Douc,
• 40:42
  Speaker 3: I didn't feel anything. I don't really do breast exams,
• 40:44
  Speaker 3: And I tell him, you know, no reason to feel
• 40:46
  Speaker 3: bad about that, Like that's okay, you went and got
• 40:48
  Speaker 3: your mammogram and now we're here, so I'm really happy
• 40:51
  Speaker 3: that you got your mammogram.
• 40:54
  Speaker 1: Yeah, because sometimes it is an indicator to someone that
• 40:57
  Speaker 1: something might be awry, so it is the impetus for
• 41:01
  Speaker 1: them to go into the doctor. What are some other
• 41:03
  Speaker 1: warning signs, say, we're not checking our breast warning even
• 41:07
  Speaker 1: if we do, we didn't feel Are there other signs
• 41:11
  Speaker 1: that women should be aware of.
• 41:13
  Speaker 3: Yeah, so nipple discharge, like new onset nipple discharge on
• 41:18
  Speaker 3: one side in particular, especially if it's bloody, that's something
• 41:22
  Speaker 3: that you need to get some breast imaging for. And
• 41:25
  Speaker 3: oftentimes breast pain. You know, if you feel a new
• 41:27
  Speaker 3: pain somewhere, especially if it's just in one spot not
• 41:31
  Speaker 3: the whole breast. Whenever I see patients with breast pain,
• 41:34
  Speaker 3: I go ahead and order an ultrasound just to check
• 41:36
  Speaker 3: it out and make sure there's nothing going on as well.
• 41:39
  Speaker 3: And then also if you have any kind of skin changes,
• 41:42
  Speaker 3: so skin looks kind of stick in one spot, nipples,
• 41:46
  Speaker 3: kind of itching and scaling, all of that stuff should
• 41:49
  Speaker 3: be checked out with breast imaging.
• 41:52
  Speaker 2: Such a good information. I didn't know any of that.
• 41:55
  Speaker 2: Thank you.
• 41:57
  Speaker 1: What is the one thing you would say that you
• 42:00
  Speaker 1: hope our listeners take away from this conversation that we've
• 42:04
  Speaker 1: had today.
• 42:05
  Speaker 3: I think you've already sort of touched on it, which
• 42:07
  Speaker 3: is that it's so important for women to advocate for themselves.
• 42:12
  Speaker 3: So if you have a high risk family history, ask
• 42:16
  Speaker 3: your primary care doctor to refer you to a hig
• 42:19
  Speaker 3: risk breast clinic so you can talk about genetic testing,
• 42:22
  Speaker 3: maybe get diagnosed with something like Bracco one and two
• 42:25
  Speaker 3: if that's running in your family.
• 42:27
  Speaker 2: Or just be watched more closely.
• 42:30
  Speaker 3: And if you feel a lump, advocate for yourself to
• 42:34
  Speaker 3: get some type of imaging, a mammogram, an ultrasound, something,
• 42:37
  Speaker 3: because no one's physical exam is good enough. So it's
• 42:40
  Speaker 3: really important for women to use our voices because we
• 42:42
  Speaker 3: already don't get heard enough. So advocate for yourself, educate yourself.
• 42:48
  Speaker 3: And that's really my mission. I try to post a
• 42:51
  Speaker 3: lot of stuff on social media so that way I
• 42:54
  Speaker 3: can help women advocate for themselves.
• 42:56
  Speaker 1: Yeah, I mean it's so easy. I've been in this
• 42:58
  Speaker 1: position to be in the doctor's office and them to
• 43:01
  Speaker 1: tell you whether something's wrong or something's not wrong. Either way,
• 43:06
  Speaker 1: I think to myself, well, they're the doctor, they must know.
• 43:10
  Speaker 1: I guess I'll just go with that.
• 43:12
  Speaker 3: Well, here's the dirty little secret we don't know. And
• 43:16
  Speaker 3: as a doctor, like we you know, physical exam and
• 43:20
  Speaker 3: looking at how a patient looks and trying to put
• 43:22
  Speaker 3: the pieces together with what they're telling you. It's those
• 43:25
  Speaker 3: are great tools, but they're not everything. And if you,
• 43:29
  Speaker 3: as someone who's seeing a doctor, feel in your gut
• 43:32
  Speaker 3: that you know they're not hearing me, they don't know
• 43:35
  Speaker 3: the whole story, something must still be wrong. Like, don't
• 43:37
  Speaker 3: be afraid to get a second opinion. You know what
• 43:39
  Speaker 3: we talked about earlier. Find a female physician that will
• 43:43
  Speaker 3: be willing to listen to you.
• 43:45
  Speaker 2: Yes, go, ladies. We need more female doctors, more female surgeons,
• 43:49
  Speaker 2: more females everywhere we do.
• 43:52
  Speaker 3: We absolutely do in every field, we will benefit from
• 43:55
  Speaker 3: having more women.
• 43:56
  Speaker 1: Before I let you go, doctor Amani, I want to
• 44:00
  Speaker 1: know what was your last I choose me moment.
• 44:05
  Speaker 3: I would have to say that it was today doing
• 44:09
  Speaker 3: this podcast. So I spoke to my clinic team and
• 44:14
  Speaker 3: I was like, listen, I have this really exciting opportunity
• 44:18
  Speaker 3: to be on Jennygart's podcast. I'm really excited about meeting her.
• 44:21
  Speaker 3: So if you can just make sure that I can
• 44:24
  Speaker 3: get home on time so I can participate. And that's
• 44:27
  Speaker 3: how I'm choosing me. And they made it happen and
• 44:31
  Speaker 3: I was able to be here today. So I'm so
• 44:33
  Speaker 3: excited for this opportunity. Thank you so much for having
• 44:35
  Speaker 3: me on.
• 44:36
  Speaker 2: Oh I love that.
• 44:37
  Speaker 1: I love that because this is the greatest opportunity for
• 44:40
  Speaker 1: you to educate more women, and I know that that's
• 44:42
  Speaker 1: so important to you.
• 44:44
  Speaker 2: Yes, it is.
• 44:44
  Speaker 3: That's definitely my mission, not just in my clinic, but
• 44:47
  Speaker 3: also the women out there on social media to try
• 44:50
  Speaker 3: to help them, help empower them to advocate for themselves.
• 44:55
  Speaker 1: As the mother of three women, I thank you from
• 44:59
  Speaker 1: the bottom of my heart for all that you do
• 45:02
  Speaker 1: and the education that you're dispensing to people.
• 45:05
  Speaker 3: Well, I really appreciate everything you're doing and all of
• 45:08
  Speaker 3: the information you're providing through your podcast and helping me
• 45:12
  Speaker 3: have this platform to talk to women and so we
• 45:16
  Speaker 3: can get more women to get their mammograms.
• 45:19
  Speaker 1: Yes, yes, thank you so much for your time. I
• 45:21
  Speaker 1: hope you have a great night you too. All right,
• 45:26
  Speaker 1: take and enjoy your flown.
• 45:28
  Speaker 3: Oh, thank you, just delicious. You got to give it
• 45:31
  Speaker 3: another chance.
• 45:32
  Speaker 2: I'll come and see you and we can have some
• 45:33
  Speaker 2: flawn together. I think that'd be a good idea.
• 45:36
  Speaker 3: That if you haven't been to Santa Fe recently been
• 45:39
  Speaker 3: to Santa Fe.
• 45:40
  Speaker 2: Oh my gosh, you're missing out. It is such a
• 45:42
  Speaker 2: magical city.
• 45:42
  Speaker 3: I got to tell you I moved here from Houston,
• 45:45
  Speaker 3: and I was like, oh my god, I strongly recommend
• 45:47
  Speaker 3: you come.
• 45:48
  Speaker 1: I love that of ringing endorsement. Yes Santa Fe, yes okay,
• 45:52
  Speaker 1: and mammograms yes both okay.
• 45:55
  Speaker 2: Thank you so much, thank you for having me on.
• 46:01
  Speaker 1: I want to thank doctor Ramani John Bacar for coming
• 46:04
  Speaker 1: on our podcast today. I know none of us like
• 46:08
  Speaker 1: to talk or think about cancer, but it is important
• 46:11
  Speaker 1: for all of us to understand the warning signs and
• 46:15
  Speaker 1: understand why it's crucial for us to get our mammograms.
• 46:19
  Speaker 1: As we continue to choose ourselves each week, I want
• 46:22
  Speaker 1: to challenge you this week. It's going to be an
• 46:25
  Speaker 1: obvious one, but maybe this conversation has inspired you. I
• 46:29
  Speaker 1: want to encourage you to have that I choose me
• 46:32
  Speaker 1: moment and get your mammogram. Or maybe you and a friend,
• 46:37
  Speaker 1: or you and your sister, or you and your daughter
• 46:40
  Speaker 1: go get them together, make a mammogram date out of it.
• 46:45
  Speaker 1: I encourage you to share your story and your mammogram
• 46:48
  Speaker 1: experience on our social media and use the hashtag I
• 46:51
  Speaker 1: Choose Me. Let's all inspire each other and be brave
• 46:54
  Speaker 1: and look out for each other and for our bodies.
• 46:58
  Speaker 1: Thanks for listening to I Choose Me. You can check
• 47:00
  Speaker 1: out all of our social links on our show notes,
• 47:03
  Speaker 1: rate us, review the podcast, give us your comments, tell
• 47:05
  Speaker 1: us everything you want to tell us, and don't forget
• 47:07
  Speaker 1: to use the hashtag I Choose Me. I'll be right
• 47:10
  Speaker 1: here next week. I hope you choose to be here too,