October 2, 2024 • 36 mins
One in eight American women will develop breast cancer in their lifetime. In this first Wellness Wednesday of Breast Cancer Awareness Month, we talk with renowned breast cancer surgeon and women’s health advocate, Dr. Kristi Funk, about the latest research on prevention and the critical importance of early detection. Dr. Funk sheds light the things within our control when it comes to breast cancer risk — including diet, weight, harmful chemicals, and drinking.
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Speaker 1 (00:03):
Hey, besties, Hello Sunshine.
Speaker 2 (00:06):
Today on the bright Side, it's Wellness Wednesday. We're honoring
Breast Cancer Awareness Month with breast cancer surgeon and women's
health advocate, doctor Christy Funk. She's breaking down the latest
in breast cancer research and prevention, including changes we can
all make to lower our risk. It's Wednesday, October second.
I'm Danielle Robe and.
Speaker 3 (00:27):
I'm Simone Boyce. This is the bright Side from Hello Sunshine,
a daily show where we come together to share women's stories, laugh,
learn and brighten your day. Today's Wellness Wednesday is presented
by Coligard. All Right, y'all. October is Breast Cancer Awareness Month,
and to be honest, I don't know a woman who
(00:49):
doesn't have a personal connection to breast cancer. Danielle, have
you seen this show up in your own life? Oh
my goodness, yes, I will never forget.
Speaker 2 (00:57):
When I was in fifth I would say, and one
of my mom's best friends was diagnosed with breast cancer,
and we would go to her house at night and
bring her plants and cookies and sit with her on
the couch and talk. And I just remember how difficult
it was for everybody who loved her. And I think
(01:20):
as I've gotten older, I know so many women who
have been diagnosed with breast cancer. Statistically, one in eight
women in the US will develop it in their lifetime.
Do you do you have a personal touch point to it, Simone.
Speaker 3 (01:33):
Yeah, breast cancer is something that really loomed large over
my whole childhood. It was kind of this like medical
boogeyman in my family because I grew up hearing all
these stories about my wonderful grandmother, Bonnie, my mom's mom,
but I never actually got to meet her because she
died a few months after I was born, when she
was fifty eight years old, because of breast cancer. So
(01:55):
it was of course something that my mom talked about
a lot in terms of preventative measure and I actually
in high school, when I was like sixteen years old,
had my first brush with a potential breast cancer diagnosis. Thankfully,
it was not cancerous, but I did have a benign
(02:15):
lump at the time, so I had to go through
surgery and get it removed from my breast. But I'm
thankful for that experience because I think it helped me
gain a deeper awareness of my body and just know
what to look out for.
Speaker 2 (02:28):
Sixteen is really young to experience something like that. That
must have been scary. Yeah, it was.
Speaker 3 (02:34):
I had the best friends, though, Like I can remember
coming home from surgery and they all just came over
and hung out on my couch while I was like
knocked out from painkillers. And so it's all about support,
like you were talking about, do.
Speaker 2 (02:46):
You think about that moment now today?
Speaker 1 (02:50):
I have a scar.
Speaker 3 (02:52):
I have a scar, so you know, when I'm looking
at myself in a mirror, it's one of the scars
that is visible, and it certainly takes me back to
that time. But I'm kind of glad that I have
the scar because that scar reminds me to take care
of myself, and it reminds me to go get my
annual checkups and do my exams at home. And I
(03:13):
just got my first mammogram this year. I'm thirty six
years old, and I got it done a little bit earlier,
perhaps by some standards, but given my family's medical history,
I feel so much better having it done. I have
this tremendous peace of mind because of it.
Speaker 2 (03:28):
Well, I think part of what you're sharing is that
early detection is so helpful. It really increases the chances
of successful treatment and survival, and I think opening up
these conversations about breast health can really save lives. Every
time The Today's Show or Good Morning America does a
segment on this and there's a live mammogram, viewers write
in talking about how somebody was triggered to go to
(03:50):
the doctor and it saved their life. And so today
we're hoping to do the same. We're going to be
talking about early detection along with so much more. So
we're joined by doctor Christy Funk. She's a board certified
breast cancer surgeon and physician.
Speaker 3 (04:05):
Doctor Funk runs the Pink Lotus Breast Center in Santa Monica,
where she's counseled and treated thousands of women just like
me and Danielle. And she's also the author of Breast
the Owner's Manual, Doctor Christy Funk, Welcome to the bright Side.
Speaker 1 (04:19):
Welcome, Thank you, so excited to be here.
Speaker 3 (04:23):
Something that Danielle and I have both felt convicted about
is the fact that so many women have stories of
how breast cancer has impacted their families or ripped loved
ones away from them, or exists in the back of
their mind as this you know, fear that kind of
looms over their medical history. So we're really excited to
(04:47):
talk to you and start off with this. How pervasive
is breast cancer? I mean, we know that the rates
are going up. I'd love to know from you, just
get this kind of lay of the lane and an
update on the landscape. How many people are diagnosed each
year in the US and how does that compare to
when you started in the field.
Speaker 1 (05:08):
Oh, what a great question. Okay. So in twenty twenty,
breast cancer surpassed lung to become the number one malignant
tumor in the world men and women combined. Wow, with
about two point three million cases every single year and
six hundred and eighty five thousand deaths worldwide last year,
this year, even more next year. And as you were
(05:31):
just saying, the numbers seem to be going up because
they are going up in our own backyard, as you
were asking, this year twenty twenty four, we're expecting between
two hundred and eighty eight thousand and three hundred and
ten thousand new cases of invasive breast cancer, with about
forty three thousand, two hundred and fifty deaths this year
(05:51):
alone from breast cancer. One of the most alarming things
to me is that while the death rate has been
steadily going down about one point three percent per year
since twenty eleven, that's owing largely to earlier detection and
better treatments, the incident's rate has been a very steady
(06:12):
zero point four percent per year after year increase for
the last twenty years, since two thousand and four. I
started my practice in two thousand and two, so twenty
two years ago, and the incident's rate was something like
two hundred and ten thousand. That was the number. It
was two hundred and ten thousand women per year diagnosed
(06:34):
with invasi of kids. So we've gone up about another
one hundred thousand. How do you stay hopeful? I stay
hopeful because I know something that most people don't know.
I know that the vast majority of all breast cancer
is under your control. What you eat or don't eat,
(06:56):
drink or don't drink, do or don't do, think or
don't think eat, even down to like if you forgive
or don't forgive, it alters the cell micro environment inside
of you, pushing you toward cancer or away. And you
have so much control in your choices. So I'm hopeful
because I know this message is not getting out, and
(07:18):
so I get to preach it from the mountaintop. I
get to try every chance. I get to help empower
women and men to understand that their daily choices impact
cellular health, which impacts cancer incidents, recurrence, mortality, and not
just cancer, heart disease, stroke, diabetes, Alzheimer's, obesity, All the
(07:39):
things that contribute to the major killers in our lives
are largely related to diet and lifestyle.
Speaker 3 (07:46):
I'm so glad you brought up lifestyle. This is one
of those big risk factors that we hear a lot about.
And there's actually a very fresh study that just came
out end of September that gives us more insight into
how life style plays into this. So, this new study
suggested that many commonly used food packaging products contain known
breast cancer causing chemicals. And the packaging they're talking about
(08:10):
is the type of thing we see all the time
in our own homes or at restaurants, shrink wrap, cardboard trays,
or paper containers. What do you make of this study
and how should we interpret the results.
Speaker 1 (08:20):
Okay, this study is absolutely accurate. What I make of
it is that we are bombarded day in and day out.
With all of these endocrine disruptors. There are literally an
estimated one hundred thousand, one hundred thousand synthetic chemicals used
in the United States. A substantial number of these are
bound to be zeno estrogens. By that, I mean chemicals
(08:42):
that mimic the action of estrogen in your body. This
is important because eighty percent of all breast cancers are
fed and fueled by estrogen, and yet no regulatory body
has mandated that we test products for zeno estrogen levels
or their effects, so we don't really even know what happens.
They attached to the same receptors as your natural estrogen will,
(09:05):
But do they cause a stronger downstream reaction than normal hormones,
A weaker one, a totally different one like your guess
is as good as mine. And the EPA, the Environmental
Protection Agency, formed the Endocrine Disruptor Screening Program. Okay, their
first update came in August twenty twenty fifteen e ish.
(09:28):
And when they came guess how many of the one
hundred thousand chemicals they looked at, I'll just tell you
fifty two.
Speaker 3 (09:37):
Oh my gosh.
Speaker 1 (09:39):
So if every seventeen years we look at fifty two
of the one hundred thousand chemicals. We're going to finish
with all of them in thirty three thousand years. That's
when we'll get our final update. So when this study
came out, I was intrigued by it because I love
that it gets some attention and press to find out that, Yeah,
(09:59):
in our daily lives, we are bombarded by these endocrine disruptors,
and it's always good to be aware of it. But
the thing is these are everywhere, right, Like you wake
up in the morning and that sunscreen you put on
endocrine disruptor EDC, right, endocrine disrupting compound, the gas pump
(10:22):
that you handled at the station, etc. The plastic fork
and water bottle that you had at your takeout lunch, etc.
The detergent you washed your pillow case with that you're
sleeping on, maybe an EEDC. So they are everywhere. So
what I like to tell people is, look, they're so ubiquitous,
(10:42):
these environmental toxicities. All you can do is live your
life well with some attention, particularly to the things that
are on you, on your skin, or that you are
swallowing down, because those have the closest proximity to impact
(11:03):
cellular health. Right, doesn't that make the most sense. So practically,
what this means is have a look at your ingredients.
A lot of people never thought about it. They never
thought like, oh, I should actually read what's in my
laundry detergent, the lotion I'm putting on my skin, the
toothpaste I'm putting all over my gums, the stuff I
wash my dishes with and then eat food off of
(11:26):
plastics is the big was the big This report was
talking about plastics, right, and per fluorocarbonated alkophenols, right, These
pfast chemicals, they're called forever chemicals because they get into fat.
(11:46):
I mean, forever is a good thing if you're talking
about like the stability of a relationship or maybe your job.
But beyond that, you do not want these stable chemicals
inside your body. So you want to just limit them
with your cooking. Look at your cookware. Store everything in
(12:06):
glass or ceramic. Never ever, ever, ever microwave or heat
anything that is in plastic. And I don't know where
this idea came from. I was a kid in the
seventies and we microwave dinners like I think they just started,
and the microwaves were fascinating, and you'd put the food
in there and you'd stare at it while it was cooking,
and then it would come out and you just remember
(12:28):
you're supposed to peel up the corner of the I
can't even believe people think about doing that. And this
idea that you need to have it in the packaging
and order for it to heat well is a farce.
Like anything, if I'm having some frozen vegetables or something
that I need to cook up, I just dump them
into a glass dish and put them in the microwave.
You can heat them on the stove, put them in
an instapot. Just get away from all the plastics, all
(12:50):
the baby bottles and the sippy cups and the infant
formula cans and all of that. Like, just make sure
everything is glass or ceramic.
Speaker 2 (13:00):
People on our show always make fun of me because
I don't wear any fragrance, and it's for this reason, actually,
doctor Funk. But I've found that the EWG, the Environmental
Working Group, is a great resource, particularly because you mentioned
the EPA hasn't updated many of their many of their lists, right.
Speaker 1 (13:24):
Yeah, I love the EWG. Yeah, they've also got that
Dirty Dozen in the Clean fifteen. Yes, because eating organic
is a great weight to be avoiding a lot of
these toxicities. And probably the best way of all, by
the way, is to be eating plant based because whenever
you cook barbecue grill meat, you are creating these pfast
(13:48):
chemicals and swallowing them down, and they are potent carcinogens.
Speaker 2 (13:53):
We need to take a quick break, but we'll be
right back to wellness Wednesday with doctor Christy Funk. And
we're back. There's a study I'm curious about. It was
from Susan g. Coman, and they linked weight gain to
(14:16):
breast cancer. And I know you're talking about the chemicals
in food, but can weight gain increase our chance of
getting breast cancer.
Speaker 1 (14:24):
One hundred percent? Yes, So, for reasons that are not
entirely clear, premenopausal weight gain and being overweight or obese
is somehow protective against pre menopausal breast cancer. But the
second you hit menopause, there is no question, in no
controversy that obese women have fifty to two hundred and
(14:45):
fifty percent more breast cancer, more breast cancer recurrence, and
more breast cancer related death. Wow, there are multiple reasons. Yeah, No,
weight is a really big deal. The beauty in this
statement is that if you lose the weight, you lose
the risk. So it's not like you've locked into this
risk at a certain weight and there's no way to
(15:07):
undo it. But a couple things I'll say so. One,
there was a study that looked at gaining more than
five percent of your initial body weight during or after
breast cancer treatment, irrespective of your baseline body mass index,
so you didn't even have to be overweight. If you
just gained five percent of your initial body weight, it
increased the risk of recurrence in survival by four hundred percent.
(15:30):
That's staggering. What fat is doing is a number of things,
but it's under recognized by like the quick blanket statement
that you might hear in media in that estrogen feeds
and fuels eighty percent of breast cancers. Once your ovary
shuts down, either because of natural menopause or perhaps you
(15:54):
had premature ovarian failure or chemical menopause, which is meaning
chemo therapy kind of destroyed your ovarian production, or you
had them surgically removed. Okay, that estrogen source is gone.
That was your main estrogen source. One percent of the
amount of estrogen that your ovary was making is made
by you from your fat. So you've got these fat
(16:17):
cells predominantly in the fat itself. But there's an enzyme
in the fat called aroma tase, and some of this
is also found in liver in the ovary itself, so
it's not the ovarian production, but it's from the fat
in the ovary in muscle. And believe it or not,
these sinister cancers, if they've already formed, they have their
(16:40):
own aromatase enzyme. Maybe got like a little backpack, like
one of those little running backpack water bottle things, Like
it's like, oh, I need some more estrogen. Let me
just sip out of my backpack here and get some more.
Aromatase is an enzyme in all these places. It's turning
adrenal gland steroids into estrogen. So it's not enough to
(17:00):
stop a hot flash if you're menopausal, but it is
sure enough to feed and fuel that cancer. That's usually
where the story ends for people who make the connection
between weight, overweight, obesity and breast cancer, but that is
hardly the story. The real sinister mechanisms of how weight
(17:22):
intersects with breast cancer have to do with inflammation. So
the number one, two and three things are leptin, chronic
inflammation produced by fat cells, and insulin. So lectin. It's
created mostly by adipose tissue and it's secreted into circulation,
(17:44):
and once leptin binds to its receptor, it crosstalks with
all of these oncogenes, with all of these genetic switches
that you flip on and off to suit a cancer's need.
It ignites this signaling pathway multiple pathway that release growth
factors and cidokinds. And the endgame is breast cancer initiation, progression,
(18:09):
and metastases. If it's already there, So that's leptin. The
second thing fat does is it activates. It has these
macrophases in the adipose tissue of obese women that produce
inflammatory mediators, things that have letters and numbers TNF, alpha,
interluken six. The specifics do matter so much as the
(18:32):
endgame again chronic inflammation, which is promoting this cancer growth
in metastatic spread. And the other thing it makes happen
is angiogenesis. Angio means blood vessel genesis is birth. If
you are a breast cancer cell and you aspire to
be bigger than the tip of a ballpoint pen, which
every cancer aspires to be. You must create your own
(18:55):
blood supply, and you must have this environment around you
that's conducive to doing that. Angiogenesis the birth of these
blood vessels, so you can bring your own new nutrients
to yourself, and then when you get big enough, shoot
them exit strategy straight through those same blood vessels to
the brain, to the lung, to the liver, to the bone.
(19:16):
That's how it all goes down. And the activated macrophases
in fat create angiogenesis and modify your immune response so
much so that this is probably the reason why we
know that obese women don't respond as well to both
(19:38):
the anti estrogen therapies and the chemo therapy we give
them when they have breast cancer. They have uniformly worse prognoses.
Speaker 2 (19:45):
Doctor funk I think that we hear a lot about
the effects of alcohol on our healths, and a study
published this September looks specifically at the potential link between
alcohol and increased breast cancer diagnosis and patients under fifty.
What should we know about alcohol consumption and breast cancer?
Speaker 1 (20:04):
Okay, so pick your poison. What is alcohol? It's five
ounces of wine equals one point five ounces of hard
liquor equals a twelve ounce beer. A drink a day
and a premenopausal woman increases breast cancer by seven percent.
A drink a day in a postmenopausal woman thirteen percent.
Every drink thereafter adds about another ten percent. So two
drinks a day seventeen percent pre menopausal, it's twenty three
(20:27):
percent postmenopausal, and onwards and upwards from there.
Speaker 2 (20:31):
I do want to say, one drink a day is
quite a lot of drinks. So if you're just like
you know, drinking once a week or once every two weeks,
you're pretty much okay with alcohol as it relates to
breast cancer.
Speaker 1 (20:44):
Yes, that amount of drinking is not going to really
become carcinogenic, but a seegl aaldehyde is the carcinogen that
you form. Even if you just use your alcohol as mouthwashed,
which would be a terrible waste of an excellent wine draft.
But if you just fish and spad swallow down, you
are already swallowing down a carcinogen that then even becomes
(21:04):
more prevalent as it gets broken down by your liver
into a cel aaldehyde. One of the main reasons why
alcohol causes breast cancer though. Back to that is its
interference with an enzyme called MTHFR, which sounds like bad
word MTFR. It stands for methyl tas or hydrofolate reductase,
(21:26):
And what that enzyme is doing is that's taking full
eight from your leafy grains and full of acid from
your vitamins and turning it into methyl fulate. Methyl Fulate
in its active form is babysitting DNA as it divides.
So when your body makes a mistake, which it does
millions of time miss every day, methyl fullate swoops in
(21:48):
and fixes it or throws it out so it doesn't
set as a mutation that then gets propagated. One cell
becomes two, becomes four until you have a cancer. Right
when you drink you knock out that enzyme. Thirty to
fifty percent of all people already have a suboptimal NTHFR,
so they have a mutation. It's not complete, but it's partial.
(22:11):
And then the alcohol on top of it is just like,
forget it, lady, I'm not making any methyl fool. I
did a good luck with that mutation.
Speaker 3 (22:19):
We need to take another short break, but we'll be
right back and we're back with breast cancer surgeon and
women's health advocate, doctor Christy Funk. So we've talked about lifestyle, diet, alcohol,
we want to talk about genetics next. This is something
(22:41):
that directly impacts me. My maternal grandmother passed away from
breast cancer when she was fifty eight, and so it's
always been something that my mom has warned me about
growing up, and especially the power of early detection when
we think about lifestyle and genetics, which is more of
a determining factor when it comes to breast cancer diagnoses.
Speaker 1 (23:03):
Genetics, for sure, there are about nineteen of these gene
mutations that we know are strongly associated with the predisposition
to getting breast cancer. Can diet and lifestyle circumvent or
overrule the problems with this gene mutation that you may
have inherited, Probably not, or at least not yet with
(23:27):
any real certainty. However, and this is a really important point,
only five to ten percent of all women diagnosed with
breast cancer carry a genetic mutation they've inherited from mom
or dad, which means that ninety to ninety five percent
of all women with breast cancer did not get it
(23:49):
from a genetic predisposition.
Speaker 3 (23:52):
Whose environmental you're saying, I.
Speaker 1 (23:54):
Think diet and lifestyle. There's a saying that I like,
and it's that genetics load the gun, but your choice
is pulled the trigger.
Speaker 3 (24:05):
And then in terms of figuring out where you stand genetically,
it's DNA testing, right, those are the options. Yes, talk
to us about the options that are available.
Speaker 1 (24:13):
So think about your family tree for second and third
degree relatives on both sides of the family, and let's
analyze that. If you have two relatives on the same
side with breast cancer prior to age fifty or ovarian
cancer at any age, then you should consider genetic testing
(24:35):
because your risk of carrying a G mutation is ten
percent or higher. If you are Ashkenazi Jewish in heritage,
then you only need one of those one breast cancer
prior to fifty one, ovarian cancer any age, if you
yourself have had breast cancer. I test everybody now because
it's so affordable. It used to be very cost prohibitive.
(24:56):
It was literally if you wasn't covered by insurance, it
was forty five one hundred dollars and that was just
to find out if you carried BRCA. Now, if you
don't qualify by insurance criteria. For two hundred and fifty dollars,
you can get a full genetic panel of eighty five
genetic mutations. So again, two relatives with breast under fifty.
(25:17):
One relative with ovarian cancer at any age, if you
yourself had breast cancer, particularly prior to age fifty a
triple negative subtype, which if you had that you would know,
and or if you yourself have had breast cancer twice,
not a recurrence of the same one, but two totally
separate breast cancers, if there are any men in the
(25:39):
family tree with breast cancer, or if anybody had pancreatic melanoma,
gastric prostate. These are all like associated with certain syndromes,
So the breast, ovarian and then all the other cancers.
There's just a whole lot going on, three or more
(26:00):
relatives than I would consider testing.
Speaker 2 (26:03):
I feel like we've all heard how important early detection is.
I know this may sound silly, but I grew up
hearing about it on the Today Show in Good Morning America.
I think traditionally the advice has been to start getting
mammograms at the age of forty. Is that still the recommendation?
Speaker 1 (26:22):
It is different societies have different recommendations, but we are
all sort of trending back hearing about oh you can
start at fifty, you can do every other year. The
United States Preventive Task Force as now dialed it back
again to beginning at age forty. Look, especially in life
(26:46):
with the conversation we were just having. Knowing that breast
cancer is getting diagnosed earlier than ever before in women
under fifty, there's no reason to be excluding them from screening.
So I signed with the America Society of Breast Surgeons,
and we advise women of normal breast cancer risks to
(27:06):
begin in age forty and don't stop or skip years
until your life expectancy is less than five years, which
is admittedly a little hard to predict when you're going
to die. But you know certain people, it's obvious that
their heart disease or their advanced COPD, etc. Is more
critical than a breast cancer diagnosis would be, because it
(27:31):
would potentially cause too much harm to treat that cancer,
which was never going to be the reason why they
died if they already have something else more serious looming,
like advanced cardiac for lung disease.
Speaker 2 (27:47):
What about for women in their twenties and thirties. What
do you think they should be paying attention to in
terms of their breasts.
Speaker 1 (27:53):
I always encourage women to be breast aware, so to me,
that involves monthly self breast exams. The official rule on
the street is that doing self breast exams don't save lives,
but in my practice, I've just seen it to be otherwise.
I think you're with your breasts every day, all day,
and I might be with them once a year or so.
(28:16):
I think it's smart to not get creeped out by
feeling the lumpy bumpiness of your breast, and the only
way to have that self confidence in doing an exam
is to do it regularly and develop this unconscious sort
of memory of where the lumpy bumpiness is, where it's
tender when you press, and not. So you want to
(28:38):
begin doing self breast exams. I believe, in my opinion,
as young as when you start having periods. I don't
think that you're going to ever have a breast cancer
at sixteen or twenty one, but I want you to
have had that unconscious memory developing along with the development
of your breasts. So I suggest women do it every
(29:00):
single month. One week after their periods. That's when your
breast are going to be less tender and less lumpy.
And then don't worry about finding a cancer. I just
want you to pick a method of examining your breast
that is a repeat pattern, so that one day, God forbid.
But if you ever do feel something, you'll be like
that was not there before, Like hands down, I know
(29:23):
that wasn't there before. I created a nice five minute
tutorial on how to do a self breast exam. It's
an easybreastexam dot com. There's a video there that I made,
and I think it's an excellent thing to view because
you for sure are not doing your self breast exam correctly.
Speaker 3 (29:42):
I'm really tempted to do one right now, but I
don't want to make everyone in the studio uncomfortable, so
I'll move on. So, when it comes to breast cancer detection,
we've always heard that mammograms are the gold standard. However,
we've been seeing some news stories lately about mammograms potentially
missing early stages of breast cancer. Perhaps this has to
(30:04):
do with the density of breast tissue. What factors contribute
to a mammogram missing a diagnosis.
Speaker 1 (30:11):
Mammograms miss breast cancer largely due to density, so we
grade density A through D season DS are dense as
and bs are not. It's simply a visual ratio of
the white, splotchy stuff to the dark gray stuff. The
denser your breast, the whiter your mammogram appears. And that's
a problem for two reasons. Number One, cancer is always white,
(30:35):
so now you're looking for a snowball in a snowstorm.
If you are graded C with your density, which has
word correlates, so the c's are called heterogeneously dense on
the report, we will miss twenty five percent of breast
cancers when present. If you are D, called extremely dense
(30:56):
in word form on the report, we miss forty percent
of breast cancer. Part two of that is not just
that we miss the cancers, but you have more of
the stuff underneath your breast skin that actually makes cancer.
So the milk producing lobules and the hair thin little
ducks in there as opposed to fat and blood vessels
and connective tissue, etc. You have more of the stuff
(31:19):
that makes cancer. That's what's making it white. So your
higher risk to make a breast cancer versus the woman
with fattier, less dense breasts, and we are higher risks
to miss that cancer if you make one. Actually, a
new national federal law went into effects September tenth, twenty
(31:39):
twenty four that mandates every single imaging facility in the
United States to report two women getting a mammogram whether
or not their breasts are dense. They have to use
this extremely specific language. It's a cut and paste. It's
a uniform for every imaging center, and to paraphrase it,
it says, Hey, your mammograms fine, but your breasts are dense,
(32:02):
which means we could mis cancer. Good luck with that.
Speaker 3 (32:07):
At least, you know, I got one of those after
my mammogram, right.
Speaker 1 (32:11):
It's very disconcerting, right because you're like, well, yeah, it is.
What did you do with that information?
Speaker 3 (32:16):
You know, it's something that I've always known, just because
I've talked about it with my mom. My mom has
the same thing. But I think it. You know, it's
got me on like a healthy high alert. I'd say,
it just makes me want to stay on top of
it more.
Speaker 1 (32:27):
Doctor funk.
Speaker 2 (32:28):
I want to end on a positive note. There's been
so much new research out lately. What's an exciting development
or treatment that you've seen that's giving you hope for
better patient outcomes.
Speaker 1 (32:41):
Immunotherapy, So when it comes to an existing breast cancer patient,
immunotherapy has become such an exciting new intervention and so
successful in the advanced stage cancer patients that they are
now using it in the early stages one and two
when they're diagnosed, because we know it'll improve their prognosis
(33:04):
and dramatically decrease the chances that they deal with the recurrence.
And the second thing I think is exciting to me
is the awareness and openness of women at large to
the idea that they do have control over their health
destiny and in the context of this conversation, their breast
(33:28):
health density. I've created a campaign with the Physicians Committee
for Responsible Medicine. It's called Let's Beat Breast Cancer dot org.
We have over fifty rallies across the country, their drum
rallies to beat the Drum to beat breast cancer, to
get communities excited. It's all about raising eyebrows and awareness,
(33:48):
not funds. And if you go to Let's Beat Breast
Cancer dot org, we invite you to sign up for
free to accept this challenge that we put out there.
To adopt a four approach to beating breast cancer, and
those four problems are to eat a plant based diet,
to exercise regularly, to maintain ideal body weight, and to
(34:09):
limit or eliminate alcohol. And as soon as you sign up,
we send you a free e starter kit and a
vegan cookbook that we've created specifically surrounding foods that maximize
breast health and reduce occurrence and recurrence risk for breast cancer.
It's a really fun campaign and people get very excited
(34:31):
about it.
Speaker 3 (34:32):
That sounds awesome, Doctor Funk, Thank you so much for
sharing that. I just love the way that you approach
this whole topic. Even though I'm not gonna lie, part
of me is terrified after hearing everything you said. You
also did a wonderful job of putting my mind at
ease in terms of providing information and resources and options,
because at the end of the day, it all comes
back to agency and as you mentioned, having agency over
(34:55):
our health destinies as much as we possibly can.
Speaker 2 (34:57):
Absolutely, Yeah, I feel really empowered by the information you shared.
Thank you.
Speaker 1 (35:02):
Oh You're so welcome.
Speaker 3 (35:03):
Thank you so much for joining us on the bright side,
Doctor Funk, Thanks for.
Speaker 1 (35:06):
Having me.
Speaker 2 (35:09):
Doctor Christy Funk is a Board certified breast cancer surgeon
and women's health advocate. She also runs the Pink Lotus
Breast Center in Santa Monica, California, and is the author
of Bress, the Owner's Manual.
Speaker 3 (35:21):
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(35:43):
dot com slash podcast. That's it for today's show. Tomorrow,
we're talking confidence and self worth with the president of
Lorel Paris USA, Ali Goldstein. Join the conversation using hashtag
the bright Side and connect with us on social media
(36:03):
at Hello Sunshine on Instagram and at the bright Side
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Speaker 2 (36:13):
Listen and follow The bright Side on the iHeartRadio, app,
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Speaker 3 (36:19):
See you tomorrow, folks, keep looking on the bright side.
Hey, besties, Hello Sunshine.
Speaker 2 (00:06):
Today on the bright Side, it's Wellness Wednesday. We're honoring
Breast Cancer Awareness Month with breast cancer surgeon and women's
health advocate, doctor Christy Funk. She's breaking down the latest
in breast cancer research and prevention, including changes we can
all make to lower our risk. It's Wednesday, October second.
I'm Danielle Robe and.
Speaker 3 (00:27):
I'm Simone Boyce. This is the bright Side from Hello Sunshine,
a daily show where we come together to share women's stories, laugh,
learn and brighten your day. Today's Wellness Wednesday is presented
by Coligard. All Right, y'all. October is Breast Cancer Awareness Month,
and to be honest, I don't know a woman who
(00:49):
doesn't have a personal connection to breast cancer. Danielle, have
you seen this show up in your own life? Oh
my goodness, yes, I will never forget.
Speaker 2 (00:57):
When I was in fifth I would say, and one
of my mom's best friends was diagnosed with breast cancer,
and we would go to her house at night and
bring her plants and cookies and sit with her on
the couch and talk. And I just remember how difficult
it was for everybody who loved her. And I think
(01:20):
as I've gotten older, I know so many women who
have been diagnosed with breast cancer. Statistically, one in eight
women in the US will develop it in their lifetime.
Do you do you have a personal touch point to it, Simone.
Speaker 3 (01:33):
Yeah, breast cancer is something that really loomed large over
my whole childhood. It was kind of this like medical
boogeyman in my family because I grew up hearing all
these stories about my wonderful grandmother, Bonnie, my mom's mom,
but I never actually got to meet her because she
died a few months after I was born, when she
was fifty eight years old, because of breast cancer. So
(01:55):
it was of course something that my mom talked about
a lot in terms of preventative measure and I actually
in high school, when I was like sixteen years old,
had my first brush with a potential breast cancer diagnosis. Thankfully,
it was not cancerous, but I did have a benign
(02:15):
lump at the time, so I had to go through
surgery and get it removed from my breast. But I'm
thankful for that experience because I think it helped me
gain a deeper awareness of my body and just know
what to look out for.
Speaker 2 (02:28):
Sixteen is really young to experience something like that. That
must have been scary. Yeah, it was.
Speaker 3 (02:34):
I had the best friends, though, Like I can remember
coming home from surgery and they all just came over
and hung out on my couch while I was like
knocked out from painkillers. And so it's all about support,
like you were talking about, do.
Speaker 2 (02:46):
You think about that moment now today?
Speaker 1 (02:50):
I have a scar.
Speaker 3 (02:52):
I have a scar, so you know, when I'm looking
at myself in a mirror, it's one of the scars
that is visible, and it certainly takes me back to
that time. But I'm kind of glad that I have
the scar because that scar reminds me to take care
of myself, and it reminds me to go get my
annual checkups and do my exams at home. And I
(03:13):
just got my first mammogram this year. I'm thirty six
years old, and I got it done a little bit earlier,
perhaps by some standards, but given my family's medical history,
I feel so much better having it done. I have
this tremendous peace of mind because of it.
Speaker 2 (03:28):
Well, I think part of what you're sharing is that
early detection is so helpful. It really increases the chances
of successful treatment and survival, and I think opening up
these conversations about breast health can really save lives. Every
time The Today's Show or Good Morning America does a
segment on this and there's a live mammogram, viewers write
in talking about how somebody was triggered to go to
(03:50):
the doctor and it saved their life. And so today
we're hoping to do the same. We're going to be
talking about early detection along with so much more. So
we're joined by doctor Christy Funk. She's a board certified
breast cancer surgeon and physician.
Speaker 3 (04:05):
Doctor Funk runs the Pink Lotus Breast Center in Santa Monica,
where she's counseled and treated thousands of women just like
me and Danielle. And she's also the author of Breast
the Owner's Manual, Doctor Christy Funk, Welcome to the bright Side.
Speaker 1 (04:19):
Welcome, Thank you, so excited to be here.
Speaker 3 (04:23):
Something that Danielle and I have both felt convicted about
is the fact that so many women have stories of
how breast cancer has impacted their families or ripped loved
ones away from them, or exists in the back of
their mind as this you know, fear that kind of
looms over their medical history. So we're really excited to
(04:47):
talk to you and start off with this. How pervasive
is breast cancer? I mean, we know that the rates
are going up. I'd love to know from you, just
get this kind of lay of the lane and an
update on the landscape. How many people are diagnosed each
year in the US and how does that compare to
when you started in the field.
Speaker 1 (05:08):
Oh, what a great question. Okay. So in twenty twenty,
breast cancer surpassed lung to become the number one malignant
tumor in the world men and women combined. Wow, with
about two point three million cases every single year and
six hundred and eighty five thousand deaths worldwide last year,
this year, even more next year. And as you were
(05:31):
just saying, the numbers seem to be going up because
they are going up in our own backyard, as you
were asking, this year twenty twenty four, we're expecting between
two hundred and eighty eight thousand and three hundred and
ten thousand new cases of invasive breast cancer, with about
forty three thousand, two hundred and fifty deaths this year
(05:51):
alone from breast cancer. One of the most alarming things
to me is that while the death rate has been
steadily going down about one point three percent per year
since twenty eleven, that's owing largely to earlier detection and
better treatments, the incident's rate has been a very steady
(06:12):
zero point four percent per year after year increase for
the last twenty years, since two thousand and four. I
started my practice in two thousand and two, so twenty
two years ago, and the incident's rate was something like
two hundred and ten thousand. That was the number. It
was two hundred and ten thousand women per year diagnosed
(06:34):
with invasi of kids. So we've gone up about another
one hundred thousand. How do you stay hopeful? I stay
hopeful because I know something that most people don't know.
I know that the vast majority of all breast cancer
is under your control. What you eat or don't eat,
(06:56):
drink or don't drink, do or don't do, think or
don't think eat, even down to like if you forgive
or don't forgive, it alters the cell micro environment inside
of you, pushing you toward cancer or away. And you
have so much control in your choices. So I'm hopeful
because I know this message is not getting out, and
(07:18):
so I get to preach it from the mountaintop. I
get to try every chance. I get to help empower
women and men to understand that their daily choices impact
cellular health, which impacts cancer incidents, recurrence, mortality, and not
just cancer, heart disease, stroke, diabetes, Alzheimer's, obesity, All the
(07:39):
things that contribute to the major killers in our lives
are largely related to diet and lifestyle.
Speaker 3 (07:46):
I'm so glad you brought up lifestyle. This is one
of those big risk factors that we hear a lot about.
And there's actually a very fresh study that just came
out end of September that gives us more insight into
how life style plays into this. So, this new study
suggested that many commonly used food packaging products contain known
breast cancer causing chemicals. And the packaging they're talking about
(08:10):
is the type of thing we see all the time
in our own homes or at restaurants, shrink wrap, cardboard trays,
or paper containers. What do you make of this study
and how should we interpret the results.
Speaker 1 (08:20):
Okay, this study is absolutely accurate. What I make of
it is that we are bombarded day in and day out.
With all of these endocrine disruptors. There are literally an
estimated one hundred thousand, one hundred thousand synthetic chemicals used
in the United States. A substantial number of these are
bound to be zeno estrogens. By that, I mean chemicals
(08:42):
that mimic the action of estrogen in your body. This
is important because eighty percent of all breast cancers are
fed and fueled by estrogen, and yet no regulatory body
has mandated that we test products for zeno estrogen levels
or their effects, so we don't really even know what happens.
They attached to the same receptors as your natural estrogen will,
(09:05):
But do they cause a stronger downstream reaction than normal hormones,
A weaker one, a totally different one like your guess
is as good as mine. And the EPA, the Environmental
Protection Agency, formed the Endocrine Disruptor Screening Program. Okay, their
first update came in August twenty twenty fifteen e ish.
(09:28):
And when they came guess how many of the one
hundred thousand chemicals they looked at, I'll just tell you
fifty two.
Speaker 3 (09:37):
Oh my gosh.
Speaker 1 (09:39):
So if every seventeen years we look at fifty two
of the one hundred thousand chemicals. We're going to finish
with all of them in thirty three thousand years. That's
when we'll get our final update. So when this study
came out, I was intrigued by it because I love
that it gets some attention and press to find out that, Yeah,
(09:59):
in our daily lives, we are bombarded by these endocrine disruptors,
and it's always good to be aware of it. But
the thing is these are everywhere, right, Like you wake
up in the morning and that sunscreen you put on
endocrine disruptor EDC, right, endocrine disrupting compound, the gas pump
(10:22):
that you handled at the station, etc. The plastic fork
and water bottle that you had at your takeout lunch, etc.
The detergent you washed your pillow case with that you're
sleeping on, maybe an EEDC. So they are everywhere. So
what I like to tell people is, look, they're so ubiquitous,
(10:42):
these environmental toxicities. All you can do is live your
life well with some attention, particularly to the things that
are on you, on your skin, or that you are
swallowing down, because those have the closest proximity to impact
(11:03):
cellular health. Right, doesn't that make the most sense. So practically,
what this means is have a look at your ingredients.
A lot of people never thought about it. They never
thought like, oh, I should actually read what's in my
laundry detergent, the lotion I'm putting on my skin, the
toothpaste I'm putting all over my gums, the stuff I
wash my dishes with and then eat food off of
(11:26):
plastics is the big was the big This report was
talking about plastics, right, and per fluorocarbonated alkophenols, right, These
pfast chemicals, they're called forever chemicals because they get into fat.
(11:46):
I mean, forever is a good thing if you're talking
about like the stability of a relationship or maybe your job.
But beyond that, you do not want these stable chemicals
inside your body. So you want to just limit them
with your cooking. Look at your cookware. Store everything in
(12:06):
glass or ceramic. Never ever, ever, ever microwave or heat
anything that is in plastic. And I don't know where
this idea came from. I was a kid in the
seventies and we microwave dinners like I think they just started,
and the microwaves were fascinating, and you'd put the food
in there and you'd stare at it while it was cooking,
and then it would come out and you just remember
(12:28):
you're supposed to peel up the corner of the I
can't even believe people think about doing that. And this
idea that you need to have it in the packaging
and order for it to heat well is a farce.
Like anything, if I'm having some frozen vegetables or something
that I need to cook up, I just dump them
into a glass dish and put them in the microwave.
You can heat them on the stove, put them in
an instapot. Just get away from all the plastics, all
(12:50):
the baby bottles and the sippy cups and the infant
formula cans and all of that. Like, just make sure
everything is glass or ceramic.
Speaker 2 (13:00):
People on our show always make fun of me because
I don't wear any fragrance, and it's for this reason, actually,
doctor Funk. But I've found that the EWG, the Environmental
Working Group, is a great resource, particularly because you mentioned
the EPA hasn't updated many of their many of their lists, right.
Speaker 1 (13:24):
Yeah, I love the EWG. Yeah, they've also got that
Dirty Dozen in the Clean fifteen. Yes, because eating organic
is a great weight to be avoiding a lot of
these toxicities. And probably the best way of all, by
the way, is to be eating plant based because whenever
you cook barbecue grill meat, you are creating these pfast
(13:48):
chemicals and swallowing them down, and they are potent carcinogens.
Speaker 2 (13:53):
We need to take a quick break, but we'll be
right back to wellness Wednesday with doctor Christy Funk. And
we're back. There's a study I'm curious about. It was
from Susan g. Coman, and they linked weight gain to
(14:16):
breast cancer. And I know you're talking about the chemicals
in food, but can weight gain increase our chance of
getting breast cancer.
Speaker 1 (14:24):
One hundred percent? Yes, So, for reasons that are not
entirely clear, premenopausal weight gain and being overweight or obese
is somehow protective against pre menopausal breast cancer. But the
second you hit menopause, there is no question, in no
controversy that obese women have fifty to two hundred and
(14:45):
fifty percent more breast cancer, more breast cancer recurrence, and
more breast cancer related death. Wow, there are multiple reasons. Yeah, No,
weight is a really big deal. The beauty in this
statement is that if you lose the weight, you lose
the risk. So it's not like you've locked into this
risk at a certain weight and there's no way to
(15:07):
undo it. But a couple things I'll say so. One,
there was a study that looked at gaining more than
five percent of your initial body weight during or after
breast cancer treatment, irrespective of your baseline body mass index,
so you didn't even have to be overweight. If you
just gained five percent of your initial body weight, it
increased the risk of recurrence in survival by four hundred percent.
(15:30):
That's staggering. What fat is doing is a number of things,
but it's under recognized by like the quick blanket statement
that you might hear in media in that estrogen feeds
and fuels eighty percent of breast cancers. Once your ovary
shuts down, either because of natural menopause or perhaps you
(15:54):
had premature ovarian failure or chemical menopause, which is meaning
chemo therapy kind of destroyed your ovarian production, or you
had them surgically removed. Okay, that estrogen source is gone.
That was your main estrogen source. One percent of the
amount of estrogen that your ovary was making is made
by you from your fat. So you've got these fat
(16:17):
cells predominantly in the fat itself. But there's an enzyme
in the fat called aroma tase, and some of this
is also found in liver in the ovary itself, so
it's not the ovarian production, but it's from the fat
in the ovary in muscle. And believe it or not,
these sinister cancers, if they've already formed, they have their
(16:40):
own aromatase enzyme. Maybe got like a little backpack, like
one of those little running backpack water bottle things, Like
it's like, oh, I need some more estrogen. Let me
just sip out of my backpack here and get some more.
Aromatase is an enzyme in all these places. It's turning
adrenal gland steroids into estrogen. So it's not enough to
(17:00):
stop a hot flash if you're menopausal, but it is
sure enough to feed and fuel that cancer. That's usually
where the story ends for people who make the connection
between weight, overweight, obesity and breast cancer, but that is
hardly the story. The real sinister mechanisms of how weight
(17:22):
intersects with breast cancer have to do with inflammation. So
the number one, two and three things are leptin, chronic
inflammation produced by fat cells, and insulin. So lectin. It's
created mostly by adipose tissue and it's secreted into circulation,
(17:44):
and once leptin binds to its receptor, it crosstalks with
all of these oncogenes, with all of these genetic switches
that you flip on and off to suit a cancer's need.
It ignites this signaling pathway multiple pathway that release growth
factors and cidokinds. And the endgame is breast cancer initiation, progression,
(18:09):
and metastases. If it's already there, So that's leptin. The
second thing fat does is it activates. It has these
macrophases in the adipose tissue of obese women that produce
inflammatory mediators, things that have letters and numbers TNF, alpha,
interluken six. The specifics do matter so much as the
(18:32):
endgame again chronic inflammation, which is promoting this cancer growth
in metastatic spread. And the other thing it makes happen
is angiogenesis. Angio means blood vessel genesis is birth. If
you are a breast cancer cell and you aspire to
be bigger than the tip of a ballpoint pen, which
every cancer aspires to be. You must create your own
(18:55):
blood supply, and you must have this environment around you
that's conducive to doing that. Angiogenesis the birth of these
blood vessels, so you can bring your own new nutrients
to yourself, and then when you get big enough, shoot
them exit strategy straight through those same blood vessels to
the brain, to the lung, to the liver, to the bone.
(19:16):
That's how it all goes down. And the activated macrophases
in fat create angiogenesis and modify your immune response so
much so that this is probably the reason why we
know that obese women don't respond as well to both
(19:38):
the anti estrogen therapies and the chemo therapy we give
them when they have breast cancer. They have uniformly worse prognoses.
Speaker 2 (19:45):
Doctor funk I think that we hear a lot about
the effects of alcohol on our healths, and a study
published this September looks specifically at the potential link between
alcohol and increased breast cancer diagnosis and patients under fifty.
What should we know about alcohol consumption and breast cancer?
Speaker 1 (20:04):
Okay, so pick your poison. What is alcohol? It's five
ounces of wine equals one point five ounces of hard
liquor equals a twelve ounce beer. A drink a day
and a premenopausal woman increases breast cancer by seven percent.
A drink a day in a postmenopausal woman thirteen percent.
Every drink thereafter adds about another ten percent. So two
drinks a day seventeen percent pre menopausal, it's twenty three
(20:27):
percent postmenopausal, and onwards and upwards from there.
Speaker 2 (20:31):
I do want to say, one drink a day is
quite a lot of drinks. So if you're just like
you know, drinking once a week or once every two weeks,
you're pretty much okay with alcohol as it relates to
breast cancer.
Speaker 1 (20:44):
Yes, that amount of drinking is not going to really
become carcinogenic, but a seegl aaldehyde is the carcinogen that
you form. Even if you just use your alcohol as mouthwashed,
which would be a terrible waste of an excellent wine draft.
But if you just fish and spad swallow down, you
are already swallowing down a carcinogen that then even becomes
(21:04):
more prevalent as it gets broken down by your liver
into a cel aaldehyde. One of the main reasons why
alcohol causes breast cancer though. Back to that is its
interference with an enzyme called MTHFR, which sounds like bad
word MTFR. It stands for methyl tas or hydrofolate reductase,
(21:26):
And what that enzyme is doing is that's taking full
eight from your leafy grains and full of acid from
your vitamins and turning it into methyl fulate. Methyl Fulate
in its active form is babysitting DNA as it divides.
So when your body makes a mistake, which it does
millions of time miss every day, methyl fullate swoops in
(21:48):
and fixes it or throws it out so it doesn't
set as a mutation that then gets propagated. One cell
becomes two, becomes four until you have a cancer. Right
when you drink you knock out that enzyme. Thirty to
fifty percent of all people already have a suboptimal NTHFR,
so they have a mutation. It's not complete, but it's partial.
(22:11):
And then the alcohol on top of it is just like,
forget it, lady, I'm not making any methyl fool. I
did a good luck with that mutation.
Speaker 3 (22:19):
We need to take another short break, but we'll be
right back and we're back with breast cancer surgeon and
women's health advocate, doctor Christy Funk. So we've talked about lifestyle, diet, alcohol,
we want to talk about genetics next. This is something
(22:41):
that directly impacts me. My maternal grandmother passed away from
breast cancer when she was fifty eight, and so it's
always been something that my mom has warned me about
growing up, and especially the power of early detection when
we think about lifestyle and genetics, which is more of
a determining factor when it comes to breast cancer diagnoses.
Speaker 1 (23:03):
Genetics, for sure, there are about nineteen of these gene
mutations that we know are strongly associated with the predisposition
to getting breast cancer. Can diet and lifestyle circumvent or
overrule the problems with this gene mutation that you may
have inherited, Probably not, or at least not yet with
(23:27):
any real certainty. However, and this is a really important point,
only five to ten percent of all women diagnosed with
breast cancer carry a genetic mutation they've inherited from mom
or dad, which means that ninety to ninety five percent
of all women with breast cancer did not get it
(23:49):
from a genetic predisposition.
Speaker 3 (23:52):
Whose environmental you're saying, I.
Speaker 1 (23:54):
Think diet and lifestyle. There's a saying that I like,
and it's that genetics load the gun, but your choice
is pulled the trigger.
Speaker 3 (24:05):
And then in terms of figuring out where you stand genetically,
it's DNA testing, right, those are the options. Yes, talk
to us about the options that are available.
Speaker 1 (24:13):
So think about your family tree for second and third
degree relatives on both sides of the family, and let's
analyze that. If you have two relatives on the same
side with breast cancer prior to age fifty or ovarian
cancer at any age, then you should consider genetic testing
(24:35):
because your risk of carrying a G mutation is ten
percent or higher. If you are Ashkenazi Jewish in heritage,
then you only need one of those one breast cancer
prior to fifty one, ovarian cancer any age, if you
yourself have had breast cancer. I test everybody now because
it's so affordable. It used to be very cost prohibitive.
(24:56):
It was literally if you wasn't covered by insurance, it
was forty five one hundred dollars and that was just
to find out if you carried BRCA. Now, if you
don't qualify by insurance criteria. For two hundred and fifty dollars,
you can get a full genetic panel of eighty five
genetic mutations. So again, two relatives with breast under fifty.
(25:17):
One relative with ovarian cancer at any age, if you
yourself had breast cancer, particularly prior to age fifty a
triple negative subtype, which if you had that you would know,
and or if you yourself have had breast cancer twice,
not a recurrence of the same one, but two totally
separate breast cancers, if there are any men in the
(25:39):
family tree with breast cancer, or if anybody had pancreatic melanoma,
gastric prostate. These are all like associated with certain syndromes,
So the breast, ovarian and then all the other cancers.
There's just a whole lot going on, three or more
(26:00):
relatives than I would consider testing.
Speaker 2 (26:03):
I feel like we've all heard how important early detection is.
I know this may sound silly, but I grew up
hearing about it on the Today Show in Good Morning America.
I think traditionally the advice has been to start getting
mammograms at the age of forty. Is that still the recommendation?
Speaker 1 (26:22):
It is different societies have different recommendations, but we are
all sort of trending back hearing about oh you can
start at fifty, you can do every other year. The
United States Preventive Task Force as now dialed it back
again to beginning at age forty. Look, especially in life
(26:46):
with the conversation we were just having. Knowing that breast
cancer is getting diagnosed earlier than ever before in women
under fifty, there's no reason to be excluding them from screening.
So I signed with the America Society of Breast Surgeons,
and we advise women of normal breast cancer risks to
(27:06):
begin in age forty and don't stop or skip years
until your life expectancy is less than five years, which
is admittedly a little hard to predict when you're going
to die. But you know certain people, it's obvious that
their heart disease or their advanced COPD, etc. Is more
critical than a breast cancer diagnosis would be, because it
(27:31):
would potentially cause too much harm to treat that cancer,
which was never going to be the reason why they
died if they already have something else more serious looming,
like advanced cardiac for lung disease.
Speaker 2 (27:47):
What about for women in their twenties and thirties. What
do you think they should be paying attention to in
terms of their breasts.
Speaker 1 (27:53):
I always encourage women to be breast aware, so to me,
that involves monthly self breast exams. The official rule on
the street is that doing self breast exams don't save lives,
but in my practice, I've just seen it to be otherwise.
I think you're with your breasts every day, all day,
and I might be with them once a year or so.
(28:16):
I think it's smart to not get creeped out by
feeling the lumpy bumpiness of your breast, and the only
way to have that self confidence in doing an exam
is to do it regularly and develop this unconscious sort
of memory of where the lumpy bumpiness is, where it's
tender when you press, and not. So you want to
(28:38):
begin doing self breast exams. I believe, in my opinion,
as young as when you start having periods. I don't
think that you're going to ever have a breast cancer
at sixteen or twenty one, but I want you to
have had that unconscious memory developing along with the development
of your breasts. So I suggest women do it every
(29:00):
single month. One week after their periods. That's when your
breast are going to be less tender and less lumpy.
And then don't worry about finding a cancer. I just
want you to pick a method of examining your breast
that is a repeat pattern, so that one day, God forbid.
But if you ever do feel something, you'll be like
that was not there before, Like hands down, I know
(29:23):
that wasn't there before. I created a nice five minute
tutorial on how to do a self breast exam. It's
an easybreastexam dot com. There's a video there that I made,
and I think it's an excellent thing to view because
you for sure are not doing your self breast exam correctly.
Speaker 3 (29:42):
I'm really tempted to do one right now, but I
don't want to make everyone in the studio uncomfortable, so
I'll move on. So, when it comes to breast cancer detection,
we've always heard that mammograms are the gold standard. However,
we've been seeing some news stories lately about mammograms potentially
missing early stages of breast cancer. Perhaps this has to
(30:04):
do with the density of breast tissue. What factors contribute
to a mammogram missing a diagnosis.
Speaker 1 (30:11):
Mammograms miss breast cancer largely due to density, so we
grade density A through D season DS are dense as
and bs are not. It's simply a visual ratio of
the white, splotchy stuff to the dark gray stuff. The
denser your breast, the whiter your mammogram appears. And that's
a problem for two reasons. Number One, cancer is always white,
(30:35):
so now you're looking for a snowball in a snowstorm.
If you are graded C with your density, which has
word correlates, so the c's are called heterogeneously dense on
the report, we will miss twenty five percent of breast
cancers when present. If you are D, called extremely dense
(30:56):
in word form on the report, we miss forty percent
of breast cancer. Part two of that is not just
that we miss the cancers, but you have more of
the stuff underneath your breast skin that actually makes cancer.
So the milk producing lobules and the hair thin little
ducks in there as opposed to fat and blood vessels
and connective tissue, etc. You have more of the stuff
(31:19):
that makes cancer. That's what's making it white. So your
higher risk to make a breast cancer versus the woman
with fattier, less dense breasts, and we are higher risks
to miss that cancer if you make one. Actually, a
new national federal law went into effects September tenth, twenty
(31:39):
twenty four that mandates every single imaging facility in the
United States to report two women getting a mammogram whether
or not their breasts are dense. They have to use
this extremely specific language. It's a cut and paste. It's
a uniform for every imaging center, and to paraphrase it,
it says, Hey, your mammograms fine, but your breasts are dense,
(32:02):
which means we could mis cancer. Good luck with that.
Speaker 3 (32:07):
At least, you know, I got one of those after
my mammogram, right.
Speaker 1 (32:11):
It's very disconcerting, right because you're like, well, yeah, it is.
What did you do with that information?
Speaker 3 (32:16):
You know, it's something that I've always known, just because
I've talked about it with my mom. My mom has
the same thing. But I think it. You know, it's
got me on like a healthy high alert. I'd say,
it just makes me want to stay on top of
it more.
Speaker 1 (32:27):
Doctor funk.
Speaker 2 (32:28):
I want to end on a positive note. There's been
so much new research out lately. What's an exciting development
or treatment that you've seen that's giving you hope for
better patient outcomes.
Speaker 1 (32:41):
Immunotherapy, So when it comes to an existing breast cancer patient,
immunotherapy has become such an exciting new intervention and so
successful in the advanced stage cancer patients that they are
now using it in the early stages one and two
when they're diagnosed, because we know it'll improve their prognosis
(33:04):
and dramatically decrease the chances that they deal with the recurrence.
And the second thing I think is exciting to me
is the awareness and openness of women at large to
the idea that they do have control over their health
destiny and in the context of this conversation, their breast
(33:28):
health density. I've created a campaign with the Physicians Committee
for Responsible Medicine. It's called Let's Beat Breast Cancer dot org.
We have over fifty rallies across the country, their drum
rallies to beat the Drum to beat breast cancer, to
get communities excited. It's all about raising eyebrows and awareness,
(33:48):
not funds. And if you go to Let's Beat Breast
Cancer dot org, we invite you to sign up for
free to accept this challenge that we put out there.
To adopt a four approach to beating breast cancer, and
those four problems are to eat a plant based diet,
to exercise regularly, to maintain ideal body weight, and to
(34:09):
limit or eliminate alcohol. And as soon as you sign up,
we send you a free e starter kit and a
vegan cookbook that we've created specifically surrounding foods that maximize
breast health and reduce occurrence and recurrence risk for breast cancer.
It's a really fun campaign and people get very excited
(34:31):
about it.
Speaker 3 (34:32):
That sounds awesome, Doctor Funk, Thank you so much for
sharing that. I just love the way that you approach
this whole topic. Even though I'm not gonna lie, part
of me is terrified after hearing everything you said. You
also did a wonderful job of putting my mind at
ease in terms of providing information and resources and options,
because at the end of the day, it all comes
back to agency and as you mentioned, having agency over
(34:55):
our health destinies as much as we possibly can.
Speaker 2 (34:57):
Absolutely, Yeah, I feel really empowered by the information you shared.
Thank you.
Speaker 1 (35:02):
Oh You're so welcome.
Speaker 3 (35:03):
Thank you so much for joining us on the bright side,
Doctor Funk, Thanks for.
Speaker 1 (35:06):
Having me.
Speaker 2 (35:09):
Doctor Christy Funk is a Board certified breast cancer surgeon
and women's health advocate. She also runs the Pink Lotus
Breast Center in Santa Monica, California, and is the author
of Bress, the Owner's Manual.
Speaker 3 (35:21):
Thank You to our partners at Cologard, the one of
a kind way to screen for colon cancer in the
privacy and comfort of your own home. Talk to your
doctor or healthcare provider, or go to coliguard dot com
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If you're forty five or older in an average risk,
ask your healthcare provider about screening for colon cancer with Colguard.
You can also request a Colguard prescription today at coliguard
(35:43):
dot com slash podcast. That's it for today's show. Tomorrow,
we're talking confidence and self worth with the president of
Lorel Paris USA, Ali Goldstein. Join the conversation using hashtag
the bright Side and connect with us on social media
(36:03):
at Hello Sunshine on Instagram and at the bright Side
Pod on TikTok Oh, and feel free to tag us
at Simone Boye and at Danielle Robe.
Speaker 2 (36:13):
Listen and follow The bright Side on the iHeartRadio, app,
Apple podcasts or wherever you get your podcasts.
Speaker 3 (36:19):
See you tomorrow, folks, keep looking on the bright side.
Host
Simone Boyce
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