Breast Health Exposed: Myths, Risks, and the Untold Truth

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🚨 Attention, podcast listeners! 🚨 You won’t want to miss this enlightening episode of Soma Says with Dr. Soma! In this powerful conversation, Dr. Soma is joined by the brilliant Dr. Lauren Ramsey, a board-certified Breast Surgical Oncologist and Medical Director of Breast Surgery at Acclaim Multi-Specialty Group in Fort Worth, Texas.

🎙️ Get ready for an eye-opening journey through the world of breast cancer care and cutting-edge research! Dr. Ramsey breaks down the science behind genetic testing for those at higher risk, shares lifestyle choices that can help lower your cancer risk, and reveals the latest breakthroughs in breast cancer screening.

But that’s not all! Dr. Ramsey introduces her revolutionary BAT™ Radiation Protection Garment, designed to reduce cancer risk for healthcare workers exposed to radiation — a game-changer in the field!

🔬 From the alarming link between alcohol and breast cancer, to the role of hormone replacement therapy, and the promising new screening technologies on the horizon, this episode covers it all. Dr. Ramsey’s personalized approach to cancer care and her passion for patient education and advocacy will leave you inspired and informed.

⏰ Here’s a sneak peek at what’s inside: 00:00 – Introduction and Disclaimer 00:41 – The Life-Saving Importance of Genetic Counseling & Testing for Breast Cancer 01:20 – Meet Dr. Lauren Ramsey 03:16 – Dr. Ramsey’s Inspiring Journey to Breast Surgery 05:09 – The Surprising Link Between Alcohol and Breast Cancer Risk 08:21 – Lifestyle Changes that Can Reduce Breast Cancer Risk 11:16 – How Hormones Play a Role in Breast Cancer Development 13:29 – Menopause & HRT: What You Need to Know About Risks 19:57 – The Latest Advances in Breast Cancer Screening 26:37 – Breast Density and Ultrasounds: What They Mean for You 28:43 – Exciting Future Innovations in Breast Cancer Screening 30:57 – Genetic Testing for High-Risk Breast Cancer Patients 32:23 – Weighing the Risks and Benefits of Hormone Replacement Therapy 35:02 – Innovative Radiation Protection for Healthcare Workers 45:41 – Diet and Lifestyle Tips to Lower Your Cancer Risk 47:41 – Conclusion + Contact Information

💡 Whether you’re at risk, a healthcare professional, or just someone eager to stay on top of cutting-edge cancer research, this episode is a must-listen!

🔥 Tune in now and be empowered to take control of your breast health — your future self will thank you!

 

To learn more about Dr. Lauren Ramsey, please visit https://www.laurenramseymd.com/

Episode Transcript

(00:00):
Hi, this is Dr.

(00:01):
Soma.
Just a disclaimer, this podcast is for informational purposes only and isn't intended as medical advice.
Always consult with your doctor before making any changes to your diet, exercise, or health regimen.
Let's go to the show.

(00:41):
When a woman is at a higher risk, I also, would counsel them on going to see a genetic counselor and getting genetic testing, especially if they have a family history of breast cancer. 7 00:00:52,509.999 --> 00:00:59,104.999 One of the most common mutations that people might've heard of are the BRCA1 and BRCA2 mutations. 8 00:00:59,832.482 --> 00:01:01,702.482 we're catching cancers very early now. 9 00:01:01,852.482 --> 00:01:04,862.482 And our survival and our outcomes are very good. 10 00:01:05,132.482 --> 00:01:06,882.481 However, there are more cancers. 11 00:01:07,609.964 --> 00:01:11,629.964 orthopedic surgeons have up to three times higher rate of breast cancer. 12 00:01:12,49.964 --> 00:01:13,959.963 And that was pretty shocking to me. 13 00:01:13,979.964 --> 00:01:20,49.964 And, and also the x ray techs, the radiologic technologists have higher rates of breast cancer too. 14 00:01:20,827.447 --> 00:01:22,217.447 Today's guest is Dr. 15 00:01:22,217.447 --> 00:01:23,177.447 Lauren Ramsey. 16 00:01:24,367.447 --> 00:01:24,677.447 Dr. 17 00:01:24,677.447 --> 00:01:32,47.447 Ramsey is a board-certified Breast Surgical Oncologist with a profound dedication to advancing healthcare and patient safety. 18 00:01:32,687.447 --> 00:01:33,687.447 She earned her B.S. 19 00:01:33,687.447 --> 00:01:35,627.447 in Neuroscience and M.D. 20 00:01:35,667.447 --> 00:01:40,87.447 from the University of Pittsburgh, and further expanded her expertise with an M.B.A. 21 00:01:40,87.447 --> 00:01:41,437.447 from American University. 22 00:01:41,937.447 --> 00:01:50,887.447 After honing her skills at Baylor University Medical Center and completing a fellowship in Breast Surgical Oncology, she became board-certified by the American Board of Surgery. 23 00:01:52,52.447 --> 00:01:53,2.447 Currently, Dr. 24 00:01:53,2.447 --> 00:02:04,752.447 Ramsey is making strides as the Medical Director of Breast Surgery for Acclaim Multi-Specialty Group in Fort Worth, Texas, and as an Assistant Professor of Surgery at the TCU Burnett School of Medicine. 25 00:02:05,452.447 --> 00:02:15,752.447 Her groundbreaking research, particularly in breast cancer and radiation, has not only been featured at numerous conferences but also published in peer-reviewed journals and textbooks. 26 00:02:16,182.447 --> 00:02:21,132.447 Notably, she is the inventor of the BAT™, a pioneering radiation protection garment. 27 00:02:21,572.447 --> 00:02:26,742.447 Join us as we delve into her inspiring journey and innovations in breast cancer care. 28 00:02:28,144.93 --> 00:02:30,694.93 I wanted to officially welcome you to my podcast. 29 00:02:30,744.93 --> 00:02:33,144.93 I'm very excited about today's topic. 30 00:02:33,169.93 --> 00:02:35,409.93 I'm an internist, a primary care physician. 31 00:02:35,419.93 --> 00:02:41,109.93 So I spend a lot of time talking to women about their breast health and mammograms and all of that. 32 00:02:41,109.93 --> 00:02:43,829.9295 But as there's a lot of time shortage. 33 00:02:44,244.9305 --> 00:02:52,174.9305 And going over however many things that we have to do, I can't spend even 15 minutes talking about breast health. 34 00:02:52,654.9305 --> 00:02:58,674.9305 So a lot of patients have questions about how they can reduce their risk of breast cancer. 35 00:02:59,124.9305 --> 00:03:00,314.9305 And then along comes you. 36 00:03:00,314.9315 --> 00:03:06,294.8305 And I was like, okay, this is a great way of having a lot of information in one place where. 37 00:03:06,629.8305 --> 00:03:07,959.8305 patients can refer to. 38 00:03:07,959.8305 --> 00:03:13,739.8305 And obviously, more than patients listen to my podcast, people in general. 39 00:03:14,279.8305 --> 00:03:16,719.8305 So wanted to learn more about you. 40 00:03:16,719.8305 --> 00:03:21,759.8305 So my audience can hear what inspired you, Dr. 41 00:03:21,769.8305 --> 00:03:25,409.8305 Ramsey To become a breast surgeon, a breast specialist. 42 00:03:25,869.8305 --> 00:03:26,179.8305 Yes. 43 00:03:26,329.8305 --> 00:03:30,179.8305 So when I was in medical school, I really enjoyed surgery. 44 00:03:30,229.8305 --> 00:03:31,699.83 I love my surgery rotation. 45 00:03:31,699.83 --> 00:03:32,719.8305 I loved anatomy. 46 00:03:33,39.8305 --> 00:03:37,299.8295 So I decided that I wanted to do surgery and I always had an interest in women's health. 47 00:03:37,589.8305 --> 00:03:41,439.8305 I have a strong, we have a lot of strong women in my family. 48 00:03:41,669.8305 --> 00:03:47,629.8305 My grandmother actually had breast cancer, so it's something that I was familiar with growing up. 49 00:03:47,909.8295 --> 00:03:58,469.8295 And so when I got to surgery, I just really was attracted to breast surgery and specifically because you get a really good relationship with the patient and breast surgical oncology. 50 00:03:58,479.8295 --> 00:03:59,149.8295 I love just. 51 00:03:59,359.8295 --> 00:04:06,529.8295 Counseling women and having clinic and getting to talk with them and like the emotional side of breast cancer as well. 52 00:04:06,769.8295 --> 00:04:17,119.8295 I feel like I can really connect with the patients and be there when they're very overwhelmed because they have a breast cancer diagnosis and they don't know where to go or what their prognosis is. 53 00:04:17,129.8285 --> 00:04:19,869.8295 So really that attracted me to it. 54 00:04:19,869.8295 --> 00:04:26,109.8285 You get to both do surgery, but then also have a really in depth connection with the patients. 55 00:04:26,129.8285 --> 00:04:29,304.8295 And then Also have a longitudinal relationship. 56 00:04:29,304.8295 --> 00:04:36,234.8295 So I follow my patients, every year for many years after their treatment and they're recovered and in survivorship. 57 00:04:36,634.8295 --> 00:04:41,684.8285 So it's really cool to see the whole journey and that's what really attracted me to breast surgery. 58 00:04:42,544.8295 --> 00:04:47,664.8295 There's a lot and I work very closely with the breast specialists in my practice. 59 00:04:47,994.8295 --> 00:05:05,174.8285 So following those same patients together, I get to see, obviously review their consultations and we, they, I think that you have a, like a very different relationship with these patients than let's say, other specialists. 60 00:05:05,234.8285 --> 00:05:05,484.6285 It's a, yeah. 61 00:05:05,674.7285 --> 00:05:08,744.7285 It seems to me that it's a lot more personal. 62 00:05:09,194.7285 --> 00:05:29,924.7285 So I, I do like that aspect as well, as that there's a lot that has come out recently, especially the use of alcohol and the surgeon general has stated that even moderate consumption of alcohol can increase the risk of certain cancers is breast cancer. 63 00:05:29,924.7285 --> 00:05:30,454.7285 One of them. 64 00:05:30,824.7285 --> 00:05:32,534.7285 Yes, breast cancer is one of them. 65 00:05:32,544.7285 --> 00:05:51,564.7285 We knew that before even the Surgeon General released his statement, but I think now it's very important that people are realizing that and I did like his call to get labels on the beverage bottles just so consumers are aware of this risk and it's a risk factor. 66 00:05:51,584.7285 --> 00:05:54,864.7285 It's not going to be a direct cause and effect relationship. 67 00:05:54,894.7285 --> 00:06:02,484.7285 I don't think that we can say, Oh, you got this breast cancer because you were drinking alcohol like no, there's not a cause and effect, but there it's a risk factor. 68 00:06:02,484.7285 --> 00:06:05,774.7285 And there's so many different risk factors as we'll get into. 69 00:06:05,794.7285 --> 00:06:19,394.729 So I think that if you can eliminate one and it also has so many other health benefits as well, not just reducing your cancer risk, but it's Just something to be aware of and just to, if you can cut back completely, that's the most ideal. 70 00:06:19,414.729 --> 00:06:23,934.729 But if not, then we say no more than three drinks per week, ideally. 71 00:06:24,944.729 --> 00:06:33,444.629 I also have patients who are in their mid lives who are either perimenopausal or menopausal. 72 00:06:33,444.729 --> 00:06:42,304.7285 And they've noticed that at some point, unlike their twenties or early thirties, that alcohol isn't always their friend. 73 00:06:42,499.7285 --> 00:06:49,579.7285 They've noticed that they've have more symptoms, more irritability, more fatigue, more hot flashes. 74 00:06:49,919.7285 --> 00:07:15,599.7285 How do you explain what happens to the body? And does, do those kinds of symptoms signal that they may be at higher risk for other things as well? I think it just has to do with aging and cellular aging as we get older or, ourselves get older and we can't process things as much as we could when we were in our twenties and could have drinks and be up early and just be going for it. 75 00:07:15,599.7285 --> 00:07:20,329.7285 I'm only in my thirties, but I feel like I already feel some effects like that as well. 76 00:07:20,329.7285 --> 00:07:23,349.7285 And then other stressors add on too. 77 00:07:23,399.7285 --> 00:07:27,959.7285 When you're younger, you maybe aren't as stressed about family stuff or work, things like that. 78 00:07:27,969.7285 --> 00:07:37,529.7295 So I think when you're combining alcohol, which we already know has negative effects on, for example, sleep quality, but then you have other stressors as well, it adds up. 79 00:07:37,739.7295 --> 00:07:44,829.7295 And then your general health, maybe you have now you've developed, heart disease or diabetes, and you're just at, as. 80 00:07:44,979.7295 --> 00:07:50,259.7295 As you get older, unfortunately, you are at risk for diseases and even cancer. 81 00:07:50,259.7295 --> 00:07:52,749.7295 We know that one of the risk factors is age. 82 00:07:53,99.7295 --> 00:08:04,379.7295 I wouldn't say that necessarily means they're at a higher risk, but I think that it's a sign that if it's not, if they're not feeling good and they're feeling these side effects, then it's obviously not doing good for their body. 83 00:08:05,589.7305 --> 00:08:21,534.7295 As I mentioned to you, A lot of patients come in and they want to know what they can do to reduce their risk, especially patients who have a higher risk due to genetics and, or if they have other types of cancers in their family. 84 00:08:21,874.7295 --> 00:08:37,984.7295 How do you typically guide your patients when it comes to everyday things, lifestyle choices what they can do better in terms of what they're eating, how they can store their food to screening and testing. 85 00:08:38,664.7295 --> 00:08:39,24.7295 Yeah. 86 00:08:39,274.7285 --> 00:08:42,804.7275 So we'll start with the everyday ways of risk reduction. 87 00:08:43,64.7275 --> 00:08:46,464.7275 Lifestyle factors, exercise is key one. 88 00:08:46,664.7275 --> 00:08:53,84.7275 The American Cancer Society recommends 150 minutes of moderate intensity exercise a week. 89 00:08:53,84.7275 --> 00:08:57,54.726 So if you could, get out about 30 minutes, maybe five times a week. 90 00:08:57,114.727 --> 00:09:01,714.726 Just keep that 150 minutes in mind and moderate, I'm not talking about. 91 00:09:01,714.726 --> 00:09:08,934.726 We don't have to be high intensity training here, but things like brisk walking, swimming, water aerobics. 92 00:09:08,964.726 --> 00:09:10,994.726 I personally like Pilates. 93 00:09:11,224.725 --> 00:09:12,494.726 I've been doing pickleball. 94 00:09:12,594.726 --> 00:09:14,14.725 Tennis is a good one. 95 00:09:14,224.725 --> 00:09:19,384.725 Just, or even activities like gardening, moving around the house, things like that, just staying active. 96 00:09:19,384.725 --> 00:09:26,564.725 And if you can do that, as I said, for 30 minutes a day, five days a week, that is very helpful to reduce your risk of cancer. 97 00:09:27,89.725 --> 00:09:29,829.725 Going along with that, maintaining a healthy weight. 98 00:09:29,869.725 --> 00:09:40,969.725 Obesity, we do unfortunately have an epidemic of obesity and in the United States and your body actually has an enzyme that can convert fat into estrogen. 99 00:09:41,124.725 --> 00:09:44,424.725 which can fuel hormone sensitive breast cancers. 100 00:09:44,714.725 --> 00:09:53,394.724 So by reducing your weight, reducing excess fat, you are reducing your body's estrogen, especially for postmenopausal women. 101 00:09:53,394.725 --> 00:09:55,424.725 That's the estrogen that their body is seeing. 102 00:09:55,754.725 --> 00:10:01,54.724 So with exercise, also weight loss, and then along with that, eating a healthy diet. 103 00:10:01,64.724 --> 00:10:02,674.625 So I don't. 104 00:10:02,724.725 --> 00:10:09,364.725 Have a strict diet that I tell my patients to follow, but really just whole foods and minimally processed foods. 105 00:10:09,384.725 --> 00:10:17,464.725 The overly processed foods are, have seed oils and these oils that are just not good and can be associated with inflammation. 106 00:10:17,704.725 --> 00:10:22,800.7056 So just as the most whole foods they can eat fruits, vegetables, things that aren't processed. 107 00:10:22,800.7056 --> 00:10:24,354.726 That's what I really promote. 108 00:10:24,554.726 --> 00:10:28,44.726 Also protein lean proteins and obviously vegetables. 109 00:10:28,129.727 --> 00:10:34,909.727 Those are diet exercise and weight loss are very important when it comes to food storage. 110 00:10:34,959.727 --> 00:10:45,19.727 There are, there have been some studies showing that some of the chemicals that can be in these storage, especially plastic packaging, can actually leach into the foods. 111 00:10:45,269.726 --> 00:10:50,569.727 And these chemicals are endocrine disruptors, so they can affect the hormones in your body. 112 00:10:50,599.727 --> 00:10:54,644.727 And Breast cancer is a cancer that can be sensitive to hormones. 113 00:10:54,654.727 --> 00:11:03,974.727 So I tell them, don't microwave things in plastic because you don't want that plastic melting on your food and kind of leaching the chemicals into your food. 114 00:11:04,234.727 --> 00:11:07,834.726 Also using a glass water bottle instead of a plastic. 115 00:11:08,24.727 --> 00:11:15,669.627 And just being aware that all of those tightly packaged foods can also have chemicals that could affect your affect your hormones. 116 00:11:16,899.727 --> 00:11:41,59.728 I'm going to bring up some questions that come up sometimes through patient portal messages, or even during when patients come to see me, I had a patient recently who said that she read an article saying that her Mirena IUD put her at a little bit of a higher risk for developing breast cancer. 117 00:11:41,339.728 --> 00:11:45,74.728 Is that true? And why? Yeah, so it is true. 118 00:11:45,84.728 --> 00:11:51,224.728 The why is that it's thought to be related to the progesterone and the hormonal IUD. 119 00:11:51,224.728 --> 00:11:53,924.728 So the Mirena IUD does have progesterone. 120 00:11:54,174.728 --> 00:11:55,204.728 It is local. 121 00:11:55,504.728 --> 00:11:57,964.727 It's not systemic because it's in the uterus. 122 00:11:58,554.728 --> 00:12:01,354.728 However, they did do a study that was published recently. 123 00:12:01,354.728 --> 00:12:02,384.728 So it's been in the news. 124 00:12:02,624.728 --> 00:12:09,489.728 And it does the Mirena has been shown or any hormonal IUD has been shown to slightly increase the risk of breast cancer. 125 00:12:09,489.728 --> 00:12:11,989.728 And the risk is small though. 126 00:12:11,989.728 --> 00:12:13,479.728 I don't want to alarm patients. 127 00:12:13,549.728 --> 00:12:17,559.728 It's about when they looked at the numbers, it was about one in 1000. 128 00:12:17,889.728 --> 00:12:19,769.728 So it was a very small risk. 129 00:12:19,779.727 --> 00:12:23,559.728 And this is similar to the risk of oral contraception pills. 130 00:12:23,569.728 --> 00:12:28,979.728 So your OCPs, we know that those also, have a slightly higher risk of breast cancer. 131 00:12:29,304.728 --> 00:12:31,854.728 but they are protective against other cancers. 132 00:12:31,864.728 --> 00:12:36,164.728 So they are protective actually against ovarian and endometrial cancer. 133 00:12:36,214.728 --> 00:12:43,654.7275 So I don't think that this is something that patients who are at an average risk of breast cancer need to go and get them removed. 134 00:12:43,664.7265 --> 00:12:49,244.7265 I wouldn't say it's a, it's alarming, but it's just something to be aware of that it can slightly increase your risk. 135 00:12:49,484.7265 --> 00:12:52,64.7265 However, there are many other benefits patients that have. 136 00:12:52,344.7265 --> 00:12:57,504.7265 very heavy periods or regular, bleeding this, they can help patients a lot as well. 137 00:12:57,504.7265 --> 00:13:00,564.7265 So it just, it's weighing the risks versus benefits. 138 00:13:00,754.7255 --> 00:13:10,464.7265 If you do have a very strong family history of breast cancer, or say you do have a genetic mutation, then maybe you would want to consider the COBRA IUD, which does not have any hormones. 139 00:13:11,969.7265 --> 00:13:18,579.7265 Yes, that's basically what I said to her but obviously this is for a broader audience. 140 00:13:18,979.7265 --> 00:13:26,189.7265 So I think that answer is great and I think you know it should help a lot, a lot of women who are hopefully listening. 141 00:13:27,44.7265 --> 00:13:29,14.7265 Another question that comes up. 142 00:13:29,14.7265 --> 00:13:37,204.7265 And as the world of perimenopause and menopause and HRT has just swung in a totally different direction. 143 00:13:37,214.7255 --> 00:13:48,959.6255 And there's some very good things about that, but there are times when I have patients who have been menopausal for a bit. 144 00:13:49,199.7255 --> 00:13:55,809.7255 So they may not be in their sixties, but they're in their late fifties and maybe menopause happened to them. 145 00:13:55,839.7255 --> 00:14:09,979.7245 I'm making up a number here at 51, let's say, but they had a family member, let's say a sister who had breast cancer around that similar age. 146 00:14:10,719.7245 --> 00:14:16,89.7245 And they come to me and say, I really don't know what to do here. 147 00:14:16,139.7245 --> 00:14:20,309.7245 I'm suffering with a lot of menopausal issues. 148 00:14:21,79.7245 --> 00:14:27,349.7245 How do you usually guide your patients when it comes to those kinds of situations? Yes. 149 00:14:27,629.7245 --> 00:14:35,249.7245 So yeah, I do think that this is very exciting with this because there has been some new research coming out, especially in breast cancer patients as well. 150 00:14:35,579.7245 --> 00:14:43,519.724 One thing that I do tell my patients, even if they do have a history of breast cancer, is that the studies have been showing that vaginal estrogen is safe. 151 00:14:44,124.725 --> 00:14:52,974.725 So if that's, most of their symptoms dryness that we can do vaginal estrogen it has not been shown to increase the risk of breast cancer. 152 00:14:52,984.725 --> 00:15:01,934.7265 So that is reassuring because I think some people thought that, there's absolutely no, they can't have any, even if it's local. 153 00:15:02,304.7265 --> 00:15:07,504.7265 So I think that if a person doesn't have a history of breast cancer themselves. 154 00:15:07,514.7265 --> 00:15:10,124.7265 Then it is safe to do hormone replacement. 155 00:15:10,134.7265 --> 00:15:13,34.7255 It does put you at a slightly higher risk of breast cancer. 156 00:15:13,294.7265 --> 00:15:23,394.7255 But if the symptoms are intolerable and they're suffering, then I think we have to get away the risk and benefits and the benefits might be that it makes them feel so much better. 157 00:15:23,414.7255 --> 00:15:34,454.7275 And maybe they're getting sleep and then they can exercise and do other things that can reduce their risk instead of just living with, in this torture basically from all these hot flashes and everything. 158 00:15:34,514.7275 --> 00:15:48,344.7265 In breast cancer patients, so patients who've had a history of breast cancer, there's research ongoing right now about if HRT not just the local one, as I said, we know that safe, but if that, this is safe in breast cancer patients. 159 00:15:48,354.7265 --> 00:15:52,844.7265 So that's ongoing, I wouldn't recommend it for a breast cancer patient. 160 00:15:53,54.7265 --> 00:15:55,424.7265 If they had a hormone sensitive breast cancer. 161 00:15:55,634.7265 --> 00:15:58,764.7265 If they did not have a hormone sensitive breast cancer, then it is okay. 162 00:15:58,774.7265 --> 00:16:05,854.7255 If they had a triple negative but if someone had just a family history, maybe just one family member, then I think it's safe. 163 00:16:05,854.7265 --> 00:16:09,144.727 If there's concern for a genetic mutation, if they had multiple. 164 00:16:09,319.727 --> 00:16:20,165.647 if their family member was diagnosed at a young age things like that would make you more suspicious for genetic mutation, then maybe you should get genetic testing before doing it. 165 00:16:20,185.646 --> 00:16:25,445.647 But I think overall it is safe just knowing that they're there, it could slightly increase your risk. 166 00:16:26,220.647 --> 00:16:35,640.647 Do you have more patients coming in to see you because since this, movement started about what they should be doing? Yes. 167 00:16:35,640.647 --> 00:17:01,560.6455 So we have, do you mean about the HRT or just in just patients and cancer patients or people who want to reduce their risk of breast cancer? A lot of patients who who come to see me at least No, I'm not saying that they all follow with breast specialists that would be actually very, remarkable, but the ones that do, they often feel confused because they're like, okay my mom had it. 168 00:17:01,970.6465 --> 00:17:05,750.6465 But I'm not sure what kind of, if it was estrogen positive or not. 169 00:17:06,180.6465 --> 00:17:10,90.6465 And my breast specialist is saying not to, even though I'm suffering. 170 00:17:10,440.6465 --> 00:17:16,830.6455 So I'm not putting this on the breast specialist, but a lot of people are questioning what they should be doing. 171 00:17:17,180.6445 --> 00:17:22,440.6455 And this has come up more in the past year or so than it ever has in the past. 172 00:17:24,30.6455 --> 00:17:30,750.6445 Yeah I know I do see patients who are at a high risk of breast cancer and and then I see my breast cancer patients. 173 00:17:30,760.6455 --> 00:17:34,990.645 So when my breast cancer patients ask me, I say, it's okay for topical. 174 00:17:35,190.645 --> 00:17:43,210.644 I probably not recommend doing the systemic, especially if they're close just to their cancer diagnosis and their treatment. 175 00:17:43,460.645 --> 00:17:45,240.645 But but yeah, I think. 176 00:17:45,365.645 --> 00:17:50,245.645 just being open minded about things and really talking with patients and treating everyone as individual. 177 00:17:50,275.645 --> 00:17:54,55.645 Because as I said, it's not worth to be living if you're suffering. 178 00:17:54,375.644 --> 00:18:00,975.645 So I think that if it's really unbearable, then it's something that we can discuss and maybe then we just keep a closer eye on you. 179 00:18:01,185.645 --> 00:18:09,245.645 I have another patient who went through menopause at a much later age than the average woman menopause for her. 180 00:18:09,845.645 --> 00:18:10,565.645 Started. 181 00:18:10,575.645 --> 00:18:13,895.645 She's not officially menopausal at 58. 182 00:18:13,975.645 --> 00:18:25,615.645 And one of her questions was, she read that because menopause was happened later for her, that she was also at a slightly higher risk for breast cancer. 183 00:18:25,615.645 --> 00:18:28,925.644 Is that true? It is a small, very small risk. 184 00:18:28,975.644 --> 00:18:45,620.644 So basically So the breast cancer risk when it comes to gynecologic and reproductive history is that the more estrogen or more, periods or menstrual cycles that a woman has over their lifetime, the higher risk they are for breast cancer. 185 00:18:45,860.644 --> 00:18:59,160.644 So if you start your, menstruation earlier when I do think that this is one of the reasons why we're seeing higher rates of breast cancer now too, is that, with there is actually girls that, young women are starting their menstrual cycles earlier. 186 00:18:59,330.644 --> 00:19:14,490.644 We don't really know the reasons why one of them might be obesity or hormonal factors, but so starting your cycles earlier, and then obviously then if you have menopause later, you're having more cycles over your lifetime and that can slightly increase your breast cancer risk. 187 00:19:14,730.644 --> 00:19:17,100.644 There's nothing really to do, or, we don't want to like. 188 00:19:17,330.644 --> 00:19:21,350.644 say you can't really change that, but it's just something that we look at. 189 00:19:21,370.644 --> 00:19:26,340.644 And it's take it into account for in some of the risk risk assessment tools. 190 00:19:26,640.644 --> 00:19:32,340.644 So if a doctor is going to say, let's do your breast cancer risk assessment, they ask things like that. 191 00:19:32,340.644 --> 00:19:38,80.6435 How, what did you start your cycle? When did you do menopause? How many times have you been pregnant? Cause. 192 00:19:38,385.6435 --> 00:19:44,605.6435 pregnancy is actually protected because you're not having your periods, during those top those months when you're pregnant. 193 00:19:44,915.6435 --> 00:19:53,675.6425 Did you breastfeed? So we take all these factors in and then we can give you a kind of percentage that you're of your lifetime risk of breast cancer. 194 00:19:53,685.6415 --> 00:19:57,55.6425 And then that helps us decide how often you should do your screenings. 195 00:19:57,605.6425 --> 00:20:05,65.6415 What other guidelines do you recommend to patients? There's so much out there in terms of information. 196 00:20:05,435.6415 --> 00:20:10,865.6425 And as patients sometimes go to social media, right? And then they follow. 197 00:20:11,440.6425 --> 00:20:15,890.6425 oftentimes misadvice on things like TikTok and Instagram. 198 00:20:16,280.6425 --> 00:20:41,185.6415 How do you direct your patients so that they can be going to the right sources and not getting misinformation? Yes, that definitely is tough, especially with, as you said, all the access to information on the social media, but how do you know who's actually legitimate? I direct them to the American Cancer Society because their recommendations are always very solid and they're backed by research. 199 00:20:41,575.6425 --> 00:20:49,275.6425 Also, when it comes to screening guidelines for high risk patients and treatment protocols, I direct them to the NCCN. 200 00:20:49,285.6425 --> 00:20:54,755.6415 So that's the National Comprehensive Cancer Network and they have guidelines for patients. 201 00:20:54,765.6425 --> 00:21:05,515.6445 So it breaks down, if your risk of cancer is this is the screening you should be getting or, and then when it comes to cancer patients, if you have this type of breast cancer, these are the surgical options and. 202 00:21:05,740.6445 --> 00:21:07,430.6445 A flow chart and walk them through it. 203 00:21:07,440.6445 --> 00:21:23,240.6435 So I think those are two very reputable sources and then also just, coming in with us and having established follow up in our clinic so we can answer their questions and talk to them with studies that are evidence based. 204 00:21:24,275.6445 --> 00:21:31,525.6445 And mentioning the studies, right? I know that there's been a lot of research going on in the world of breast cancer. 205 00:21:31,825.6445 --> 00:21:54,83.6055 What exciting developments may be on the horizon that we don't know about that you can educate us about? Yeah, so there's a lot of advancements when it comes to patients who have advanced breast cancer, metastatic breast cancer, a lot of new developments with specific drugs and not just chemotherapies, but immune immune therapy to, target cancers. 206 00:21:54,83.7055 --> 00:22:07,983.706 So a more personalized approach to treatment, not that, not just this one size fits all of cancer medications, but one study that I saw that was cool that this affects like everyone listening, just any woman who doesn't have breast cancer. 207 00:22:08,243.706 --> 00:22:10,33.706 It's actually called the Wisdom Study. 208 00:22:10,273.706 --> 00:22:21,153.705 And it is looking at our recommendations right now for screening, which are saying that if you're an average woman, that we recommend getting an annual mammogram starting at the age of 40. 209 00:22:21,553.706 --> 00:22:28,78.706 But the Wisdom Study is specifically looking at how we can do a more personalized approach to screening. 210 00:22:28,98.706 --> 00:22:33,88.706 And maybe you don't have to get a mammogram every year, or maybe we're going to alternate with something else. 211 00:22:33,98.706 --> 00:22:40,508.705 So it's reevaluating our thought that we need to get mammograms every year and how can we. 212 00:22:40,878.706 --> 00:22:43,638.706 make this better based on the individual patient. 213 00:22:43,648.706 --> 00:22:53,888.706 So I think that is very exciting, especially as we're moving towards more individualized care and screening and what might be better for a specific woman. 214 00:22:54,578.706 --> 00:23:02,128.706 So would that mean that certain Women don't need a mammogram every year or they might need more. 215 00:23:03,128.706 --> 00:23:03,398.706 Yeah. 216 00:23:03,798.706 --> 00:23:06,958.706 So I think that there'll be some sort of screening every year. 217 00:23:06,988.706 --> 00:23:13,348.705 So if it's a ultrasound or a mammogram or some sort of other imaging, an MRI. 218 00:23:13,628.706 --> 00:23:15,408.706 We're not just going to let women go. 219 00:23:15,658.706 --> 00:23:23,908.706 However, we're going to see what the best modality is and, to really just keep track of that woman and hopefully to find breast cancers. 220 00:23:23,938.705 --> 00:23:27,28.707 But yeah, maybe find them earlier and some patients as well. 221 00:23:28,128.707 --> 00:23:45,753.707 I also read that And please educate me if I'm wrong that breast cancer that it's gone up slightly is that does that have anything to do with Cove it and the maybe the decline in screening that was happening at that time. 222 00:23:46,118.707 --> 00:23:49,308.707 Yes, I think that it definitely has been shown. 223 00:23:49,308.707 --> 00:23:50,658.707 Our rates are increasing. 224 00:23:50,678.707 --> 00:23:59,328.707 Unfortunately I do know that during covid there was a pause in some of the screening, especially in some specific patient populations. 225 00:23:59,588.707 --> 00:24:02,828.706 So we have seen more breast cancers. 226 00:24:02,858.707 --> 00:24:05,893.707 I don't I'm not positive of the numbers of that. 227 00:24:06,133.707 --> 00:24:13,133.707 I think that's also related to the other factors going on in our society with the, environmental factors, obesity. 228 00:24:13,383.707 --> 00:24:17,543.708 And then we're detecting them earlier because our imaging modalities have gotten better. 229 00:24:17,833.708 --> 00:24:19,943.708 Now even mammogram has advanced. 230 00:24:19,943.708 --> 00:24:21,273.709 We have a 3D mammogram. 231 00:24:21,483.709 --> 00:24:26,278.609 So we're able to see cancers that are very tiny that, years ago they weren't really great. 232 00:24:26,688.709 --> 00:24:26,778.709 seeing. 233 00:24:26,778.709 --> 00:24:28,978.709 So they were there, but we just weren't catching them. 234 00:24:28,978.709 --> 00:24:31,328.709 So we're catching cancers very early now. 235 00:24:31,478.709 --> 00:24:34,488.709 And our survival and our outcomes are very good. 236 00:24:34,758.709 --> 00:24:36,508.708 However, there are more cancers. 237 00:24:37,818.708 --> 00:24:41,468.709 The other thing is I feel like I'm doing catch ups. 238 00:24:41,518.709 --> 00:24:48,98.709 And so a lot of patients I feel are not necessarily aware of the recent changes in screening guidelines. 239 00:24:48,613.709 --> 00:25:03,703.7085 that came out and they're like, Oh, I thought I was supposed to have a mammogram every two years and not every year is the slightly higher rates of breast cancer, which led to the guideline changes. 240 00:25:03,703.7085 --> 00:25:18,973.7085 What precipitated that in your opinion? In my opinion, I think it was just looking at the Just the number of cancers that we were seeing and as you said, if we let it go for two years most likely the rates were higher. 241 00:25:18,983.7085 --> 00:25:32,743.7085 I'm not positive of the study that led to the change, but I would imagine that's what it was and that if letting it go every two years, we were seeing a higher rates of breast cancer and cancers can develop in a year, they, they can grow, they can be fast. 242 00:25:32,743.7085 --> 00:25:38,603.7418333 So I think having that yearly follow up is really important just to make sure that's nothing changes. 243 00:25:38,603.7418333 --> 00:25:43,833.7751667 Just because cancers get two years is a long time to let, breast go unchecked. 244 00:25:44,203.7751667 --> 00:25:45,233.7741667 It's a long time. 245 00:25:45,243.7751667 --> 00:25:50,993.7741667 And I think when that change happened, I was very uneasy with that decision. 246 00:25:51,313.7751667 --> 00:25:55,13.7761667 So I personally made that into a year and a half. 247 00:25:55,53.7761667 --> 00:25:57,203.7761667 Not that, insurance already paid for it. 248 00:25:57,613.7761667 --> 00:26:05,193.7761667 But then I was like, going closer to getting it every year, even at that time when it wasn't recommended. 249 00:26:05,523.7761667 --> 00:26:12,463.7761667 Yeah, I think that was smart because, we can do our clinical examinations, but we can only really only feel masses that are, two centimeters. 250 00:26:12,463.7771667 --> 00:26:15,953.7761667 And it's hard for us to see, we can't feel calcifications. 251 00:26:15,953.7771667 --> 00:26:21,753.7761667 And we're then, if we're just relying on our physical exam, we're catching them at later stages, once they're already. 252 00:26:22,48.7761667 --> 00:26:23,788.7761667 grown or they're in the lymph nodes. 253 00:26:23,788.7761667 --> 00:26:29,798.7761667 So I think doing it every one year, we're able to catch them earlier, do a less invasive surgery and then have better survival. 254 00:26:30,58.7761667 --> 00:26:30,508.7761667 Yes. 255 00:26:31,288.7761667 --> 00:26:36,838.7761667 Also, I think it would be useful to, for our listeners to learn about. 256 00:26:37,178.7771667 --> 00:26:43,258.7771667 Why certain women need ultrasounds along with their mammograms. 257 00:26:43,468.7771667 --> 00:26:50,498.7781667 There's some terms that come along and you could see it on the reports where it says heterogeneously dense or extremely dense. 258 00:26:50,968.7761667 --> 00:26:57,138.7771667 And a lot of women get confused as to why an ultrasound needs to be done in those kinds of situations. 259 00:26:57,493.7771667 --> 00:26:57,853.7771667 Yes. 260 00:26:57,903.7771667 --> 00:27:04,313.7771667 So women are usually categorized into four categories of breast density on their mammogram report. 261 00:27:04,323.7771667 --> 00:27:10,633.7771667 So this ranges from mostly fatty breast to all the way to the diffusely dense. 262 00:27:10,963.7771667 --> 00:27:20,293.7771667 So the reason why it's hard to see a cancer on a mammogram, if you have a dense breast is because density on a mammogram appears white. 263 00:27:20,573.7771667 --> 00:27:27,73.7766667 So if you if a woman who's listening, if you just want to google a picture of dense breast mammogram, you will see a breast. 264 00:27:27,73.7766667 --> 00:27:32,733.7771667 But then you can see all these kind of like lines and white spots basically everywhere. 265 00:27:33,13.7771667 --> 00:27:35,33.7761667 And that's the dense tissue of the breast. 266 00:27:35,503.7771667 --> 00:27:39,533.7771667 So cancers also appear white on a mammogram. 267 00:27:39,783.7771667 --> 00:27:44,323.8771667 So that's why it's very hard then to see maybe a cancer that's white. 268 00:27:44,523.8771667 --> 00:27:47,623.8771667 It could be hiding in the dense white tissue. 269 00:27:47,933.8771667 --> 00:27:50,863.8771667 So we say it's like looking for a snowman in the stow store. 270 00:27:50,993.8771667 --> 00:27:55,33.8761667 So you have this white thing, but it's in the middle of a white background. 271 00:27:55,293.8771667 --> 00:27:56,183.8761667 It's hard to see. 272 00:27:56,623.8771667 --> 00:28:12,543.8771667 So that is why When a woman has dense breast, they will do an ultrasound, which the ultrasound, the densities don't look white, so it's easier to see a mass and you can actually see the density of the mass, not the breast dense breast tissue. 273 00:28:12,863.8771667 --> 00:28:14,513.8771667 Or we will consider an MRI. 274 00:28:14,513.8771667 --> 00:28:17,573.8771667 'cause MRI gives a really good picture. 275 00:28:17,703.8771667 --> 00:28:20,793.8771667 The only downside of the MRI is that sometimes we can catch. 276 00:28:21,183.8771667 --> 00:28:25,183.8771667 too much and we might see something and we're not sure what it is. 277 00:28:25,183.8771667 --> 00:28:30,793.8771667 So it might lead to a biopsy that ends up being nothing, but we're seeing everything on an MRI. 278 00:28:31,143.8771667 --> 00:28:32,943.8771667 So that's the reason. 279 00:28:32,983.8771667 --> 00:28:37,723.8751667 And if you do have dense breast it's something that your doctor should talk to you about. 280 00:28:37,723.8771667 --> 00:28:42,243.8761667 And then we would, consider doing an MRI just to make sure we're not missing anything on the mammogram. 281 00:28:43,448.8761667 --> 00:29:03,28.8756667 When it comes to at least colonoscopies, people are always saying can't you guys come up with something better that isn't so invasive and that I don't have to do a prep the day before or take off time from work? And I'm like there, there probably things on the horizon that are coming up, at least talking to some of my colleagues. 282 00:29:03,28.8756667 --> 00:29:09,878.8756667 I understand that there are in the world of breast cancer detection or screening, I should say. 283 00:29:10,178.8746667 --> 00:29:15,798.8746667 Is there anything on the horizon? Cause I still have patients who are like, I can't handle the pinch. 284 00:29:16,168.8746667 --> 00:29:18,78.8746667 It's just too painful for me. 285 00:29:18,388.8746667 --> 00:29:21,748.8746667 And I understand not everybody has the same pain tolerance. 286 00:29:22,128.8746667 --> 00:29:31,658.8756667 But is there anything on the horizon that, that would be interesting to learn about? Yes, there's some new imaging devices that are trying to be radiation free. 287 00:29:31,908.8756667 --> 00:29:41,578.8756667 There's their mom thermography where they are basically using like your body temperature to evaluate your normal body and then what's abnormal, like a tumor. 288 00:29:41,878.8756667 --> 00:29:46,58.8756667 So I think that these are all in trials and looking to be validated. 289 00:29:46,408.8746667 --> 00:29:51,258.8756667 In my practice, we don't routinely use those yet just because they have not been validated. 290 00:29:51,528.8746667 --> 00:29:58,878.8766667 However, there are hopefully in 10 years or 5, 5 or 10 years from now, we'll be offering something that's a lot more comfortable for women. 291 00:30:00,148.8766667 --> 00:30:00,598.8766667 Okay. 292 00:30:00,598.8766667 --> 00:30:05,598.8766667 Cause I, there are patients who do ask me about thermography and I'll be honest with you. 293 00:30:05,598.8766667 --> 00:30:08,488.8766667 I typically wouldn't order it. 294 00:30:08,508.8766667 --> 00:30:11,468.8756667 I would say, you can go outside and get that done. 295 00:30:11,468.8756667 --> 00:30:15,18.8766667 Like my group does not offer those kinds of tests. 296 00:30:15,368.8756667 --> 00:30:21,158.8766667 I wouldn't necessarily even be able to guide them because this is, I've been practicing for 25 years. 297 00:30:21,158.8766667 --> 00:30:28,848.8766667 I've certainly gone through many different mammogram reports, but I wouldn't necessarily Even know, what to look for or how to guide them. 298 00:30:29,268.8766667 --> 00:30:34,618.8756667 But it's interesting that it is being looked at as a possible modality. 299 00:30:35,38.8766667 --> 00:30:36,848.8766667 Yeah, that's something, I agree with you. 300 00:30:36,848.8766667 --> 00:30:46,388.8756667 It's not, we haven't learned about it and our training and our, and my fellowship and my training, I was never instructed on it on my radiology rotation. 301 00:30:46,398.8756667 --> 00:30:48,208.8766667 So it's, I'm the same as you. 302 00:30:48,208.8766667 --> 00:30:49,598.8766667 I don't order it. 303 00:30:49,598.8766667 --> 00:30:51,158.8766667 I don't really see it. 304 00:30:51,378.8766667 --> 00:30:53,263.7766667 But I have seen that it is. 305 00:30:53,843.8766667 --> 00:30:55,393.8766667 being researched and studied. 306 00:30:55,403.8766667 --> 00:31:07,953.8766667 So we will see what happens with it When a woman is at a higher risk, I also, would counsel them on going to see a genetic counselor and getting genetic testing, especially if they have a family history of breast cancer. 307 00:31:08,323.8756667 --> 00:31:14,918.8756667 One of the most common mutations that people might've heard of are the BRCA1 and BRCA2 mutations. 308 00:31:14,918.8756667 --> 00:31:16,218.8756667 These have been in the media. 309 00:31:16,528.8756667 --> 00:31:27,118.8746667 So with BRCA mutations, women are at a higher risk of breast cancer and also ovarian cancer and pancreatic cancer as well. 310 00:31:27,448.8746667 --> 00:31:30,248.8756667 So that's one cluster that we look at. 311 00:31:30,308.8756667 --> 00:31:38,118.8756667 And men can also have the BRCA mutation as well, where then men, they would be at a risk of also breast cancer and pancreatic cancer. 312 00:31:38,458.8756667 --> 00:31:43,428.8756667 There's some other genetic syndromes that have breast cancer, also colon cancer. 313 00:31:43,818.8756667 --> 00:31:46,808.8756667 So those can be seen in some of the genetic mutations. 314 00:31:47,78.8746667 --> 00:31:48,388.8736667 But those are the big ones. 315 00:31:49,238.8746667 --> 00:31:57,928.8746667 If a woman has BRCA or a man, and they are at a higher risk of those cancers, then we send them to see the gynecologist. 316 00:31:58,703.8746667 --> 00:32:07,673.8746667 We do recommend having the ovaries removed for the BRCA patients because it actually has been shown to improve survival when they have their ovaries removed. 317 00:32:07,843.8746667 --> 00:32:14,213.8746667 We do this, after the child childbearing years but as soon as we can to reduce their risk of ovarian cancer. 318 00:32:14,483.8746667 --> 00:32:22,213.8736667 And then if they have since they have the risk of pancreas cancer, we can do annual screening with a MRI of their pancreas. 319 00:32:23,968.8736667 --> 00:32:37,838.8721667 Shifting back to women who are in their menopausal years as the women's health initiative, which was, two or more decades ago, changed the game for a lot of women. 320 00:32:37,838.8721667 --> 00:32:43,328.8726667 And I was actually, and I'm dating myself now I, I was in my training years at that time. 321 00:32:43,338.8726667 --> 00:32:44,498.8726667 And, I. 322 00:32:45,198.8726667 --> 00:32:54,318.8726667 was exposed to some HRT, not myself personally, in terms of how to prescribe and but that came to a a sudden halt. 323 00:32:54,698.8726667 --> 00:33:04,38.8736667 And for, two or more decades after that, we basically have not been prescribing hormones and now we suddenly are. 324 00:33:04,498.8736667 --> 00:33:11,938.8736667 And so my question for is, as you are probably well aware that their women are. 325 00:33:12,348.8736667 --> 00:33:17,768.8736667 have been not as well represented in when it comes to research. 326 00:33:17,768.8736667 --> 00:33:27,828.8726667 And as far as I know, there haven't been really any great trials that have shown that HRT is relatively safe. 327 00:33:28,178.8736667 --> 00:33:39,398.8736667 So A very common question for patients who are on the fence at this point they're listening to their friends, they're watching stuff on Facebook and whatever else, social media. 328 00:33:39,678.8736667 --> 00:33:42,678.8726667 And they're like, Oh, I want to reduce my risk of dementia. 329 00:33:42,918.8726667 --> 00:33:47,68.8736667 I don't want to get osteoporosis, but yet I don't want to increase my risks. 330 00:33:47,628.8736667 --> 00:33:58,403.8736667 What are, what do you think their risks should be? How should we be guiding these types of patients? I think that they have to assess their other risk factors. 331 00:33:58,593.8736667 --> 00:34:11,993.8746667 So if they are an average risk woman, if they don't have significant family history, if overall they're, healthy weight, living a healthy lifestyle they don't have a history of abnormal breast biopsies in the past. 332 00:34:12,263.8746667 --> 00:34:17,123.8746667 If they're, at an average risk of breast cancer, then I do think that there's a lot of benefits. 333 00:34:17,153.8736667 --> 00:34:18,223.8726667 As you said, it can. 334 00:34:18,688.8726667 --> 00:34:21,908.8726667 make them feel a lot better, reduce your risk of osteoporosis. 335 00:34:21,918.8726667 --> 00:34:30,158.8716667 So I do think it's safe, but it's, you can't guarantee that they're not going to get a breast cancer, but they might still get a breast cancer if they don't take it. 336 00:34:30,208.8726667 --> 00:34:31,628.8726667 We don't have a crystal ball. 337 00:34:31,718.8726667 --> 00:34:33,628.8716667 But I think that it is. 338 00:34:33,893.8726667 --> 00:34:43,103.8711667 If the person doesn't have a family history of strong family history or a personal history of breast cancer, then, I think that is perfectly reasonable. 339 00:34:43,863.8721667 --> 00:34:48,43.8721667 I think a lot of breast cancer, we will just have them stop immediately. 340 00:34:48,243.8721667 --> 00:34:50,883.8711667 Especially if it's a hormone sensitive breast cancer. 341 00:34:50,893.8711667 --> 00:34:58,343.8711667 So yeah, it's, people might never take HRT a day in their life and can still develop a breast cancer. 342 00:34:58,453.8711667 --> 00:35:00,613.8711667 It's not always about, the estrogen. 343 00:35:00,613.8711667 --> 00:35:02,383.8711667 There are other factors as well. 344 00:35:02,383.8711667 --> 00:35:09,543.8711667 Obviously, I'm going to shift gears a little bit because I understand and I love women who are entrepreneurs. 345 00:35:09,933.8711667 --> 00:35:19,203.8711667 It's just, cause I have been an entrepreneur, even this podcast I've, I feel is, something that I created and I think of it as some, being in an entrepreneur. 346 00:35:19,573.8711667 --> 00:35:25,263.8711667 And so I wanted to, we wanted to learn about what it is that you have created. 347 00:35:25,263.8711667 --> 00:35:27,813.8711667 I already know, but I wanted you to talk about that. 348 00:35:28,453.8701667 --> 00:35:29,133.8701667 Of course. 349 00:35:29,213.8701667 --> 00:35:43,973.8711667 It comes from a sad story, but I unfortunately had a colleague, she was a medical school classmate of mine pass away from breast cancer two years ago, and she was an orthopedic surgeon and orthopedic surgeon. 350 00:35:43,983.8711667 --> 00:35:45,453.8711667 That specialty is. 351 00:35:45,713.8711667 --> 00:35:54,933.8711667 always around radiation because they're doing x rays in the operating room and they're, just around the x ray machine and taking x rays, which is a a source of radiation. 352 00:35:54,963.8701667 --> 00:35:59,483.8701667 So after she passed away, I was just thinking about her risk factors. 353 00:35:59,483.8711667 --> 00:36:00,553.8706667 I was like, she was young. 354 00:36:00,553.8706667 --> 00:36:08,773.8711667 Did she ever look at me history? No, but she was around radiation and we know that radiation is a risk factor for breast cancer. 355 00:36:09,13.8711667 --> 00:36:10,973.8711667 Not necessarily for patients. 356 00:36:10,973.8711667 --> 00:36:21,3.8716667 I don't want people to get alarmed like you want to go to the dental office or if you're getting your x ray or even your mammogram, you know that's different for patients because it's a very small dose. 357 00:36:22,53.8716667 --> 00:36:26,133.8716667 But where it's a risk factor is for people who work with radiation every day. 358 00:36:26,423.8716667 --> 00:36:29,183.8716667 So occupational radiation exposure. 359 00:36:29,193.8716667 --> 00:36:33,973.8706667 So this is the people who are doing these procedures that are involved radiation. 360 00:36:33,973.8716667 --> 00:36:42,863.8716667 So the health care providers, especially orthopedic surgeons, interventional radiologist, interventional cardiologist the x ray tech. 361 00:36:43,338.8716667 --> 00:36:46,548.8716667 Those people who are around that occupational exposure every day. 362 00:36:47,28.8716667 --> 00:36:53,528.8716667 So I looked at the research and it showed that orthopedic surgeons have up to three times higher rate of breast cancer. 363 00:36:53,948.8716667 --> 00:36:55,858.8706667 And that was pretty shocking to me. 364 00:36:55,878.8716667 --> 00:37:01,948.8716667 And, and also the x ray techs, the radiologic technologists have higher rates of breast cancer too. 365 00:37:02,38.8716667 --> 00:37:06,388.8716667 So I was thinking, why is this? And we wear protection. 366 00:37:06,688.8716667 --> 00:37:09,448.8706667 But I thought about the protection that we wear. 367 00:37:09,458.8716667 --> 00:37:13,978.8716667 And There are these large aprons and they were basically designed for men. 368 00:37:13,988.8716667 --> 00:37:20,98.8716667 The original patent was like back in the 1950s before there were a lot of female surgeons for sure. 369 00:37:20,368.8716667 --> 00:37:29,348.8706667 So they have this big gap basically, and there's a big hole in the arm and it really leaves the upper outer quadrant of the breast exposed. 370 00:37:29,348.9706667 --> 00:37:33,708.8716667 And the most common site of breast cancer is the upper outer quadrant of the breast. 371 00:37:33,728.8716667 --> 00:37:35,78.8716667 So that area. 372 00:37:35,503.8716667 --> 00:37:40,763.8716667 With our current protection, it's very vulnerable, and it's basically just getting hit by radiation. 373 00:37:42,843.8716667 --> 00:37:52,113.8706667 So I invented a vest, and it is called the BAT, B A T, it stands for Breast Axilla, and that's where the lymph nodes are. 374 00:37:52,368.8716667 --> 00:37:54,388.8716667 the listeners and thyroid. 375 00:37:54,698.8716667 --> 00:37:55,158.8716667 So B. 376 00:37:55,158.8716667 --> 00:37:55,188.8716667 A. 377 00:37:55,188.8716667 --> 00:37:55,488.8716667 T. 378 00:37:55,508.8716667 --> 00:37:55,868.8716667 BAT. 379 00:37:55,908.8716667 --> 00:37:58,768.8716667 And this goes on over or under the standard apron. 380 00:37:58,768.8716667 --> 00:38:06,358.8706667 So it works with any apron, but it protects that area that's basically exposed and actually reduces radiation to the breast by 97%. 381 00:38:08,928.8716667 --> 00:38:09,618.8706667 That is. 382 00:38:10,223.8716667 --> 00:38:11,123.8716667 Phenomenal. 383 00:38:11,503.8716667 --> 00:38:16,833.8716667 And so how, and now I'm like, my, my brain is getting into gear to ask you all sorts of questions. 384 00:38:17,233.8716667 --> 00:38:30,528.8721667 So how do you market that? Do you market that to, different radiology centers and hospitals and have these places been interested in getting this from you? Yes. 385 00:38:30,538.8721667 --> 00:38:40,628.8721667 So I partnered with a company called Burlington Medical and they are actually the number one supplier of radiation protection already in the United States and also international. 386 00:38:40,918.8721667 --> 00:38:48,968.8721667 So they have contracts with a lot of the hospitals because, I love being an entrepreneur, but I wanted to get this out to patients as fast as possible. 387 00:38:49,28.8731667 --> 00:38:49,958.8731667 So I needed up. 388 00:38:50,33.8731667 --> 00:38:52,13.8731667 Person to manufacture and get it out there. 389 00:38:52,13.8731667 --> 00:38:53,283.8731667 They have a great sales team. 390 00:38:53,623.8731667 --> 00:38:59,353.8726667 So I work with them and we are in 28 States now for in different hospitals. 391 00:38:59,663.8736667 --> 00:39:07,913.8726667 And yes, people are very receptive of it just because as we were talking about before women being, we were talking about patients being. 392 00:39:08,218.8736667 --> 00:39:12,918.8736667 Underrepresented upper underrepresented research female patients. 393 00:39:13,228.8736667 --> 00:39:16,418.8726667 But now let's talk about female health care providers. 394 00:39:16,718.8736667 --> 00:39:24,328.8736667 And I think that there are a lot of things that were in health care that we just accepted that it's time for us to rethink like. 395 00:39:24,843.8746667 --> 00:39:25,473.8746667 for women. 396 00:39:25,473.8746667 --> 00:39:29,823.8746667 Now that 55 percent of medical school attendees are females now. 397 00:39:30,103.8746667 --> 00:39:35,373.8746667 So it's great, but we have this like shifting workforce and there are a lot of females in medicine now. 398 00:39:35,653.8746667 --> 00:39:37,973.8746667 So people are very receptive of it. 399 00:39:37,993.8746667 --> 00:39:42,13.8746667 They when they hear about the facts they're shocked because they didn't really know about this. 400 00:39:42,13.8746667 --> 00:39:45,703.8746667 So I think the first step is like educating people about it. 401 00:39:45,723.8746667 --> 00:39:49,253.8746667 And that's why I'm trying to be active on my social media. 402 00:39:49,303.8746667 --> 00:39:52,748.8746667 And I've I partnered with some different people on social media, like Dr. 403 00:39:52,748.8746667 --> 00:40:04,68.8746667 Betsy Grunch to get the word out there just because people don't know about it, so they don't even know they should be asking for it because they don't know that this even exists or there's this risk. 404 00:40:04,238.8746667 --> 00:40:11,508.8746667 It's been great, but we've just been trying to build it up, but everyone who hears about it and wears the bat, they they feel a lot more protected. 405 00:40:11,798.8746667 --> 00:40:14,778.8736667 And I also made sure that it was very easy to move in. 406 00:40:14,788.8746667 --> 00:40:16,88.8746667 It has mesh on the back. 407 00:40:16,373.8746667 --> 00:40:17,823.8746667 I actually have one here. 408 00:40:17,893.8746667 --> 00:40:18,333.8746667 Okay. 409 00:40:18,703.8746667 --> 00:40:19,743.8746667 I have it hanging here. 410 00:40:19,813.8746667 --> 00:40:24,493.8746667 It is this The back is all nice and mesh, so it keeps it cool and lightweight. 411 00:40:24,813.8736667 --> 00:40:26,993.8746667 And then, this is the arm part. 412 00:40:27,243.8746667 --> 00:40:30,783.8746667 And basically, all of this is radio protective material. 413 00:40:31,13.8736667 --> 00:40:33,63.8746667 You can see how this will really cover. 414 00:40:33,323.8746667 --> 00:40:39,53.8746667 The upper outer quadrant of the breast and the arm and the armpit basically where all the lymph nodes are. 415 00:40:39,393.8746667 --> 00:40:41,303.8741667 Yeah, it's been exciting. 416 00:40:41,303.8741667 --> 00:40:46,903.8746667 We just launched in October and now we are launching internationally in February. 417 00:40:47,438.8746667 --> 00:40:50,688.8746667 Wow, congratulations question. 418 00:40:50,768.8746667 --> 00:40:55,648.8746667 Are there different sizes for different, sizes of people? Yeah, absolutely. 419 00:40:55,648.8746667 --> 00:40:57,928.8736667 So we make it for both females and males. 420 00:40:57,928.8746667 --> 00:41:09,328.8746667 Okay, males have a risk of breast cancer, their risk is smaller, but If a man is around a lot of radiation and they want to reduce their risk, like I think that adding this is a very simple, easy way. 421 00:41:09,588.8746667 --> 00:41:15,108.8736667 So it comes in female and male sizing and it ranges from extra small all the way to triple extra large. 422 00:41:15,378.8746667 --> 00:41:17,638.8746667 And then there's also adjustable features on it. 423 00:41:17,648.8736667 --> 00:41:21,208.8736667 So the chest piece where it goes around your chest, that's Velcro. 424 00:41:21,418.8736667 --> 00:41:24,648.8746667 So that can be adjusted for women of different size bust. 425 00:41:24,908.8746667 --> 00:41:27,718.8736667 And then also the arms have Velcro in the back. 426 00:41:27,948.8746667 --> 00:41:29,558.8746667 The sleeves, so you can tighten it. 427 00:41:29,718.8746667 --> 00:41:31,948.8746667 based on the circumference of your arm. 428 00:41:32,18.8746667 --> 00:41:39,768.8746667 Some hospitals are purchasing like an assortment of sizes just to have for different people who want to wear them different women. 429 00:41:39,998.8746667 --> 00:41:44,828.8746667 Some doctors are purchasing their own because they want to have them no matter where they go. 430 00:41:44,868.8746667 --> 00:41:49,808.8751667 My goal was that this becomes the new standard that hospitals should have this for women who. 431 00:41:50,83.8751667 --> 00:41:51,333.8751667 want to wear it. 432 00:41:51,393.8751667 --> 00:42:00,113.8751667 You don't have to wear it, but if you want to reduce your risk of breast cancer, it should be available to you because your job is putting you at a higher risk of breast cancer. 433 00:42:00,243.8751667 --> 00:42:08,213.8751667 You were mentioning that statistics show that orthopedics are at that high, risk of breast cancer. 434 00:42:08,463.8751667 --> 00:42:16,913.8741667 Do you plan on doing any studies after some time to see if this is making any difference? Yeah. 435 00:42:16,923.8751667 --> 00:42:24,533.8741667 So we did our first initial studies and that was basically just to evaluate the radiation exposure and the radiation risk reduction. 436 00:42:24,833.8751667 --> 00:42:40,303.8751667 So that was in the lab where we had a phantom that simulated the health care provider and we had a regular apron on the phantom and then we compared the radiation doses with the bat versus without the bat and that's where we saw the 97. 437 00:42:40,603.8751667 --> 00:42:45,173.8751667 risk reduction, 97 percent radiation reduction to the operatic quadrant of the breast. 438 00:42:45,503.8751667 --> 00:42:54,443.8751667 It also reduce radiation to the spine because there's an additional piece that covers your chest, which can sometimes be exposed and that goes back to your spine. 439 00:42:54,793.8751667 --> 00:43:05,973.8741667 So yeah, our next study is to look at it clinically and to see the radiation exposure reduction versus, where your back versus not wearing a bat over time in the operating room. 440 00:43:06,3.8751667 --> 00:43:08,793.8751667 And then ultimately it would be to do. 441 00:43:09,233.8751667 --> 00:43:18,213.8751667 To see a reduction of cancers or how this reduces cancer that would probably take a long time to do, but that would be our ultimate goal. 442 00:43:19,333.8751667 --> 00:43:24,83.8751667 I look forward to that, to seeing that published. 443 00:43:24,403.8751667 --> 00:43:27,23.8751667 Yeah, the American Medical Association also. 444 00:43:27,298.8751667 --> 00:43:36,848.8751667 They just had their interim annual meeting or interim meeting and they have a section called the women's physician section of the American Medical Association. 445 00:43:37,258.8751667 --> 00:43:53,488.8751667 And they actually released a resolution talking about this, which I didn't even know, but I don't know who the authors were, but they were talking about the increased risk of breast cancer and how hospitals should have garments that protect, protect women and. 446 00:43:53,988.8751667 --> 00:43:56,58.8751667 Our better protection for healthcare providers. 447 00:43:56,308.8751667 --> 00:43:58,478.8751667 So I was really happy to see that. 448 00:43:58,668.8751667 --> 00:44:05,658.8751667 And I've reached out to the authors and hopefully we can, try to partner and hopefully lobby that we can get this out there to people. 449 00:44:05,768.8741667 --> 00:44:06,588.8741667 I hope so too. 450 00:44:06,658.8731667 --> 00:44:08,738.8741667 That would I think make a big difference. 451 00:44:09,338.8731667 --> 00:44:11,58.8731667 We've talked about a lot. 452 00:44:11,213.8741667 --> 00:44:21,113.8741667 In this in the past 45 minutes, I've asked you a lot of questions that I think that women will be paying very close attention to. 453 00:44:21,593.8741667 --> 00:44:34,203.8741667 Are there any other topics that you would like to talk about that I have not touched on? We have talked about a lot so great. 454 00:44:34,723.8741667 --> 00:44:37,993.8741667 I think if you are a high risk patient. 455 00:44:37,993.8741667 --> 00:44:55,383.8741667 So if you know that you have a family history of breast cancer, or if you did an assessment in your lifetime risk is over 20 percent that you A lot of breast surgeons, you know, me, myself a lot of people, we do see patients that are just are high risk patients. 456 00:44:55,393.8741667 --> 00:45:01,313.8741667 So you don't have to have a breast cancer diagnosis to come in and get established with a breast specialist. 457 00:45:01,663.8741667 --> 00:45:07,134.6117821 So if you are a high risk patient, we'll talk to you about getting the additional screening. 458 00:45:07,134.6117821 --> 00:45:10,823.6741667 So in addition to your mammogram, we would do an MRI. 459 00:45:10,963.7741667 --> 00:45:15,743.7741667 at the six months after your mammogram and then alternate that with the mammogram and then a yearly MRI. 460 00:45:16,513.7741667 --> 00:45:23,623.7741667 So we will follow you and you don't have to just feel like you're stranded and you have this high risk and you don't know where to go. 461 00:45:23,633.7731667 --> 00:45:31,323.7731667 So where we have a high risk clinic where we see patients a lot and just counsel them and talk to them about risk reduction strategies. 462 00:45:32,278.7731667 --> 00:45:34,308.7731667 So I think that's important. 463 00:45:34,308.7731667 --> 00:45:39,758.7721667 And then we can talk about all these lifestyle things and what you can do to really reduce your risk if you're a high risk patient. 464 00:45:41,48.7731667 --> 00:45:50,998.7731667 So I think, a lot of patients are interested in learning about, healthier foods and what they can incorporate into their diet. 465 00:45:51,318.7721667 --> 00:46:02,868.7731667 What do you generally advise your patients? You touched upon some things, but are there any other specific things that can help women who are listening to this podcast? Yeah. 466 00:46:02,868.7731667 --> 00:46:13,748.7741667 So as I said, just keeping a diet of whole foods, avoiding the minimally processed foods, vitamin D has been shown to maybe decrease the risk of cancer, decrease inflammation. 467 00:46:13,778.7741667 --> 00:46:16,498.7741667 So making sure that your vitamin D levels are. 468 00:46:16,923.7741667 --> 00:46:19,713.7741667 adequate or maybe taking a vitamin D supplement. 469 00:46:20,3.7741667 --> 00:46:22,953.7741667 Some of my patients have been liking the seed cycling. 470 00:46:22,953.7741667 --> 00:46:23,783.7741667 You might have seen it. 471 00:46:23,783.7741667 --> 00:46:31,153.7741667 If you look at my social media, I talk about it on there that has not been scientifically proven by the American Cancer Society. 472 00:46:31,433.7751667 --> 00:46:32,583.7731667 Just a disclaimer. 473 00:46:32,803.7731667 --> 00:46:36,383.7741667 However, we know that seeds do have a lot of health benefits. 474 00:46:36,553.7741667 --> 00:46:40,273.7741667 They have good vitamins like vitamin E other, just good. 475 00:46:40,553.7741667 --> 00:46:44,693.7741667 Good nutrients, selenium, zinc, healthy omega threes. 476 00:46:45,13.7741667 --> 00:46:54,513.7741667 So what seed cycling is basically during the first 14 days of your cycle, you eat flaxseed and pumpkin seeds and just like one to two tablespoons. 477 00:46:54,523.7731667 --> 00:46:57,963.7741667 You can add them onto your yogurt or cottage cheese. 478 00:46:58,53.7741667 --> 00:47:04,443.7741667 And then during the second phase of your cycle is so days 15 through 28, you're doing sesame seeds and sunflower seeds. 479 00:47:04,453.7741667 --> 00:47:09,103.7726667 So sprinkle them on a salad, some sunflower seeds, or as I said, into a yogurt. 480 00:47:09,413.7736667 --> 00:47:13,723.7736667 This, as I said, this isn't really backed by any specific studies. 481 00:47:13,773.7736667 --> 00:47:17,523.7736667 I've researched it and I haven't seen anything, but they are healthy for you. 482 00:47:17,523.7736667 --> 00:47:20,593.7736667 And some women say that it makes them feel better by doing this. 483 00:47:20,743.7736667 --> 00:47:28,403.7746667 So that's something that my patients say, but overall, I think just any diet where you're eating whole foods is good. 484 00:47:29,703.7746667 --> 00:47:29,893.7746667 Yep. 485 00:47:30,13.7746667 --> 00:47:37,503.7746667 And I think some of these seeds, especially the flax and the pumpkin can be balancing for hormones as well. 486 00:47:37,753.7736667 --> 00:47:41,113.7736667 And that may be a reason why women feel better. 487 00:47:41,543.7736667 --> 00:47:44,353.7736667 It's been a great pleasure talking to you today. 488 00:47:44,623.7736667 --> 00:47:47,973.7746667 How can my listeners find you when it comes to. 489 00:47:48,263.7746667 --> 00:47:52,853.7746667 Where you practice your social media and anything else. 490 00:47:53,628.7746667 --> 00:47:53,918.7746667 Yes. 491 00:47:53,968.7746667 --> 00:47:55,718.7746667 So I am in Fort Worth, Texas. 492 00:47:55,748.7746667 --> 00:47:58,538.7746667 I am at John Peter Smith hospital. 493 00:47:58,568.7746667 --> 00:48:03,288.7746667 So I am the medical director of breast surgery for a claim multi specialty group. 494 00:48:03,288.7746667 --> 00:48:06,838.7746667 So we're a physician group that works at John Peter Smith hospital. 495 00:48:07,118.7746667 --> 00:48:10,628.7741667 You can find me on social media at Lauren Ramsey MD. 496 00:48:10,868.7741667 --> 00:48:16,298.7751667 I'm also on LinkedIn, Lauren Ramsey MD, and I have a website, Lauren Ramsey md. 497 00:48:16,298.7751667 --> 00:48:20,113.7751667 com, which is just It just shows everything on there with all of the links. 498 00:48:20,123.7751667 --> 00:48:22,473.7751667 Yeah, but it's been really great talking with you as well. 499 00:48:22,473.7751667 --> 00:48:31,393.7736667 It's cool to hear your perspective on everything because as you said, we have a lot of overlapping patients, but a lot of times we don't get to speak. 500 00:48:31,393.7736667 --> 00:48:32,23.7746667 So it's great. 501 00:48:32,713.7746667 --> 00:48:34,573.7746667 To hear, to talk to you, yes. 502 00:48:35,593.7746667 --> 00:48:41,213.7746667 Often with, with my breast specialist colleagues, it's when I really need them, as you can imagine. 503 00:48:41,533.7736667 --> 00:48:45,353.7746667 That's when we have that conversation and then throughout the rest of the year. 504 00:48:45,773.7746667 --> 00:48:46,293.7746667 Yeah. 505 00:48:46,313.7746667 --> 00:48:48,963.7746667 It's mostly just following along together. 506 00:48:49,383.7746667 --> 00:48:52,813.7756667 But yeah, I couldn't practice and do what I do without you guys. 507 00:48:53,183.7756667 --> 00:48:54,283.7756667 Yeah, we feel the same. 508 00:48:55,653.7756667 --> 00:48:57,403.7756667 Thank you so much for being here. 509 00:48:57,733.7756667 --> 00:48:58,993.7756667 Yeah, thank you very much. 510 00:49:00,248.7756667 --> 00:49:04,348.7756667 And don't forget to like, share and review my podcast. 511 00:49:04,898.7756667 --> 00:49:08,688.7756667 Remember, it's always ladies first on Soma Says. 512 00:49:08,988.7756667 --> 00:49:12,648.7756667 Let's make a difference one conversation at a time.