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October 16, 2025 • 15 mins
iHeart Media Personality, Abby Bonell interviews doctor Jon Shakespear, a radiologist with Intermountain Health in Utah about the imporance of having an annual mammogram screening. In partnership with KUTV's, Baby Your Baby Program.
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Episode Transcript

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Speaker 1 (00:00):
Happy bonel here with iHeartMedia. October is Breast cancer Awareness Month.
Is also a great opportunity to catch up on the
importance of screening and joining me in the studio today
is doctor John Shakespeare, a diagnostic radiologist with Intermountain Health.
Thanks so much, doctor for joining us today.

Speaker 2 (00:21):
Happy to be here.

Speaker 1 (00:22):
Well. Mammograms are one of the most important health screenings
a woman can have, doctor, It can save your life.

Speaker 2 (00:28):
Yeah, that's true. We don't know when breast cancer is
going to strike, and yearly screening mammography for women older
than forty gives us the best chance to find breast
cancers when they're early. Early breast cancers are small and treatable,
and the prognosis is typically excellent when we find it
at its earliest stages.

Speaker 1 (00:48):
A concerning statistic though, here in Utah shows that we
have the second lowest mammogram screening rates in the nation.
Why do you think women are not prioritizing their health heal?
Is it fair? Is it family commitments, they're too busy
at work, or is it a combination of all of
the above.

Speaker 2 (01:06):
I think it's complicated. I'm sure it is different for
every individual. Definitely in discussing with some of the patients
that I see who have not been screened or who
have not participated in screening in the past. Often they
think that screening may not really be that important for
them individually. They know about what the risk factors are

(01:29):
for breast cancer. They have friends who have a really
strong family history. They know that controlling your weight, eating right,
all of those things, limiting your intake of alcohol, all
of those things can reduce your risk for breast cancer.
And they know that they're doing many of those things,
and so they feel pretty good about their own individual risk.

(01:52):
What I try to emphasize to those women is that
about seventy five percent of the breast cancers that we
see are in average risk women, and so screening is
important for everyone. Whether you consider yourself to be high
risk or not. Breast cancer can affect anyone. So it's
best to keep up with that yearly screening schedule.

Speaker 1 (02:13):
Yeah, it should be like clockwork. Really, your family, your friends,
you'll love ones depend upon you, and we'd miss you.
We really need you to make that appointment.

Speaker 2 (02:21):
Yeah, I agree. Whenever you get your screening doesn't matter
to us. Regular screening is what we want to emphasize.
Some women choose their birth month to get their screening mammogram.
Other women schedule it around their children's schedule. Some women
go in with a group of other women they get
their mammograms together. Some women go in with their sisters,

(02:44):
their mother. Whenever you do it, whatever makes it automatic,
whatever makes it easy, that is what will make it
most sustainable. And doing this for the long haul is
what's really important.

Speaker 1 (02:55):
The rates of breast cancer are really quite high. One
in eight women will be diagnosed.

Speaker 2 (03:00):
Yeah, that's the lifetime risk for breast cancer in the
United States.

Speaker 1 (03:04):
What about younger women. We always say the age that
we recommend somebody to undergo a mammogram is at the
age of forty, But we are seeing women who are
younger coming in and being diagnosed. You see it firsthand, doctor.

Speaker 2 (03:17):
Yeah, that's true, and it's an unfortunate part of my job.
There are younger and younger women getting diagnosed with breast cancer,
mostly women in their thirties. Breast cancer is still very
rare in women in their twenties. It does happen, but
it's very very rare. But yeah, we see it more
and more often in women in their thirties. Many of
those women are at higher risk, some not. This is

(03:40):
currently an area of active study. They're trying to determine
exactly what might be behind the increase in cancer rates.
We know that some of the cancer rates are probably
due to an overall increase in obesity. Some of that
cancer rate may be related to a gradual des increase
over time of when women start menstruating. Often your first

(04:05):
period is a risk factor. The earlier that is that
can be a risk factor for breast cancer later in life.
And it's like in most things in medicine, it's probably
quite complicated and there are probably a lot of things
interacting at once. Definitely, if anyone in that age group,
anyone in their twenties or thirties, if there's anything that

(04:27):
seems abnormal, if there's any lump that they feel, any
change that they notice in their breast, it's very easy
for us to check any of those things. So often
people put things off, and they put them off, and
they put them off, and they feel like it might
be silly to get something that seems like a small

(04:47):
thing checked. I hope that people won't put off getting
symptoms checked out. We can give them peace of mind
and if it truly is something. The earlier we detect
a breast cancer, the better equipped are to treat that
breast cancer. Also, any women in their twenties or thirties,
if they know that there are people in their family

(05:09):
with breast cancer history, it's a good idea to talk
to their doctor about having a risk assessment done. There
are questionnaires that can be filled out, and there are
a genetic test that can be done that will help
zero in on their individual risk, and many of them
may qualify for early screening, so it might be appropriate

(05:33):
even though they are in their thirties, it might be
appropriate for them to start screening early. The current assessment
that inter Mountain is using is called the Tyracusic Assessment,
kind of a mouthful to say. It's basically a list
of questions about your personal history, about your family history
that will result in a lifetime risk estimate, and if

(05:57):
you are in the twenty twenty five percent range or above,
you will qualify for some additional recommendations. So if you're
younger than forty, you'll start screening mammography at age thirty
or wherever you're at, usually not before age thirty, and
you will also qualify for annual breast MRI screening to

(06:19):
be done. In addition to mammography.

Speaker 1 (06:22):
Breast density also increases risk factors too, doesn't it.

Speaker 2 (06:27):
Yeah, that's correct. Breast density is its importance is twofold
to us as breast imagers. Number one, it can make
your mammogram a little more challenging to interpret. Imagine seeing
the moon on a clear night that's a non dense
breast versus seeing the moon on a cloudy night, whereas

(06:48):
the moon is a is a cancer that might be
in your breast. So it can be a little more
challenging to see the moon from all different directions on
a very cloudy night. And that's what's That's what reading
a dense mammogram can be like. So breast MRI, which
is not impacted by your breast density, will help us

(07:09):
see through those clouds and detect anything that might be there.
The second factor with breast density is it's an independent
risk factor for breast cancer, meaning that the denser your
breast tissue is, the higher your risk for breast cancer.

Speaker 1 (07:25):
Interesting well, also this introduces the next question, which is
a huge development I think for women. If you kind
of fall into that category, you're now offering us Intermountain
Healthcare fast mriis explain what that is, doctor.

Speaker 2 (07:41):
So fast MRI or another term for it would be
abbreviated MRI. It's a tailored protocol of MRI images that
we do specifically for breast cancer screening. So a typical
breast MRI takes about forty five minutes to do. We

(08:01):
typically do that in the setting of somebody who has
a known breast cancer or a symptom that we're investigating,
like a lump or something like that. But we've determined
that we can strip away some of those non essential
pictures that we would take with that forty five minute
exam and distill it down to about ten or fifteen minutes.

(08:25):
It's a lot easier for women to wrap their brain
around getting a ten to fifteen minute exam every year
than it is a forty five minute exam for breast MRI.
You have to be as motionless as you can and
that can be very challenging for forty five minutes. So
getting a fast MRI is a nice approach to that
yearly screening.

Speaker 1 (08:46):
It's also less costly as well than the full blown MRI.

Speaker 2 (08:50):
Yeah, that's true. That's an excellent point. So in medicine,
time in the MRI scanner equals money. If we can
condense the time that patients are in the MRI, we
can decrease the cost of doing that exam. And I
will emphasize that multiple studies have shown that in the
setting of screening, this is an equivalent exam to that

(09:13):
longer MRI. You're not accepting significant trade offs by getting
the shorter exam.

Speaker 1 (09:19):
You can visit Intermountain Healthcare dot org slash mammogram to
make those appointments online, which are pretty simple. You can
pick your times as well. I slip my name before
I come into work. It's pretty simple. What are some
of the myths about mammograms that you can dismiss right now?

Speaker 2 (09:37):
Mammographic myths. I think a lot of women love to
joke about mammography being painful. There is compression that that
is an essential part of the mammogram. The squeeze has
to be part of the mammogram. Most women feel like
mammograms are relatively painless. There are women who have maybe

(10:01):
some baseline or pre existing breast pain where mammograms can
be uncomfortable. That's true, But when you weigh the benefit
of the mammogram in balance with that temporary discomfort. I
think people in the big picture can look past it.
Other myths about mammogram I so often try to dispel myths.

(10:23):
There is a very small dose of radiation used to
obtain the mammogram image that is unavoidable. Some women are
very concerned about that. I'll emphasize that dose is extremely low.
It's equivalent to a couple of months of background radiation
that we naturally absorb here on Earth, and it's felt

(10:46):
to be a very safe exam, a much lower dose
than most other imaging tests elsewhere in medicine.

Speaker 1 (10:54):
Doctor Shakespeare. If somebody has a positive diagnosis after undergoing
a mammogram, what can they expect the next steps to be.

Speaker 2 (11:03):
We try to make everything as streamlined as possible in
inter mountains, so we try to shepherd you at every step.
So when I call women with their biopsy results, after
I've given them a chance to ask any questions that
they have, they stay on the line and we schedule
an appointment to see a surgeon. That surgeon will act

(11:26):
as quarterback and communicate any additional things that are needed.
Most women with early breast cancers do not need chemotherapy,
but if a chemotherapy doctor or oncologist is needed, that
will be arranged. If radiation doctor is needed, that will
be arranged. So we try to make it as streamlined
as possible.

Speaker 1 (11:46):
And there have been massive advances in how we treat
breast cancer today, haven't there.

Speaker 2 (11:51):
Yes, that's true. When we think about breast cancer, it
can be very scary. Most of the women that diagnose
with early breast cancer will do great. It will be
a bumpy road during treatment, though, I will emphasize most
early breast cancers do not require chemotherapy. They require surgery

(12:12):
and radiation therapy, sometimes some hormone blocking drugs. And my
perspective that I try to communicate with patients is I've
been at this for a long time. I've been doing
this for fourteen years, and I may I may have
a conversation with the patient at the beginning of their
cancer journey, and I will close that door after that

(12:32):
conversation is done, and I'll go next door and I'll
see a patient who had breast cancer twelve years ago,
and it's just a memory. And that's the perspective of
the vast majority of our patients. Is it's something that
can be dealt with. There are very effective treatments for
early breast cancers.

Speaker 1 (12:52):
And in terms of screening, what is your message right
now to women? It's so critical, isn't it, Doctor Shakespeare.
Make this a regular appointment every single year, especially if
you've hit the age of forty.

Speaker 2 (13:06):
Yes, so screening mammogram should be done annually after the
age of forty. And that's for average risk women. If
you think you might be at high risk, ask your
doctor and try to find out what your personal risk
is and you may start earlier, maybe as early as
age thirty, and breast MRI may play a role in

(13:26):
screening for you as well.

Speaker 1 (13:28):
Intermountain Health also offers genetic testing which can help you
make really informed decisions. It's a great service. Also counselors
on hand.

Speaker 2 (13:37):
Yeah, that's correct. So when that risk assessment is done,
if you are in the high risk category, we have
a high risk clinic that is very good at answering
and answering all your questions, arranging anything that you might need,
genetic testing, the MRI screening, or any additional.

Speaker 1 (13:57):
Things, Doctor Shakespeare. Survival rates increasing, We have a lot
to be hopeful.

Speaker 2 (14:02):
For Yeah, I agree. So the best way to decrease
your own risk of dying of breast cancer. And breast
cancer is the number two cause of cancer death in
the United States, so it's a big one for women.
Lung cancer is still number one, but it's something that

(14:24):
you can significantly decrease your risk for by doing annual screening,
somewhere along the lines of thirty to forty percent risk
reduction by getting that annual screening mammogram.

Speaker 1 (14:37):
So you can book your screening at Intermountainhealthcare dot org
slash mammogram. Thank you doctor Shakespeare from inter Mountain Health
for sharing your knowledge with us today. An annual visit
to your doctor and a mammogram can save your life,
so don't forget it. I'm Abbie Bonel with iHeartMedia in
Salt Lake City. Thanks for listening. We'll catch you next time.
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