278 ‒ Breast cancer: how to catch, treat, and survive breast cancer | Harold Burstein, M.D., Ph.D.

[@PeterAttiaMD]

In this episode, we discuss: 0:00:52 - The prevalence and mortality rate of breast cancer in women 0:03:34 - The anatomy of the breast and the complex factors behind breast cancer development 0:15:00 - The three main categories of breast cancer 0:20:02 - Breast cancer risk: the impact of menopause, estrogen, breast density, obesity, and more 0:24:47 - Finding and evaluating lumps in the breast 0:31:12 - Identifying and treating precancerous lesions like ductal carcinoma in situ (DCIS) 0:42:41 - Post-lumpectomy for DCIS: standard of care, future risk of cancer, and pros and cons of radiation and other preventative options 0:57:43 - Lobular carcinoma in situ (LCIS): how it differs from DCIS in terms of treatment and future risk of invasive cancer 1:07:35 - Breast cancer screening: mammography, ultrasound, MRI, and more 1:15:36 - Invasive breast cancer: pathology report, surgery, and survival 1:28:04 - The argument for aggressive screening for breast cancer 1:33:30 - Advances in the treatment of breast cancer, adjuvant therapy, and neoadjuvant therapy 1:48:30 - The use of hormone replacement therapy in women who are in remission from breast cancer 1:52:32 - The role of genetics in breast cancer 2:01:53 - The importance of multidisciplinary care delivered by cancer centers 2:13:04 - Breast cancer in men 2:15:40 - Parting thoughts and takeaways

[@mazoldavydova4561]

remember when angelina jolie got breast cancer and the she removed both her breasts and got implants. Is this an option for woman who don't want radiation therapy and when the cancer has not spread?

[@TrudyContos-gq1bw]

I'm pretty sure it is a choice that's paid for by the state. At least in this state (CA).

[@rockstar4444]

Please see Guy TENENBAUM's case about cancer : Protocol I would apply in the event of cancer: - a low-carb diet outside the fasting period (total elimination of carbohydrates/sugars) and eating OMAD (One Meal A Day) crucifers, garlic, onions, avocados, walnuts/almonds, olive oil and oily fish to avoid losing too much weight (avoid meat and cheese) - taking specific food supplements (available over the counter to the general public) that Guy TENENBAUM has called TCC (The Cancer Cure) which correspond to his 5 essentials, with the dosage he took: * High-dose melatonin 30 mgr before going to bed (Phycocyanine or Lithotamne, but the most powerful would be melatonin): inhibition of SCOT (I also supplement during the day with pure phycocyanine and lithotamne to increase the volume of SCOT inhibitors in addition to melatonin). * Allicin (either as a 2400 mg quality concentrated pill, or with crushed raw garlic): upstream or downstream inhibition of SCOT. * Matcha green tea (with turmeric and ginger): upstream or downstream inhibition of SCOT. * Metabolic treatment (metabloc): Alpha Lipoic Acid (or Sodium R Lipoate, 600mg 3 times a day, 1800mg in total) + Garcinia Cambodgia (Hydroxycitric Acid, 600mg 3 times a day, 1800mg in total) + CoQ10 (the transporter, 100mg morning noon evening). * Omega 3 in a DHA - EPA ratio (500mg DHA/200mg EPA): to combat keto paradox during ketogenic diet phases or the fasting phase. * Bromelain (850mg to 5000 GDU) and Quercetin (500mg) for nodules * Berberine and Curcumin to block several additional metabolic pathways - Alkalinise the body with a combination of bicarbonate of soda and cider vinegar (see Guy TENENBAUM's videos showing how to make this mixture). - if the body allows it: long fasting (14 days) then the following month followed by short fasting (7 days) and intermittent fasting + taking nutrients and minerals to avoid deficiencies in the young phase (vitamin D3, Magnesium Bisglycinate and multivatimes)

[@tam4givin]

How many diagnoses are wrong, false? Why are computers not used to read biopsies? They would be to accurate?

[@tam4givin]

How many fatalities are really from so called treatments? Infections from so called treatments? 🤔

[@ajp11]

Where you live and your financial resources play such a big role in your treatment options, that is the hardest realization that happens when you're diagnosed.

[@jesandnealhinman]

Thanks for this- I was diagnosed with a very small dcis and initial surgeon kept pushing lumpectomy and 20 days of radiation or multiple times pushed for double mastectomy. I didn’t see the point for so much increase in side effects for no decrease in mortality risk, and when I questioned this approach was chastised for putting my life at risk. I immediately changed providers and enrolled in the COMET study. This study randomized DCIS patients into standard treatment or observation groups. A relative of my husband had same diagnosis and proceeded to double mastectomy and reconstruction and the complications have been enormous and life changing. The fear mongering over this diagnosis and the minimization of potential complications of extensive treatment needs to stop.

[@droliver]

Well, your physician was suggesting what is still standard of care for low grade DCIS mgt. While we think observation (and tamoxifen or an ARI) is likely to be safe, it's not been published and validated. Even after that practice is accepted, I suspect most patients will choose surgery if prostate cancer observation is any lesson

[@GenXmom5]

I regret agreeing to Tamoxifen. Even though I knew and went in knowing how toxic this drug is. I was Dx at 49 with DCIS. Massive lump. Lumpectomy and Radiation therapy. I had a great care team. Never felt like I wasn’t heard. My main regret with tamoxifen is the toxicity - I really wanted baby #6 but now it’s too late.

[@cococali6589]

Amen 🙏. You articulated my exact thoughts. I have 4 friends my age being put through hell for the fear mongering $ cancer industry

[@droliver]

@@cococali6589 🙄"fear mongering for $"? Lady, the ARI's used for hormone blockade are mostly off patent generic and are literally pennies.

[@hergenie]

I too went with let’s wait and see. So far so good!

[@jeanavery925]

I am so thankful to have done my own regular self-exam. I found a lump, had a mammogram which did not show the lump [even though the area was targeted), and then an ultrasound and needle biopsy which was found to be stage 1 invasive ductile cancer, ER+PR+/ Her2 -. I highly recommend doing your own exam even if you get regular mammograms.

[@rosiedodd3844]

I hope you are doing well. I was diagnosed with IDC HER2. Please let me know how you are doing if you're up to it. ❤

[@tonaruch8623]

Breast cancer survivor here. Thanks for this deep dive

[@rosiedodd3844]

I am so glad you're a cancer survivor... I feel so, so dumb as I only now realize what Cancer Survivor truly means. ❤

[@susiepingleton3614]

Double mastectomies and refused chemo. Did 27 radiation Tx. I am stage lll had 19 bad lymph nodes taken out. I am 4 years out on anastrozole. UPDATE: at 4.5 years on anastrozole I have stopped taking it. Too many side effects such as urination, jaws, all joints, and extreme fatigue I am done. For the hope of a few more years? No thanks. After 3 weeks urination problems have ceased and zero odor in breath, urine, and skin! Joint problems are 95% gone! Fatigue is better! I am 73 and quality of life is huge! Studied charts and percentages etc as I am an RN. I just could not do it.

[@RubyTuesday-yr5gl]

❤

[@estar1277]

🙏 God give you His grace.

[@CGyog]

You made it almost to 5 years - good for you!! That will give you the majority of protection against recurrence. I have only been on it one year and the side effects are terrible!! 😢

[@susiepingleton3614]

@@CGyog I am advanced stage lll. Now my survival rate drops from 85% to 50% for next 5?years.

[@susiepingleton3614]

@@CGyog May I ask how many bad lymph nodes they removed from you?? Just curious!

[@OS-yg7cx]

The doctor is great! Peter asks great questions! Thank you

[@juliefredericksen2326]

This breast cancer podcast was so very informative. I appreciate it so much. Thank you.

[@robertmoore1583]

Dr Attia You have again presented a cogent comprehensive and compelling discussion of the most important aspects of this disease .... It rivals your presentation of prostate cancer .... I have over the past 5 decades attended a great number of educational seminars and training venues that did not come close to what you have presented. Thank you for your persistence and integrity in parsing the disparate factors in statistical outcomes inherent in medical trials and studies.

[@christinawaite8352]

Thank you so much for this video. Such great information. I was diagnosed with triple negative breast cancer in July. Just finished treatment, all genetics testing is negative thank god and my tumor is 1 cm so has been caught early. Next is surgery, and after seeing this video I feel more informed and I am blessed to have a wonderful team of doctors. Thank you again!!!!

[@CC12203]

Excellent interview. What would really help women (besides early detection/screenings) is more education for how to reverse the early pre-cancer stages. I’m someone who imaging watches multiple times per year and never once has a mainstream doctor given suggestions for lifestyle changes etc. It’s even difficult to find it. “Healthcare” seems to be procedure and medication focused so it makes you wonder if it is just to their advantage for you to be in the dark about ways to prevent/stave off precancerous things from going further. I’ll continue to seek out my own research and help.

[@deedt8279]

CANCER NO ONE TALKS ABOUT - 1] what happens down the years with those hard medications. 2] Currently doctors’ practices changed to be standard typical treatments which they apply to every patient - They themselves do not know how to think outside the box. Which is harming so many people? 3] Many agriculture and meat contains Pesticides and now-a-days these type of things diseases like cancer and dementia, muscular, Tendonitis etc. are popping up like popcorn. Nobody is taking any action against those people who are providing these foods in market. Those who get the diseases - they get occupied with their internal health issues so their ability to fight gets limited with outside world. Those who survives for little longer they will think I have just touched near death experiences so let me live my life to fullest and matter for original cause of problems are not address. IN NJ they have found 500 plus cases of dementia in kids. Those kids parents should take action . This has become a game and for some doctors a play book game. I guess that is why they call they are practicing on you. At cost of your health they are practicing on you. 4] IT shocks me when doctors tell that all medicine has side effects and if you do not follow the rules which they created they cannot help. Clearly they do not want to think outside the box. 4] Radiation has so much issues with it - while taking even if you breathe it changes the position and wrong side get radiation - which means if you have on left side under you heart - your heart muscle can get damaged. Why cannot do Open surgery to burn the lump or tumor etc....Why they are risking patients life to get damaged to other organs. WHY???? They are brain washing you with each medicine they put out in market - So pharma co makes profit at cost of your health. - Thyroid condition is another MAZE .........For Most doctors it is easy to prescribe, life time Thyroid medicine but they do not know that what level is consider for medication. - See VIDEO on KZbin - TITLE - " Escape the Hypothyroidism Trap with Dr. Antonio Bianco. "

[@jenniferchester3435]

Thank you for this. I was being monitored for a “likely fibroadenoma” in Dec. 2019, the ultrasound tech called them “harmless little lumps”, in late April of 2020 I found a walnut sized lump in my armpit. Luckily I went in to be checked and after a biopsy was diagnosed with Stage 3, Grade 3 IDC. Started 6 months of chemo, followed by radical SMX with tissue expander and 28 rounds of radiation, followed by Anastrazole. I’m now at almost 4 years post diagnosis and while I’m feeling good so far the thought that it could come back is always with me.

[@jaydenp4975]

It’s crazy how quickly a lump can form!

[@renee514]

Excellent topic and all the right questions were asked and answered as many stage 3a breast cancer survivor 2026 diagnosed and needed more answers. Thxs to you both

[@VirgiliaAvhad]

I am a cancer survivor with double mastectomy. I did all treatments like: First doble mastectomy; second: chemotherapy, immunotherapy and radiation. As now going through reconstruction surgeries. The tumor was 2.5 cm Triple Negative. No family history involved. Very informative interview.😊

[@nancybee250]

Just a note on birads 3 being a 5% likelihood of cancer: that also depends on how competent the radiologist is. We live in a small town and my 28 year old daughter had 3 mammogram s and 3 ultrasounds over 18 months and was told every time it was a BiRads 3 lump (probably fibroadenoma)with innumerable microcalcifications. she then self referred to a university hospital and found she had a triple positive 2.1 cm locally advanced breast cancer. A competent radiologist could have caught it at stage 1. I think all birads 3 films should have to be sent for a second opinion by a radiologist who specialises in mammography.

[@katcihealer]

You are not wrong. Where you get your treatment is crucial. I live in a town that is not conducive to great treatment as well. If I had been able to move I probably could have added years to my life.

[@miga6170]

I've had a very similar diagnosis, however Birads 4A, biopsy of these group calcifications. Have been waiting for the results for 3 weeks now and still nothing. I have changed my mind perception during the time of waiting. If they haven't called, there is nothing to worry about and my distress has gone. away😊

[@estar1277]

Thank for sharing

[@zsuzsibumgarner2522]

Sorry .....but they miss cancers on dense breasts ALOT!!!!! My sister died because they said birads 3...... Told her it was probably benign........she did what they said and waited a year!!!! BIG MISTAKE!

[@cherfromtn8225]

Although I am not an oncologist, I don't understand why they did not do a needle biopsy. I have always suggested to my relatives, if they think there is cancer involved, they need to get to a facility that specializes in cancer. Find the smartest guy or gal in the room, so to speak. Sometimes people are hesitant to do this because they don't want to hurt their doctors' feelings. Ignore this idea! Doctors are used to giving and getting second opinions. With some cancers, the timing is crucial.With breast, it is often urgent but not an emergency. You usually have time to seek a second opinion. However, I would think a biopsy should have been the standard of care in this case. This almost sounds like someone has not kept up with the field. In earlier times, younger women were not expected to get cancer. That is not the case now. Younger women are very ng breast cancer Same with colon cancer. Younger people are getting them. Screening now starts at 45 for these cancers, but if people have symptoms, they need to get checked earlier.

[@thirteen5634]

Thanks for this informative podcast. I see a lot of debate on diet post cancer diagnosis, especially for women with hormone positive cancers. Another hot button topic in online support groups is an AI vs Tamoxifen for post menopausal women. This podcast is a wealth of information, I would love to see a follow up covering some topics that we struggle with after active treatment. As someone else mentioned, our oncologists have about ten to fifteen minutes to spend with us, and it is not enough time for us to get the information we want/need. Thank you so much!!

[@aaronlaprise9306]

This breast cancer vid series is great. I’m male and beat triple positive last year. Neoadjuvant chemo + mastectomy because of brca 1 positivity; now tamoxifen for 10 years. My thoughts are with anyone going thru the struggle !

[@sannayoo]

I was diagnosed with breast cancer at the age of 33 in Dec of 2021… Fortunately, I had a non-aggressive type which was mucinous carcinoma that is a rare type of cancer, typically found in elderly women. Because my oncotype score was low, I didn’t need chemotherapy or radiation. Praise God!!! I am grateful but I’m still struggling with body image and the possibility of reoccurrence. Taking it day by day…

[@b58forever]

what number was your oncotype

[@nadiasingh8700]

🙏🙏

[@briggettecammett6181]

How are u doing now. I have read where mucinous cancer does not recur like other breast cancers. How big always your tumor? Grade? Oncotype score? Are you on any pills?

[@vikkster5723]

Thank you, thank you! I wish i saw this information 5 yrs ago when i was diagnosed with BC. This answered so so many question i have had. It has given me so much relief from worry. This was the best Q and A I have come accross. Thank you!

[@tonii2019]

Thanks a million for this informative discussion Dr. Attia & Dr. Burstein. 👏

[@billytheweasel]

Grateful for this. My wife has BC: luminal B, er+ pr+ her2-, stage 2. Excised tumor was 4.2cm but not in the lymph nodes.

[@lynlawley8903]

Think you have more chance if you're limphs are OK, so that's a verry big positive ,,best sent

[@cherfromtn8225]

Before I retired, I was an Oncology Data Specialist (formerly called a CTR). I have been shocked at the problems women are having in working with their medical practioners. If these facilities are accredited by the COC (Commission on Cancer), patient coordination and education should be addressed in their yearly planning meetings. It is sad to hear how so many women feel they are not being heard and their medication side effects are being downplayed. Now that I have received a cancer diagnosis and have started researching treatment, it is very disheartening. Thanks to all of you for sharing your experiences. Just FYI. I am being worked up for invasive ductal carcinoma and lobular carcinoma (same breast). Not sure about Lymph node involvement or recommended treatments yet. I am thinking of travelling to Vanderbilt in Nashville, my closest cancer center, simply because of the problems so many women have had with treatment. I am thinking a specialized medical facility might be better.

[@mssdn8976]

I was stage one, no lymph node involvement, ER +, HER-. I had lumpectomy, 5 sessions of radiotherapy and Letrozole for 5 years. I gave up on Letrozole, with the blessing of my Oncologust, after a year. The side effects were intolerable for me. I’m still scared that I may be putting myself at risk of recurrence, but I felt I aged 10 years in one year

[@lasurfette7830]

You are so fortunate. Stage 1 TNBC treatment involves chemo. Yuck.

[@deedt8279]

CANCER NO ONE TALKS ABOUT - 1] what happens down the years with those hard medications. 2] Currently doctors’ practices changed to be standard typical treatments which they apply to every patient - They themselves do not know how to think outside the box. Which is harming so many people? 3] Many agriculture and meat contains Pesticides and now-a-days these type of things diseases like cancer and dementia, muscular, Tendonitis etc. are popping up like popcorn. Nobody is taking any action against those people who are providing these foods in market. Those who get the diseases - they get occupied with their internal health issues so their ability to fight gets limited with outside world. Those who survives for little longer they will think I have just touched near death experiences so let me live my life to fullest and matter for original cause of problems are not address. IN NJ they have found 500 plus cases of dementia in kids. Those kids parents should take action . This has become a game and for some doctors a play book game. I guess that is why they call they are practicing on you. At cost of your health they are practicing on you. 4] IT shocks me when doctors tell that all medicine has side effects and if you do not follow the rules which they created they cannot help. Clearly they do not want to think outside the box. 4] Radiation has so much issues with it - while taking even if you breathe it changes the position and wrong side get radiation - which means if you have on left side under you heart - your heart muscle can get damaged. Why can not do Open surgery to burn the lump or tumor etc....Why they are risking patients life to get damaged to other organs. WHY???? They are brain washing you with each medicine they put out in market - So pharma co makes profit at cost of your health.

[@fadalr]

@@deedt8279 Once you're on the hamster wheel, it's hard to get off. Big pharma, especially cancer treatments is a multibillion-dollar industry. They have no interest in curing; just keeping you well enough to keep coming back. I personally know two people who had breast cancer. One took the medication, and it returned three times. The other stopped after 2 years and she is 12 years out without reoccurrence. The difference is the one who's cancer returned doesn't lead a healthy lifestyle, poor food choices and doesn't exercise. Meanwhile, the other one eats extremely healthy and exercises. Problem is they are not addressing the root cause of cancer. It's a metabolic disease. Did you know that Japanese women have the lowest percentages of breast cancer worldwide, until they move to the states and adopt the western way of eating/living. I'd also like to see studies of long-term effects of these medications.

[@teresamoews6695]

I had invasive lobular carcinoma in 2008. Did surgery and chemo and tamoxifen. Found metastasis in 2016. Changed my lifestyle, doctor, and started detoxing my world. I am healing. Mets are almost gone. It is a journey.

[@MiaBar]

What where the Lifestyle changes you did?

[@gmagam]

What lifestyle changes did you do? Could you share,?

[@ummtaimann6819]

@@gmagami don’t understand why people on cancer pages they speak about something but never answer questions

[@estar1277]

Im taking notes and studying. Im studying to understand the lump that was diagnosed in my mother's breast. Thanks for this podcast. God bless!

[@carriesmith9943]

Thank you for this video! Such great information! When your oncologists has less 10 min. to talk to you ( sometimes less ) they could never take the time to throughly explain your cancer and answer your questions!

[@joannegodwin5238]

This video dropped the day before my 3rd breast biopsy. Thank you, Peter et al! I am also reading "No Longer Radical: Understand Mastectomies and Choosing the Breast Cancer Care That's Right for You" by Doctors Rachel Brem & Christy Teal. I'm 67 yo and have extremely dense breast tissue. Now waiting on my results, I'm hoping for a DCIS stage 0 diagnosis, after which I intend to pursue a bilateral mastectomy. Screw this "save the breast" crap.

[@le13579]

Some DCIS don't progress to invasive. There's a debate around whether the improvement in imaging is identifying cancers that would never have progressed in the patient's lifetime, resulting in unnecessary treatment. But I am just a lay person. Obviously take recommendations from your doctor based on your individual circumstances.

[@LaurieR2255]

I haven't made it to the end of this yet. I love your interviews, you really feed my brain. I am wondering if you asked Dr. Burstein, from Boston, as he keeps stating, what he thinks of Dr. Seyfried's research on treatment of cancer as a metabolic disease...by using diet and fasting in addition to standard of care. I know you are familiar with his work. Why are we ignoring this man?

[@Sarah-dq8gm]

These questions are so helpful! Thank you for this amazing interview🤗

[@paulachin9130]

Agree really informative and covered all the areas I wanted to know about, great questions followed by great answers.

[@juliadelvecchio4495]

Dr. Attia, your question to Dr. Burstein regarding hormone replacement therapy for women who are at very low risk for a reoccurrence of their breast cancer and the analogy you used regarding testosterone replacement therapy for men with prostate cancer was fascinating. I would like to start on HRT for its many benefits and have finally found an oncologist from MD Anderson in Houston Texas that said it would be reasonably safe for me to go on HRT for a short period of time like for 6 months then off for 6 months. She didn’t recommend that I stay on it long term as we just don’t have the clinical studies that support that doing so would be safe for women with a history of breast cancer especially hormone receptor positive types like mine.

[@drironmom6815]

Thank you Drs Attia and Burstein! Excellent discussion, clarified a lot for me.

[@juliadelvecchio4495]

Thank you Dr. Attia and Dr. Burstein for this very informative podcast. I was diagnosed with invasive ductal breast cancer stage 1 er+pr+ her2- less than 1cm in size with proliferation rate at 4% and node negative. I was recommended radiation therapy after having had a lumpectomy and tamoxifen for 5 years. I refused the radiation therapy after learning about a clinical trial/study at Memorial Sloan Kettering that I ultimately qualified for to safety forego radiation. It was on its third arm when I joined. I did not tolerate the tamoxifen well and stopped taking it less than 2 years in after starting it due to its horrible side affects that I suffered. After learning that taking tamoxifen would not significantly reduce a reoccurrence, I decided that the benefits of taking it did not outweigh the risks, so I stopped taking it and feel so much better having done so. Tamoxifen decreased the quality of my life so much that I probably would’ve stopped taking it, regardless of the risk of reoccurrence.

[@angiesrecipes]

@juliadelvecchio4495 : I am taking tamoxifen now...didn't tolerate well at first and had a whole month of diarrhoea because of it. Where did you you read or learn of that tamoxifen wouldn't reduce a reoccurrence significantly?

[@rgdden2702]

Listen to interview. It’s in there.

[@droliver]

that is absolutely not accurate re. suggesting that Tamoxifen or ARI's are ineffective in reducing recurrence. They have resulted in MASSIVE reductions in recurrence (50%+) and in mortality (30%) for ER+ positive breast cancers. It's been the single biggest advance in breast cancer of the last 50 yrs

[@nextstar55]

are you getting enough vitamin c, d zinc. ?

[@lynlawley8903]

I had awful side effects of anastrzole and had a reaction to chemo and had2 lots ,and lpassed out then was stopped it's not what i expected noone examined why , I had broken my wrist when I passed out but no one explained why ,,I've stoped anastrazole as it s awful but they havnt Time to realy talk through what is going on with the disease,,and don't want to use other new ideas, , it's sad I want to be talked through this but our health service hasn't the time to give us .

[@JuliMoodyStunts]

Thank you for the podcast that explained so many things priceless THANK YOU PETER ATTIA AGAIN 💯👍

[@geauxp]

Mammography for women with dense breasts misses cancer. The reason is that cancer shows up the same shade as the dense tissue. My breasts are dense. I use thermography and ultrasound. A large percentage of women have dense breasts. Do you have dense breasts? Did your mammography report let you know whether you have dense breasts and did they also let you know you can get ultrasound and mri as another check? My local imaging center refused to do an ultrasound unless I get mammography even though my doctor called in the order.

[@nancyd7441]

My yearly script for a screening is for both mammo & ultrasound.

[@dianeatkinson6856]

My mammogram showed a suspicious spot, biopsied , found to be a benign papilloma. When being marked for surgery ultrasound tech saw a nearby suspicious spot, that turned out to be cancer. Another spot found through later MRI. Yes, dense breasts should be monitored several ways. I now get a mammogram then 6 months later, MRI

[@alyssabarajasyourrealtor]

I have dense breast and I have to do my own ultrasound voluntarily out of pocket. My insurance only covers mammo which my report showed dense breast and they couldn't determine much. 😢

[@joTerry-y9k]

Thank you for this great information . I have DCIS, pr+ er+ Her2+ genetics test BRCA2.

[@gmagam]

I just went in for a mammogram recommended by my doctor for dense breast. They didn't find anything on the mammogram ( the radiologist confirmed)but then that same appointment I had an ultrasound with a suspicious lump. Why are they not talking about ultrasounds vs mammogram😢

[@CarylCasden]

Thank you, thank you, thank you. I wish I had had all of this info when first diagnosed! Will you please do a podcast on lymphedema risk and treatment? The risk was so minimized and many women who have had breast surgery end up withnit.

[@MYOB2023]

Yes! I developed lymphedema after double mastectomy and lymph dissection. Felt like my Oncologist didn't really help there aside from the lymphedema arm sleeve and being told to avoid any cuts to my arm and to avoid shaving.

[@rosiedodd3844]

A week ago I learned that I have IDC - HER2. I found a two inch lump in left armpit. I don't really know what I am doing. I'm getting an MRI today to find where it has spread to. I get emotional thoughts - do I only have 60 days to live? Oncologist advised against googling or youtubing for information, claiming may be too overwhelming. Well, I thank you, I am glad I didn't listen. Someone else called this video a deep dive, I agree as I find this video very, very informative. ❤

[@saraimata06]

I got diagnosed on the 17th after telling them since August I had a lump in my left breast. Now lymph nodes are involved. My consultation is on the 29th or sooner and I’m so afraid I’m going to die.

[@saraimata06]

My care nurse also said not to google anything.

[@DrSummits]

Hi Dr. Attia, we'd love to have you or Dr. Burstein interviewed by one of our DrTalks Physician hosts for our upcoming breast Cancer Summit hosted by two integrative oncologists.

[@DawnRK3204]

My mammogram last year (age 50. Fit, healthy) showed a spot of concern, so I had a needle biopsy. The sample came back showing benign tissue. Thankfully the radiologist insisted I see a surgeon who removed the area of concern (lumpectomy). It was hormone receptor positive, stage 1 invasive breast cancer. I had an additional lumpectomy to clean up the margins followed by a sentinel node biopsy, which showed no spread, four weeks radiation, and am now taking daily tamoxifen. My oncotype was only 9, so no chemo. I’m over five years post-menopausal and thankfully have had no side effects yet from the anti-estrogen.

[@karenbeasley2348]

I. Took tamoxifen and later found I have chek2. I went into menopause while taking it but came out of it when I finished. My iron dropped too after periods came back. You have to individualize all treatments.

[@yogi8284]

I’m 56, 4 years post menopausal. My mammogram and breast ultrasound showed an area of concern. I am awaiting my biopsy results. I have taken note of your comments and I thank you for sharing. May you remain healthy.

[@IndeEyeLavanya]

Same condition I had but at age 44. Lumpectomy + oncotype 10+ radiation and then Tamoxifen. But in less than 2 years I started having side effects with increase in endometrial thickness of 13 mm. Now stopped Tamoxifen. But now suggestion is to go for an injection lupride to stop my mensuration every 3 months and start post menapouse letrozole treatment which is not as bad as Tamoxifen. But there was a suggestion if I remove my overies I could avoid this injection lupride depot 22.5 mg every 3 months and get into post menapouse stage and continue with letrozole 2.5 mg daily. Totally confused any suggestion anyone have it will be greatful

[@yogi8284]

@@IndeEyeLavanya it really does not help that there seems to be no support. When a person has been diagnosed, it appears that they must get information from google, KZbin or other persons on the same journey. In my case, I am preparing for chemotherapy, but need advise on a diet that would support my immune system. Yes, I know my diet needs to change and I have done that, But am I eating the right portions? Am I missing foods that should be included? It is so disheartening. We should be getting professional advice tailored to our specific need. What works for one person may not work for us. Hope you find a solution that works for you and gives the best results

[@IndeEyeLavanya]

@yogi8284 Thanks for being so kind to reply. There are interviews where fasting and starving helped to cure stage 4 cancer too, if you can google it. Hope your Chemotherapy sessions go smoothly. My prayers.

[@DaniBoy-pc9zq]

Excellent overview! Thank you! As a practicing pathologist I was both pleased and surprised to hear Dr Burnstein advocating for the high value of of radiologists and pathologists, and how they set apart the best from the average medical centers dealing with oncological patients. Pathologists are almost invisible outside the medical profession, but we make the hardcore diagnostic decisions in many instances (especially in Oncology) after which many other medical decisions branch out. I wonder if that is sufficient stimuli for Dr Attia to bring a pathologist (and/or radiologist) for an interview soon ;)

[@tam4givin]

That would be good! What percentage of biopsies reports are wrong? Why are computers not used to read the biopsies? Thank you!

[@DaniBoy-pc9zq]

@@tam4givin False positives and negatives exist, but are not common. Often they are associated with small sampling, poorly preserved tissue and/or lack of clinical context. AI is already being used to read biopsies, especially prostate, breast and, recently, gastric.

[@tam4givin]

@@DaniBoy-pc9zq Where do you get your information?🤔What lab is using AI ? Not all of them!

[@DaniBoy-pc9zq]

@@tam4givin Most labs do not use AI yet, but hopefully they will in the future. As a practicing pathologist, I am trying to implement it in my own lab

[@deedt8279]

NO ONE TALKS ABOUT - 1] what happens down the years with those hard medications. 2] Currently doctors’ practices changed to be standard typical treatments which they apply to every patient - They themselves do not know how to think outside the box. Which is harming so many people? 3] Many agriculture and meat contains Pesticides and now-a-days these type of things diseases like cancer and dementia, muscular, Tendonitis etc. are popping up like popcorn. Nobody is taking any action against those people who are providing these foods in market. Those who get the diseases - they get occupied with their internal health issues so their ability to fight gets limited with outside world. Those who survives for little longer they will think I have just touched near death experiences so let me live my life to fullest and matter for original cause of problems are not address. IN NJ they have found 500 plus cases of dementia in kids. Those kids parents should take action . This has become a game and for some doctors a play book game. I guess that is why they call they are practicing on you. At cost of your health they are practicing on you. 4] IT shocks me when doctors tell that all medicine has side effects and if you do not follow the rules which they created they cannot help. Clearly they do not want to think outside the box. 4] Radiation has so much issues with it - while taking even if you breathe it changes the position and wrong side get radiation - which means if you have on left side under you heart - your heart muscle can get damaged. Why can not do Open surgery to burn the lump or tumor etc....Why they are risking patients life to get damaged to other organs. WHY???? They are brain washing you with each medicine they put out in market - So pharma co makes profit at cost of your health.

[@shelleygower9843]

Keep hearing "Ultrasound to be sure" or "Confirmed with Ultrasound" ...... so why keep exposing breasts to mammography? should we just stick to non invasive Ultrasound????

[@lindajones4849]

Good question.

[@droliver]

All 3 common modalities (ultrasound , mammogram, MRI) have different strengths. Ultrasound wouldn't replace mammogram strengths while MRI can, but would be too expensive to use for screening purposes on non high risk population

[@misteratoz]

Because ultrasound isn't as "good" for the specific purpose and the risk of radiation, while present, is less than you probably think.

[@geauxp]

@@drolivermri and ultrasound can pick up more info on women with dense breasts. I’m fact mri is the preferred method in some European countries.

[@andreabontempo643]

@@droliver Thermography is best and safest and earliest at detecting

[@MrsDallimore08]

Thank you. Best video ever! Fabulous comprehensive discussion. As a person with BSC in genetics, awaiting biopsy results this is reassuring. Thank you so much

[@Paula-ok9ib]

Interesting to see this. Dr. Burstein is one of my oncologists. I would have been interested in hearing his thoughts in how nutrition and/or plant based plays a role in all this. Obesity IS one of the top 3 contributors to cancer, not sure he agreed.

[@lindaketelaar1335]

Thank you for discussing the impact of Tamoxifen!

[@lindajones4849]

I need to stop listening Abit early at 1.5 hours and so far no discussion yet of how debilitating the side effects of aromatase inhibitors can be. And yes, not all side effects materialize for all women. Side effects can include life altering joint pain, carpel tunnel, brain fog, osteoporosis and accelerating risk of heart disease due to being placed in a low estrogen state. Many women quit the drug, others try lowering the dose by taking the drug every other day. Others quit outright because they cannot risk losing their jobs. Oh yes, there can be debilitating insomnia that can put women at risk of falling asleep while driving or falling asleep at work and being fired. I know of women in high level jobs who had to retire early due to not being able to think due to the combination of brain fog and high intensity joint pain. Some cancer patients are asked to give up alot to stay alive. Losing your job and living in high level pain are not trivial side effects and the " be glad you are alive" advice rings hollow. See the posts by Dr. Liz Oriorden who admitted how stunned she was at the misery she experienced at the combination of instant menopause and brain fog from chemo. By the way she was a surgeon who had to retire due to side effects of her breast cancer treatment.

[@lindajones4849]

Regarding Tamoxifen: I saw a post by a young ( 40 ish) woman stating why she stopped the drug despite her genetic risk for breast cancer. She couldn't focus at work , the effects on her cognitive status were putting her job at risk and she needed to stay employable. To Dr. Attia : thanks for your sympathetic response to the women friends who called you asking " what's with this drug ? It's ruining my life!". The fact that these women seemed surprised suggests they were not given a complete explanation of the potential side effects. They should have been , they are supposed to give an informed consent . I think I know what the problem is. Until recently I was unaware that most doctors receive little or no training on managing menopause in medical school. I had to stop hormones abruptly due to a breast cancer diagnosis and made multiple attempts to get help for my symptoms from doctors and nurses who made it quite clear I should be able to manage uncontrollable crying spells and muscle tremors myself. Eventually I found an experienced acupuncturist who knew how how to treat severe menopausal symptoms. This was included herbal medicines that I did not discuss with my doctors because they are not trained in herbal medicine. I had confidence in the acupuncturist because she was cross trained in herbal and Western medicine- she explained she would not give me any herbs that would cross react with chemo. Without her I would not be here.

[@AngelHawks]

Family history of breast cancer and BRCA2 positive. I'm currently recovering from my reconstruction surgery after a bilateral mastectomy 6 months ago. After 6 biopsies they found pre malignancy. It wasn't a hard choice for me to have the mastectomy but surgery and recovery is quite a journey.

[@ummtaimann6819]

Hope you’re still feeling well but if you don’t mind me asking Why 6 biopsies ?

[@AngelHawks]

@ummtaimann6819 I had 2 areas of concern on my right side, which led to a final surgical biopsy. I also had 2 areas of concern on my left side that put me into surveillance follow-up 6 months later that resulted in an additional 2 biopsies. By this point, I received my BRCA2 results and didn't move forward with another surgical biopsy. I opted for a bilateral mastectomy. All in all, I actually had a total of 7 biopsies.

[@ummtaimann6819]

@@AngelHawks oh thank you 🙏

[@deanawells4395]

When will we start researching environmental issues and breast cancer. I was diagnosed with breast cancer and my oncologist said without a doubt the environmental issues is what is driving the numbers of breast cancer to continue rising.

[@vc88466]

Thank you for this Podcast. Learn so much. Dr. Peter Attia is a good interviewer. Now we can use to ask the question to our oncologist. My friend who is been diagnosed with cancer, this podcast should help her.

[@jaydenp4975]

Very informative video! Can you please do a video on triple negative breast cancer?

[@freeandfabulous4310]

I love hearing a learned doctor say “which is the God given purpose to nurse the child” . So beautiful.

[@ShazWag]

I think it would be good if more clinics could have dogs trained to detect cancers. There was a BBC documentary a few years ago, showing how dogs trained for this can detect breast cancers much earlier than standard radiography and biopsies.

[@lorenpowell1606]

I was just in a study in Tulsa Oklahoma to collect the breath of breast cancer patients. Early days, I think I was number 30.

[@jeancrysabb4327]

Correct. My dog sniff led to discovery of my breast cancer 🎀

[@almonmayze5678]

What a great discovery by your furbaby🙏. Could you briefly describe your dog’s behavior in detail! Thanks in advance.

[@TrudyContos-gq1bw]

I'm with that screening over a radiologist who makes mistakes bcz didn't look into patients comparisons, and or health records. Or just too damn lazy.

[@38NDY]

There is no mention of the many studies showing that mammograms and breast cancer diagnoses do not affect overall death rates and longevity. After giving in to pressure to get a mammogram, I underwent numerous needle biopsies, ultrasounds, scans and a lumpectomy for DCIS. I regret that I underwent all of this pain and anxiety and time. Even if my chance of cancer is twice that of other women, it does not mean that I have a high chance of either getting cancer or dying from it.

[@gmagam]

Why did you felt pressure to get a mammogram? Did you have history ?

[@le13579]

Exactly.

[@limo5724]

Mammography, ultrasound and MRI all have their place in screening and diagnosis. Mammography spots ductal cancers. MRI is better with lobular. I had 3 mammograms and 2 ultrasounds and none picked up my invasive lobular carcinoma. MRI finally caught my LCIS and ILC.

[@user-gr6xz7ri8b]

I wish he was my Dr. I am a Triple Negative BC survivor. No genetic issues, not overweight, no alcohol, exercised everyday blindsided literally. At least I am a survivor so. I did have a pregnancy at 34 only one child and breast fed never had hormonal replacement therapy. My diagnosis was stage 1 but my tumor grade was 3 and my KI67 was at 75%.

[@lasurfette7830]

Did you ever take birth control pills?

[@jaydenp4975]

My sister was diagnosed age 42 with TNBC stage 2. She had a lump for 6+ months in the same spot where she had a cyst removed a few years before. She thought it was another cyst until it started growing extremely rapidly and “morphing” shape. She said literally every hour it was changing like it was “alive”. She had aggressive chemo, double mastectomy, radiation and complications with necrosis after surgery. Needed hyperbaric oxygen therapy and expanders removed. She fought for a year and the chemo had little effect. Metastasis to her lungs and chest. She was BRCA negative. In her younger years she partied and drank and did drugs. She was clean for over 20 years. Smoked cigarettes and had one child at 20 years old. Did not breast feed. She was Caucasian and weight was always good. She didn’t fit into any group that were high risk and no family history that we knew of. She was never overweight and had good health most of her life. No real issues to speak of other than her smoking daily and ate a lot of fast food.

[@christinelantas8393]

Great information. I now have a much better understanding of my breast cancer. Thank you so much.

[@jjm4341]

If Anastrozole has a half-life of 50 hours, why not take it every other day? It seems like the dosage should take into account the variables among BC patients: age and weight, BC stage, node status, Oncotype score, etc. A one-size-fits-all dosage seems like an obsolete way to treat individuals whose care is best when personalized.

[@rebeccamurray5801]

I am an endocrine specialist and I am in total agreement with you. I don’t think it should be a case of 1 mg a day which gives horrendous side effects for many women. I give much smaller doses and I monitor the estradiol and estrone levels. I also thought it was interesting that they talked about the use of anastrozole when a person with DCIS decrease the occurrence in the Contralateral breast. If that is true, because they know the women are at increased risk for a reoccurrence of breast cancer, why are we not screening women who have a strong history of family breast cancer and looking at their estradiol levels and seeing whether or not very low-dose anastrozole would actually Decrease their risk. I think that would make a very interesting study

[@Ginetta-ql9hw]

Since the age of 22, I've undergone numerous unnecessary biopsies. At , 41 I had a surgical biopsy and, unexpectedly, a chip was implanted in my breast. Having a biopsy and mammogram in my twenties now seems excessive. Each result was a false positive, likely due to hormonal fluctuations. I believe many tumors in women may resolve naturally, and there's evidence supporting this. It's been over a decade since my last mammogram, and I've decided not to have any more. If it comes down to choosing preventative measures, I'd opt for a oophorectomy to prevent BC over the potential risks of radiation, chemotherapy, and unwarranted breast surgeries.

[@commonsense6967]

Yeah, I'm 72, and tired of all the unnecessary biopsies and radiologist-urged repeat mammograms and fear-porn alerts of "Birads Stage 4" when it turns out to be nothing. Or something, but they can't tell you what, only that it's not cancer, yet I was asked if I want to see a breast surgeon. When I asked why, he said I had a radial scar. (I later found out it was a 2.5 mm radial scar, but when I asked him how often that turned into cancer, he had no idea! Amazing!) Finally did a deep dive into PubMed, limited my "research" to recent studies, and found out Mayo Clinic advises no surgery for one with no atypia and less than 1 cm. but to follow up for a couple of years with breast MRI and mammograms. Meanwhile, my PCP wanted to refer me to a surgeon because she believed they DO turn into cancer often. Her referral (surgeon) never even called me back, and that was 3 mos. ago! We might as well learn to be our own doctors. What's out there practicing is generally worthless. And I don't think mammograms help anyone but radiologist's pockets.

[@rockstar4444]

Guy TENENBAUM's case about cancer and his protocol : - a low-carb diet outside the fasting period (total elimination of carbohydrates/sugars) and eating OMAD (One Meal A Day) crucifers, garlic, onions, avocados, walnuts/almonds, olive oil and oily fish to avoid losing too much weight (avoid meat and cheese) - taking specific food supplements that Guy TENENBAUM has called TCC (The Cancer Cure) which correspond to his 5 essentials, with the dosage he took: * High-dose melatonin 30 mgr before going to bed (Phycocyanine or Lithotamne, but the most powerful would be melatonin): inhibition of SCOT (to use pure phycocyanine and lithotamne to increase the volume of SCOT inhibitors in addition to melatonin) * Allicin (either as a 2400 mg quality concentrated pill, or with crushed raw garlic): up/down stream of SCOT * Matcha green tea (with turmeric and ginger): up/down stream of SCOT * Metabolic treatment (metabloc): Alpha Lipoic Acid (or Sodium R Lipoate, 600mg 3 times a day, 1800mg in total) + Garcinia Cambodgia (Hydroxycitric Acid, 600mg 3 times a day, 1800mg in total) + CoQ10 (the transporter, 100mg morning noon evening) * Omega 3 in a DHA - EPA ratio (500mg DHA/200mg EPA): to fight keto paradox during ketogenic diet or the fasting phase * Bromelain (850mg to 5000 GDU) and Quercetin (500mg) for nodules * Berberine and Curcumin to block additional metabolic pathways - Alkalinise the body with a combination of baking soda and cider vinegar - if the body allows it: long fasting then the following month by short fasting and intermittent fasting + taking nutrients and minerals to avoid deficiencies (vitamin D3, Magnesium Bisglycinate and multivitamins)

[@VirgiliaAvhad]

I had biopsy since my 30s. The the told me it was important to follow since the results could change over time. The doctor was right. A fews yeas later, it changed to a malignant tumor. I am glad l followed up with the doctor advised. At it is extending my life. I have my own KZbin channel where l tell my journey. 😊

[@tam4givin]

@@rockstar4444 The only thing worse than the cancer industry is the evil snake oil salesman called natural, integrated or whatever this week’s word is fleecing the desperate.

[@kemeticcouturellc1181]

So happy I found this post. It's very informative.

[@fondofbunny]

Peter’s question at 1:48:49 is not really answered. Not only are women not recommended to go back to estrogen replacement therapies, we are recommended to block estrogen. Even after all sign of cancer is gone. I am very curious to know the answer to Peter’s question. Why? Do we have evidence that these estrogen blocking therapies are necessary even with stage 1, bilateral mastectomy, no spread to lymph nodes, clean margins, etc.? Or do we just care more about the sexual health and comfort of men? The expert’s response was not to explain the need but rather to give a laundry list other other drugs I can take to fight bone loss, hot flashes, etc. (Each new drug with its own laundry list of side effects.)

[@MYOB2023]

For those of us with tumors caused by mutation (mine is CDH1) naturally controlling our estrogen is key to preventing recurrence. I have been refusing the pharmaceutical estrogen blockers as there's natural foods and supplements that help lower estrogen as well as diet and exercise. So many side effects to everything. (Double mastectomy and lymph dissection here.)

[@le13579]

Oh please. Cancer treatment plans are not about men. Excluding that, though, your question about necessary exceptions to standard practices is very interesting to me.

[@jeanavery925]

What decisions we each make about adjunctive therapies should be based on our personal tumor characteristics and an understanding of the risks vs the benefits of the different options as demonstrated through scientific clinical studies. My own personal frustration comes from not having any kind of confirmation (blood test, marker etc) that the AI is actually doing what it is supposed to do. So although statistics say there is benefit from taking it, there is no way to track its efficacy. And yet the risks and side effects are quite obvious. It seems that breast cancer care has made significant progress over the last 10 years but there is still a long way to go!

[@le13579]

@@jeanavery925 Interesting point. There must be some sort of measure of efficacy in the original clinical trials? I'll have a bit of a dig around but I dont have any access beyond paywalls and some journals even paywall articles from the 80s.

[@le13579]

@@jeanavery925 Just for clarification, are you interested in early breast cancer or advanced disease?

[@judithabalos2132]

ERPR+ Her2-, grade 3, node negative, DCIS , Stage 1 and ongoing chemo (4 cycles). Very informative. Will make my decision on hormonal therapy replacement. My onco recommends5-10 yrs meds.

[@sarahterry2140]

I don’t think I’ve caught the other episodes in this series so it may have been covered, but I’d like to hear more about studies that implicate factors in breast cancer initiation/progression such as constant circadian rhythm disruption (2018 Harvard study of flight attendants suggesting this), nighttime light exposure (studied since 1980s) and low Vitamin D. And are there any good data on EMF and cancer? Thank you for an excellent episode.

[@droliver]

none of those are clear major (or even minor) drivers in breast cancer rate in current understanding of the disease.

[@gretacooper6080]

Excellent question and bears monitoring

[@icarus0206]

Thank you. My friend is going through this & it's really good to know

[@billytheweasel]

As a member of a very large group for almost 40 years I rarely heard people talk about having cancer but hear of it every other day in the past 2 years.

[@Hasan-jf7by]

@@billytheweasel It is probably because of your age and awareness towards cancer.

[@deedt8279]

@@billytheweasel CANCER NO ONE TALKS ABOUT - 1] what happens down the years with those hard medications. 2] Currently doctors’ practices changed to be standard typical treatments which they apply to every patient - They themselves do not know how to think outside the box. Which is harming so many people? 3] Many agriculture and meat contains Pesticides and now-a-days these type of things diseases like cancer and dementia, muscular, Tendonitis etc. are popping up like popcorn. Nobody is taking any action against those people who are providing these foods in market. Those who get the diseases - they get occupied with their internal health issues so their ability to fight gets limited with outside world. Those who survives for little longer they will think I have just touched near death experiences so let me live my life to fullest and matter for original cause of problems are not address. IN NJ they have found 500 plus cases of dementia in kids. Those kids parents should take action . This has become a game and for some doctors a play book game. I guess that is why they call they are practicing on you. At cost of your health they are practicing on you. 4] IT shocks me when doctors tell that all medicine has side effects and if you do not follow the rules which they created they cannot help. Clearly they do not want to think outside the box. 4] Radiation has so much issues with it - while taking even if you breathe it changes the position and wrong side get radiation - which means if you have on left side under you heart - your heart muscle can get damaged. Why can not do Open surgery to burn the lump or tumor etc....Why they are risking patients life to get damaged to other organs. WHY???? They are brain washing you with each medicine they put out in market - So pharma co makes profit at cost of your health.

[@CaroleKern]

According to Dr Burstein, surgery & pharmaceuticals are most often recommended. No mention of other options such as cryoablation.

[@tobypierce3611]

Thank you for this very comprehensive discussion about breast cancer. It keeps me abreast of the latest studies and innovations about this dreaded disease.

[@carrievanderhoff]

Have been viewing/listening to this podcast for nearly 2 hours so far. This may be too simplistic but I want to know if annual screening of mammography is really necessary for women in early 60's with no breast cancer in family line whatsoever. Every yr seems excessive even to my past MD who recently retired. Can this be honestly answered/addressed? TY

[@kimim2702]

I developed invasive breast cancer at 70. Fortunately, it was caught early due to my annual screenings. I’m not medically trained, but based on my experience and the fact older women have higher incidences of breast cancer, I suggest you continue to be screened.

[@PartTimePermies]

Considering that 1/8 women get breast cancer, 70% of women with breast cancer have no familial risk (90% with no known hereditary risk), the number one association with breast cancer is age (higher risk as we get older) and the average age of sporadic (non-familial) breast cancer diagnosis is in the 60's, yes screening in the 60's is VERY important. Multiple organizations recommend screening with annual mammograms through age 75 for average risk women.

[@carrievanderhoff]

Good insight from both of you. Interesting information I was unaware of. Two yrs since last mammogram, think I will schedule an appointment. Thank you both!❤ 4:46

[@TrudyContos-gq1bw]

Go, mine was an early stage invasive ductal carcinoma and dcis and the call back for a diagnostic mammography didn't see it, but the diligent tranducer ultrasound tech caught it in another area other than indicated by orig mammograms indicated in the past. So, go cause, either way that annual mammo led to my malignant diagnoses. I'm sure your fine, and like they say minimal risk of radiation with a newer technology. Good luck prayers your way.

[@carrievanderhoff]

​@@TrudyContos-gq1bw Very impressed with you and kimim being so proactive with your healthcare! When you think of it, no one but yourself can 'take care of you' on this one but yourself. My grandmother lived to be 90yo, never had 1 mammogram. My sister as well refused to get 1, perhaps of cost. Both of you discovering your B/C so very early both have excellent chances of long term survival I bet. Prayers and positive thoughts to you both❤

[@elenitzelepis1752]

Thank you for asking such excellent questions Dr. Peter

[@MYOB2023]

For any woman with dense breasts, please make sure you follow up your mammogram with a MRI. I have a family history of lobular breast cancer (CDH1 mutation) and the mammogram came back abnormal but they suggested waiting 6 months. Sure enough, in that time I found a lump in ny armpit and breast near the underwire. If I hadn't gotten the MRI the mammogram would have missed the lobular until it was too advanced. Dense breasts make a mammogram miss lobular!!

[@BretGregory]

Hi Dr. Attia, we'd love to have you or Dr. Burstein interviewed by our DrTalks hosts on our upcoming Breast Cancer Summit. Hosted by Two integrative Oncologists, for patients and health consumers.

[@loriemcmaster3086]

Thank you Peter for speaking the truth about Tamoxifen!! I am a breast cancer survivor and refuse to take Tamoxifen. My OncoType score was 10. Oncology doctors seem to be more focused on statistics than quality of life. I am curious about using bio identical hormones during post menopause with a prior breast cancer Dx.

[@rachelkellond6313]

I have a breast biopsy next week. I feel a lot better now after seeing this. Thank you for being so thorough. I feel a lot less anxious now. 😊

[@margvalentine9626]

This was very helpful information. Thank you both so much.

[@ron1183]

Thanks for this Dr. because Ive having some issues with my breast since turning 40.

[@maureencampbell-hq9xv]

Tamoxifen is hell ..hot flushes every hour , 24 hours a day dripping wet, and lack of sleep. I chose to stop,after 12 months as I was exhausted.

[@MYOB2023]

It was the absolute worst for me and due to my history of blood clots I stopped it.

[@LillyAnnHouston]

Did everything return to normal after you stopped? Thx

[@phileseselden7802]

I'm hesitant to trust a "watch and see" approach and then react if necessary given how many providers have long treatment delays and difficulty getting appointments.

[@smooth_pursuit]

I recommend Dr Gilbert Welch’s book, Overdiagnosed

[@pauletteispassingiton943]

My daughter died at 42 with HER2 positive in 2020…still heartbroken

[@sevdarasdaras]

I’m so sorry to read this. I wish you all strenght and blessings.

[@shamsaabubakar3213]

so sorry for your loss mem

[@MadeNCda]

My sincere condolences 🙏🏻

[@janevanreenen8768]

🙏🏻✨🙏🏻

[@dianawardrip5171]

So sorry for your loss. Prayers for strength for you.

[@sherrikoop2456]

This 1:06:42 was so validating. I’ve just finished treatment for high-grade DCIS (2 lumpectomies, radiation, micro-invasion, er/pr-) and together with my oncologist made the decision to not take tamoxifen. The side effects simply are not worth it.

[@turtley8883]

I just found out I have ER+ breast cancer. I'm afraid of tamoxifen. I'm only 40. I hope they don't recommend I take it long term

[@limo5724]

If you are ER/PR negative, why would tamoxifen even be an option. I had LCIS which turned invasive, as invasive lobular breast cancer. These "pre-cancers" are cancer cells which haven't yet gained the ability to invade other tissue.

[@lizahennke9296]

Thank you for this video! I had a lumptectamy on 5/23 with very good lab results. I am waiting to recieve ONCOTYPE DX results and will make a decision regarding Radiation once I have more information. I won't do Chemo. Be blessed.

[@LencoTB]

The video was good but didn’t cover the meaning of Ki67 nor did it cover what if you have a recurrence of BC. Can you just keep doing lumpectomy? And all the gene types mentioned were not covered in detail.

[@agapeeros9743]

Incredible interview. thank you!

[@marhb6489]

Is there further información about implants and breast cancer?

[@droliver]

That issue has actually been studied quite extensively. Breast implants don't appear to increase the risk of breast cancer. That's been validated by a number of international trials

[@palmtree9815]

Sunlight is important!!!

[@Peter-gu4zc]

Super video with lots of technical info. Thank you! However, I am curious about prevalence of cysts in the breast cancerous vs non-cancerous. Any info about it? Thx.

[@Peter-gu4zc]

Are there any known cases of solid tumors in the breast that converted into cysts?

[@jaydenp4975]

My sister had benign cysts removed and several years later had triple negative invasive ductal sarcoma tumor grow in the exact same spot!

[@KatePeterson-d7t]

Lobular carcinoma was missed in my breast for years in mammogram. Lobular is not typically found in early stage. There has to be better screening. I found a ridge in my breast 8 days after a clear mammogram. I was diagnosed with Stage 3 ILC at the age of 44. No family history, no abnormal genes. The mass was 10.5cm. 4 positive nodes. Clear margins were NOT obtained after mysectomy. So many women have stories like mine. Please help spread awareness!

[@LB-zc1hj]

In the Uk I am grateful for 3 year mammograms which at 67 years old, showed up breast cancer, I then had ultrasound, punch biopsy then I had a Breast MRI which revealed my 16 x 48mm Er+ Her2 low breast cancer I’ve had a lumpectomy Stage 2 Grade 1 clear margins no lymph node involvement on to radiation therapy soon after seeing the oncologist and then probably hormone therapy. My questions follow:- How do they know how high your oestrogen level is ? When determining hormone therapy treatment? Can you have a blood test every 3 months to check if you need to take these tablets? Thank you. PS in the Uk after diagnosis you will be offered a mammogram every year for 5 years .Thank you

[@Mscloudirie]

Hello! My mom is 68 yrs old and just got diagnosed with similar cancer except hers is grade 3. Would you be willing to chat thru email or whichever easier way to talk about your experience and the options of treatment you are choosing?

[@deborahbizzell1989]

I had a normal mammogram 12/19,3 months later I saw a dark area under my axilla.I made an appt.had a biopsy and later surgery,the diagnosis was stage 3b.So every 12 months I had my exam.I thought if I caught it early,I'd be o.k.So even though you may try hard to find it early,sometimes it will sneak up on you between mammograms.

[@aidacantu3355]

Maybe the mammogram is causing the cáncer, some doctors are talking about the harmful the mammogras are. Mcdougal, I think is the doctor.

[@deborahbizzell1989]

​@aidacantu3355 it's possible,I've had them done for over 34 years every 12 months.

[@deborahcollard4560]

I had a mammogram a year ago then found I had a grade three tumour a year later whiich was found on a CT Scan done for something else.

[@rima717nc]

Thank you for this excellent information!

[@trishmarck7798]

what about the fact that tamoxifen is carcinogenic???

[@Notsorandomwalk]

Antiperspirant deodorant and compressing underwire bras? I dropped these habits long ago with no regrets.

[@7878Buzz]

GREAT Video!

[@firstlast-em2yq]

I'm frustrated by the frequent occasions when Dr. Burstein was unaware of the existence of certain studies. Please consider reaching out to someone who is knowledgeable about these studies and can provide answers to your questions.

[@cherylbrash]

great interview.

[@HappyLife8]

Great questions, Peter !

[@charlesrobbins2208]

Ladies, if or when the Dr. says to you that they have found cancer in your breast, ask them to let you see every xray they have ever done on your breasts. I would bet that the spot on the xray which they show you will show up on many of the xrays before the one which he chose to show you as when he detected the tumor. In other words that tumor will show on previous xrays. If you are able to get to look at those xrays and find that your tumor was there before he chose to inform you, let us know here, it will help others to know that the Drs are frequently missing an earlier time to start treatment, which leads to a lower case of successfully battling the cancer. You would be surprised at the rate of missed chances to start treatment of the cancer.

[@SavedbyGraceSETT]

This happened to me. Went for a mammogram was cleared felt a lump about a month later when I looked at the prior mammogram I could clearly see the mass, I have dense. I had complained to doctor of breast pain was told it was related to caffine.

[@CaroleKern]

I had a mammogram in 2/22 that was read as normal. Had another mammogram 10/23 and cancer was found. My doctor in looking back at the first mammogram was able to see the cancer

[@nancybee250]

I can never overstress the point that diagnostic imaging is only as good as the person reading it. If you have a breast abnormality, make sure your Film is read by a breast specialist. Chances are a general radiologist does not have the same knowledge and skill required to accurately diagnose an early stage breast cancer.

[@lynlawley8903]

Do we think that there could be other,wAys to treat this disease, is anybody looking at metabolic disease as mentioned ,,could be linked,,

[@shamsaabubakar3213]

Thank you so much, we apprecite the knowledge you both have shared on this subject, stay blessed from Mombasa, Kenya

[@MarionMM]

@1:06 Doctors are always telling women to continue to do what is not their best interest due to ignorance and control. Especially if the doctor's recommended course of treatment is questioned. Their egos usually make them double-down.

[@JJB-q5d]

I had a core needle biopsy 1/2023 which showed benign fragments of inflammed papilloma per path report. My GYN sent me to breast surgeon--repeat mammo showed same in the left breast and nothing in right. Had MRI which showed inside papilloma papillary cacer in left and DCIS in right---had bilateral mastectomy a year ago. Don't know if the first report was correct or second one but took no chances and had bilateral mastectomy. How could both reports be correct? Years ago I don't think DCIS was considered cancer was it?

[@christinevaseer9122]

I was pretty well much told during the biopsy that I had cancer.

[@turtley8883]

My doctor told me as soon as she saw the mamogram. I said I would hold out hope until the biopsy report. She said she could tell just by looking at it that it was cancer. She was right

[@tonial5789]

chemo, mastectomy, radiation and hormone therapy for er+ for 7 years. Doctor did not oppose to removing hormone therapy after 7 years. Two years later now it is metastatic breast cancer spread all over. I wished the doctors would know better and advise patient to stay on the drug. This happened to a loved one who thought that hormone therapy after so many years would have killed the cancer and asked if it was ok to stop the drug. Now were planning a funeral.

[@GenXmom5]

Both my older sister and I have the CHEK2 gene variation but she had lobular with mastectomy, chemo, radiation and was told to be prepared for a metastasis down the road. She was 59 at Dx. I was diagnosed at 49 with DCIS stage 3, lumpectomy, sentinel node removal with 1 of the 5 nodes removed as suspect, radiation, tamoxifen. Wish I had known this info earlier- would have not agreed to Tamoxifen. Ive been able to tolerate it, I live a fairly healthy life with diet/exercise even before dx, but I also live with an autoimmune so has been difficult to determine if the joint aches, hair loss etc is tamoxifen related or Hashimotos related. Or maybe they just balance each other out. Thank you for a wonderful podcast. I’ve shared with many including my four sons and husband. I’d like to know more about the “other” genes in a follow up podcast :)

[@droliver]

you would not have been a candidate for the trials on deferring hormone blockage with high grade ER+ DCIS

[@miriamprayalways8955]

This was Great I have learned so much. Thank you both

[@deedt8279]

CANCER NO ONE TALKS ABOUT - 1] what happens down the years with those hard medications. 2] Currently doctors’ practices changed to be standard typical treatments which they apply to every patient - They themselves do not know how to think outside the box. Which is harming so many people? 3] Many agriculture and meat contains Pesticides and now-a-days these type of things diseases like cancer and dementia, muscular, Tendonitis etc. are popping up like popcorn. Nobody is taking any action against those people who are providing these foods in market. Those who get the diseases - they get occupied with their internal health issues so their ability to fight gets limited with outside world. Those who survives for little longer they will think I have just touched near death experiences so let me live my life to fullest and matter for original cause of problems are not address. IN NJ they have found 500 plus cases of dementia in kids. Those kids parents should take action . This has become a game and for some doctors a play book game. I guess that is why they call they are practicing on you. At cost of your health they are practicing on you. 4] IT shocks me when doctors tell that all medicine has side effects and if you do not follow the rules which they created they cannot help. Clearly they do not want to think outside the box. 4] Radiation has so much issues with it - while taking even if you breathe it changes the position and wrong side get radiation - which means if you have on left side under you heart - your heart muscle can get damaged. Why can not do Open surgery to burn the lump or tumor etc....Why they are risking patients life to get damaged to other organs. WHY???? They are brain washing you with each medicine they put out in market - So pharma co makes profit at cost of your health.

[@grumbleweed-iz8bc]

Agree

[@Ms17796]

Thank you ! I had dcis stage 0, on one breast , I decided and my oncologist we do mastectomy on both just in case . Well my other breast tissue was sent to pathology and it came back positive as well for dcis stage 0 . No chemo nor radiation . Doc said it was caught way before anything . 🎉🎉

[@KIKISEYES]

I'm glad you're doing this but you need to come up with something better than that biopsy because I'm telling you that hurts bad for us women