53: Discover the Test that Could Transform Breast Health Forever with Dr. Joel Evans

Hello and welcome to the Kenya Breast podcast with Dr. Jen. The show dedicated to empowering women through knowledge, tools and resources to take control of your breast health journey. I'm your host, Dr. Jen Simmons, and I'm thrilled to have you join me on this insightful and inspiring journey. As a breast cancer surgeon turned functional medicine physician, I'm on a mission to empower women to live their breasts and need best lives. This podcast dives deep into all topics related to breast health, including prevention, diagnosis, treatment and holistic approaches to support overall well being. You know what I say? Breast health is health. So no matter who you are, a breast cancer survivor, newly diagnosed in treatment, living with metastatic disease, or you're simply seeking to improve your breast health, this podcast is for you. Join us on this transformative path towards better breast health and a thriving life. And now, let's get to today's episode.

Hi, it's Dr. Jen. Welcome back to another episode of the keeping your breasts podcast. Today we are going to be talking about something that is very near and dear to my heart because we are specifically focusing on breast cancer and breast cancer risk. And I am delighted, delighted to have someone who has been so integral in my education because he is one of the leaders in female hormones. He is one of the lead educators for the Institute for Functional Medicine, which is where I did all of my training. And he is the chief of Medical affairs with the Institute for Functional Medicine. So this is a person whose voice has been in my head for many, many years because I listened to your recordings over, over and over again while studying for my certification. And so I a little bit am starstruck and feel like I'm talking to one of my heroes. But again, was introduced to you recently because you're very involved in the breast cancer risk arena now with your new role as the chief medical officer for gene type special. So, Dr. Joel Evans, I'm so delighted to have you on today and to share you with my audience and to share what is coming in this breast cancer risk analysis space because this is the question that everyone really wants to know the answer to and because the risk right now is one in seven over a lifetime and it's only getting worse, things like what you're doing become of the utmost importance. So first let me just say welcome.

It is so good to be here and I am so excited just to be here to get the word out to the general public about this important information. But to be here with you, who's been through the Institute of Functional Medicine training and I had no idea about all these exciting things that you're doing and this great book that you've just published and all the great work that you're doing to help women in the world. So I'm proud to be here and proud of all you're doing.

Well, thank you very much. And just know that, you know, you were a part of this from the start. And, you know, none of us do this alone. Right. Like, we all need everyone. We all build on. On everyone before us. So, you know, I really, literally would never be had it not been for the foundation that I got from the Institute for Functional Medicine and specifically for the hormone training that I got for you from you. So I'm super duper grateful. So why don't we just start off by you telling people what the difference is between someone who is in the functional medicine space and focuses on hormones and someone who, you know, because we all have that background medical training as physicians. But if I'm being honest, even after medical school, residency, and fellowship, I knew very little about female hormones.

Yes, yes. And you know what's interesting about that is that there's such an interplay between what we consider to be hormones, other parts of the way the body works, and not too often do those different specialties talk to each other. So, for example, up until very, very recently, you had endocrinologists who would focus on diabetes, and they would manage people's blood sugar. And then you would have endocrinologists or gynecologists that would be focusing on estrogen levels. And people were very well aware that too much estrogen can be a risk factor for breast cancer. But the endocrinologists working in the world of diabetes or blood sugar wouldn't be talking to the people working in the world of breast cancer. But the literature would show that people that have elevated blood sugars, Diabetes, would be at more risk for breast cancer. And no one really talked about it. No one sat down to try to figure out why. And patients weren't given this information. And so early on, when I would start understanding this information and teaching this information and working with my patients with this information, I would ask my patients that were either at high risk for breast cancer or concerned about breast cancer or were just diagnosed with breast cancer, I'd ask them a simple question like, how is your blood sugar? And they wouldn't know. Or if I had a patient in one of those categories that had diabetes, I would say, did your oncologist talk to you about the importance of normalizing blood sugar? Because we actually have Science that says if your blood sugar is high at the time of your diagnosis of breast cancer, you do much worse in terms of earlier recurrence and all sorts of.

Bad things and response to treatment and risk of recurrence. Right. Ultimately, every outcome is affected by blood sugar. And it comes down to breast cancer is without question a metabolic disease. But with that in mind, there are people who are still going to be at increased risk of breast cancer, and that is because there are genetic influencers. Right. And there are things, more than just the BRCA gene and things like that, that make it more likely that you would develop a breast cancer. And I would imagine insulin sensitivity genes go into that, detoxification genes go into that, and you've done a deep dive on all of that. So can you talk a little bit about how we used to assess breast cancer risk and then segue into how we should be doing it and what you're working with now?

Sure. So we used to assess breast cancer risk in basically two buckets. One would be a genetic bucket, and another would be a sort of lifestyle type bucket. And in the lifestyle bucket, it was looking at factors that would indirectly correlate with the amount of estrogen the breast would be exposed to. So in the genetic bucket, we would look at things that we understood in terms of the way we look at genetics, which was, what does a gene do? So we would understand, for example, brca. And BRCA is a wonderful way to look at how we understand genetics, because it's one gene, we know what it does. But when you have a BRCA issue, it's actually the gene that becomes deactivated. Because the gene does a good thing. Right. The gene is good.

It's a protective gene. Right. It's a tumor suppressor gene.

Exactly. And then if you have the mutation, that tumor suppression effect goes away. And so it's easy to understand why people that have that mutation get more breast cancer. And that explains why we see breast cancer in younger women that have that gene. Now, I can tell you that genetics now has really expanded over the last few years because we have something called the Human Genome Project, where we have now, in the last 10 years, been able to look at the entire DNA or genetic sequence in a person. Now we call that understanding or analyzing or seeing the entire human genome. We really couldn't do that before. When we were first learning how to do that, it would take days to do that. We do that now in hours, and it would cost.

Isn't that amazing?

Oh, it's incredible. It's incredible.

It really is, right?

Yes. And so we have all of this information now that we can access. And when we look at breast cancer, it's more than just the BRCA gene. When we look at breast cancer, we know that there are a lot of families that have clusters or what we call family history of breast cancer. And that's roughly, you know, 15% or 10% of breast cancer cases. And we sometimes can, and sometimes can't identify the actual genetic issue in those families. But about 10 to 15% are family clusters. And then you have about 5% or 8% that are those BRCA type genes and there are a few others of those. But other than that, that leaves you about 80% of cancers that don't have that genetic super predisposition. And the term for that is sporadic or random. And those are the out of the blue breast cancers that are the most common type. 80% of breast cancers are in those genetic out of the blue cancers. And so that's really where focus prevention is important because that's the majority of cancers. So when we used to look at those out of the blue cancers, we did what I said before, which was try to find lifestyle factors like did a woman have children or not have children? Because having children was protective, you know, the age when she decided to have her first child. Those are the kinds of things that would matter. Now we have many more sophisticated questions, and those sophisticated questions are very important. Right? So what's someone's heightened weight? Because believe it or not, being overweight can increase breast cancer risk. Just like we talked about the blood sugar before, so.

Because usually, not always, but usually they correlate. Right.

And even independently risk factors too. So.

Yeah, yeah, yeah.

Normal blood sugar, it's still a problem.

Yeah, that's, that's an interesting thing because when you have, when you're overweight, you have more fat cells. So even if you're overweight with normal blood sugar, we store toxins in our fat cells. So technically, if you have more fat cells, you have more toxin.

And you know, from a functional medicine perspective, the biggest underlying functional imbalance in our society today, what we consider to be the greatest cause of underlying chronic disease is inflammation. Right? I'm sure everyone in this audience has heard of the word inflammation and heard that inflammation is bad. Well, guess what? Fat cells cause inflammation.

Now can you talk about that a little bit? Why do fat cells cause inflammation?

Fat cells cause inflammation because they produce some of these pro inflammatory chemicals, what we cause called cytokines. And interestingly enough, there is something called a Fat fat cell, meaning we all have a lot of fat cells in our bodies, but those fat cells don't have to be maximally filled with fat. Think of it as a balloon where there's less air. In that balloon you still have the cell or the balloon casing. But how much air is in that balloon or how much fat is in the fat cell changes the way that fat cell acts. So there's a good compound called adiponectin which reduces inflammation. And if the fat cell is too full of fat, it makes less adiponectin, which creates inflammation and also has pro cancer effects. So those are the two main links between obesity and inflammation, Obesity and cancer that are independent of insulin.

I remember just seeing the illustration of the fat cells that were on the smaller side and they had a couple of those green like.

Yes, that's the slide, that.

Slide. And you see that. And in a spectrum, like some of them just have a couple of those green toxic things and then along the spectrum as it gets bigger and you see more of those green toxic things and eventually like it becomes a really toxic cell. And so, and I want to be clear, we're not talking about not having any fat cells because we need fat cells. Like we need everything.

Yes, yes, yes. And being underweight isn't good either.

Yeah, you know, it's absolutely a spectrum. But we want healthy cells. Yes. And that goes across the board. And there's such a thing as a healthy fat cell and such a thing as a not so healthy fat cell.

Exactly, exactly. And so, you know, I, the way, you know, I just tell it to my patients is your fat cells are okay. It's not. The problem is that the fat cell, the problem is that the fat cell is fat.

Yeah, exactly, exactly. Okay. So we know that having too many of these kind of toxic fat cells is very pro inflammatory and inflammation is driving a huge percentage of disease. Now even if you have a good genetic profile, that is going to be a problem because ultimately breast cancer is a metabolic disease. Right. But if you don't have such a good genetic profile, this whole, this whole spectrum of inflammation, this whole environmental component, it becomes of the utmost importance. And if you are someone that doesn't have such a great genetic makeup, you have to be especially concerned about that environment.

Absolutely. And you know, the, the important message here, Jen, is that this jives with everything that you've been talking about. Right. So you know, your genetic makeup is what it is and no matter what it is, you have to work on the non genetic things to stay healthy. And that's, you know, where you're an expert. The little piece I'm trying to discuss here is that your genetic predisposition is what it is, whether you know it or not. And the worst thing that can happen is if you don't know what your genetic predisposition is, your genetic predisposition is increased and you don't know it. Yeah, that's the worst case, because then you can't do things to get rid of that genetic risk or improve it. And so that's why I think we both agree that knowing what your breast cancer risk is is so important.

Yeah, exactly. And I love that you said, either get rid of your genetic risk or improve it, because when we know better, we do better. And knowledge in this arena especially, is very powerful. And I'll just bring it back to my own personal story. And this applies to anyone with autoimmune disease in that, yes, we never get rid of our predisposition for autoimmune disease, but I have no symptoms at all of my autoimmune disease because I know very well that if I walk the line, I can control that. What you can't do is do everything the way that you did before and not respect that genetic predisposition and not. And not manage that genetic predisposition. Because when you do that, if you ignore it and just wing it or, you know, continue to do things the way that you did them before, you're going to continue to get the outcomes that you got before. You're going to continue to get the symptoms. Symptoms that you got before. You're going to continue to get the diseases and the dysfunction that you got before. So it gives you a lot of power because you have the ability to walk the line.

Yep. Yep.

So I would love to hear about this test because I know that it's based a little bit on a questionnaire that we used to use for breast cancer risk analysis, but that. That questionnaire was pretty cumbersome for a lot of people and not nearly as accurate as what you're doing right now. So can you talk about. Can you talk about that and then. And then take us through what you've. What you've come up with? Because it's really exciting.

Sure. So basically, there's two different types of risk for breast cancer. And this is exactly how we opened this podcast where I said there's the genetic and there's the lifestyle, and most. I shouldn't say most every breast cancer risk assessment model has used one or the other and never both. And so what's exciting about this is that we're using both a lifestyle risk assessment and a genetic risk assessment. So when we're talking genetic risk assessment, and here's where I'll just spend a couple of minutes to explain the background. I already talked about BRCA or brca, which, as I said, is very rare, may be responsible for 5 to 8% of breast cancers. And in women in the general public, you find that maybe 1 in 200, 1 in 400. You know, those are the magnitude of the numbers, which really means very rare. But it gets a lot of the sort of understanding of the general public because these are young women and these are celebrity women. And so we all hear about it, but it's still not that important in terms of general numbers. What is important in terms of general numbers is it's a small fraction, right? That's 5%. I'm talking about the 85% or the 80% or the out of the blue cancers. So there are genetic risks with those out of the blue cancers. And we know that because now that, as I already said, we can now sequence everyone's DNA in its entirety. We call that the whole genome sequencing. So we've looked at the entire DNA of hundreds of thousands of women with breast cancer and the DNA of hundreds of thousands of women without breast cancer. And when you compare those two groups of women, there's 313 genes that are different. That's it. Now, what's interesting, if you want to get into the details, is we don't even know what all of those 313genes do. But what we do know is that women with breast cancer have them, and then women without breast cancer don't. And not only do we know, that's.

Pretty amazing considering how many genes there are, how many choices there are, and that you have figured out that 313 apply to women with breast cancer. Pretty astounding.

Yeah. So the state of the science, as I was about to say, is we don't know what those genes do. In fact, some of those genes are in parts of DNA that science has previously said do nothing. In fact, the part of the DNA in which these genes live has a name called junk DNA. How do you like that?

Well, it shows you just how little we know.

Right, Right. So these differences are in the junk DNA sequence, but they're real. They're there. Right. So luckily, the technology is out there that we can identify these genes in people. We can tell you how much of an increase in breast cancer risk there is for each one of those 313 genes. So each one of those genes has a very low increased risk, maybe 1%, 2%, 3%. But when you add up those low Numbers for those 313 genes, you can have a high risk if you have a high number of those 313 genes that are problematic. So that's that genetic bucket I was telling you about. Yeah, that's the latest and the greatest in that genetic bucket. And then the second piece is the lifestyle piece. And that has to do with age, because breast cancer increases as we get older menopausal status. It's increasing with menopause, how many children. And, you know, I think that some of the other things that are important, and we'll talk about this for just a minute, would be breast density, because we're now realizing that breast density is a risk factor for breast cancer.

So I want to ask you about that.

Yeah, sure.

I talk about that quite a lot. And breast density takes on very different meanings when you're talking about someone who is premenopausal versus someone who is postmenopausal. And I believe that breast density is meaningful, but only in the context of being postmenopausal, because I think it's only in the context of being postmenopausal that it's a reflection of inflammation.

Yeah. And I would agree with you. I think that we're pretty much always aligned on things. And what I would do is, in that context of our agreement, just explain some of these details for the audience, because it's not just about, you know. Well, let's just backtrack to historically, what people thought the problem was with breast density. Historically, people thought the problem with breast density was that mammograms were ineffective, so you couldn't find a cancer until it was later. And so they would say, oh, because you've got dense breasts, you need, you know, mammograms aren't as effective, and that's the reason there's more breast cancer. Well, we know that's not true anymore. In fact, within the last year, it's now understood that breast density is a function of breast function or breast metabolism. And so it's not just about the inflammation, though the inflammation certainly is there, but these cells are more metabolically active and higher turnover. And when cells are active and you have cell turnover, that's when whatever the insult is, that causes the cancer. That's what makes that cell vulnerable is that increased metabolic activity.

Yeah.

Because the metabolites, it's making. So it's, you know, these Subtle nuances which are so much fun to share.

The audience, you know, and it's, it's at the time of reproduction that we make our mistakes. Right. That's when we make our DNA errors and things like BRCA mutations. Those genes identify DNA reproductive errors and correct them. But people who are born with a mutation in those genes, they can't make the corrections. That's why those people get more cancers. And so the idea is that the more breast cancer, the more breast glandular tissue you have, the more turnover you're going to have in that cell population, the more likely you are going to be to make a mistake. The more likely you are going to be to develop a breast cancer.

Exactly. And so we know that breast density is an independent risk factor for breast cancer. You can have up to a four fold increased risk of breast cancer if you've got super dense breasts.

Yeah.

So that's your lifestyle bucket. We've talked about the genetic bucket. And what's exciting about this test called genetype, what's exciting about this for me that made me decide to become the chief medical officer is this is the only company that combines the lifestyle risk with those 313 genes to give you a true personalized risk assessment. And that personalized risk assessment is two to five times more powerful than traditional risk assessment alone. So we can identify two to five times more at risk adults than traditional risk assessment. And as I said a couple of minutes ago, the worst thing that can happen is if you have an increased risk and you don't know it.

Yeah.

Want to know what your risk is so you can do everything that Jen tells you to do to reduce your risk.

So that's really powerful numbers that it's two to five times more powerful and I'm assuming predictive than any other model that we have had previously. So who should be getting this test and when should they be getting it?

So basically all women should be getting this test, I think starting at age 30, for example. Because if you find out you're at high risk at age 30, you may want to start early detection sooner. And there's many different ways.

And you only have to do this test once, right?

Well, you actually only do the test once for the genetic piece.

Okay.

The other piece changes. For example, if we find out that you've got more family members with breast cancer that goes into this algorithm.

Now why does it go into the algorithm? Explain that side of it. Why would that influence your risk?

Because remember, there's two things that increase your risk. There's your Genetics, and then there are these lifestyle factors. So we've talked about, you know, obesity, for example. So if your weight goes from thin to. To obese, and we don't know what your genes are, your breast, your risk for breast cancer goes up. So we want to be able to calculate that in a mathematical model using your genetic predisposition so we know how the number changes. So family history, let's say your breast density changes. So all of these factors that we know impact risk. We then have an algorithm or a way that we calculate risk, and it changes. Now, let's say you've got a smart doctor like Jennifer Simmons, and she'll say, you know what, your genes were actually pretty good. And you have, you know, average risk. And you would get this from a gene type risk. And, you know, your weight went up a little bit, but not too bad. So we don't need to repeat the test because I could tell you that your risk for breast cancer went up just a little bit. So you've got a smart doctor here who can manage it without having the test. But then there are some people, or I mean, some doctors out there who maybe need the patient to have another test when their lifestyle factors change so we can know the mathematical magnitude of the change.

Yeah, so it's interesting because what we had talked about previously is that you're talking about lifestyle factors changing. So if your aunt is diagnosed with breast cancer, that doesn't change your genetics. Right. But you, you, your weight changing, you developing an inflammatory condition, you. There are things about you personally that would, that would. That risk. And so for people in that situation, you are probably going to change the recommendation for screening. Now, the United States Prevention Task Force recommendations just came out. And though I don't believe in screening mammography and don't recommend screening mammography for anyone, that is still what is being recommended. And we just change those numbers from starting screening 50 to starting screening at 40. Now, those recommendations are based on the fact that we are seeing cancers in younger and younger women. I don't think it's because our genetics are changing. I think we are still living on the same gene code that we've lived on for years and years and years. I think that that is multifactorial. I think that first we are discovering things that we did know about before, like these junk genes that maybe are not so junky. Right. And our environment is changing. Yes, we are. We are not living on our grandmother's earth. We're not even living on our mother's earth. And the Earth that we live on today is markedly different. It's markedly more toxic. And our environment, even not even speaking about like the home that we live in or the, the workplace that we work at, our emotional environment, our, our stress environment, these are markedly worse than they were five years ago, 10 years ago, certainly 15 years ago. The stressors are different now. They are ever present in a way that they never were before. We have never been more available as people than, you know, we're more available now than ever, ever before. There are 3,000 ways to get in touch with someone at any, any given moment. And we don't live on our agendas, we live on other people's agendas. And this is having profound effects on our health and on our risk factors. Like if nothing else, imagine the, the amount of EMF exposure that we have now compared to 10 years ago.

Oh, EMF exposure. Right. You're familiar with those studies where they, you know, look at women that store their cell phone in their bra right.

There you can basically point to the cancer. A three year old can figure that out. Right.

And then how scary is it just, you know, the other day finding microplastics in baby food?

Yeah, yeah, it's frightening. And it's a different world.

It's a different, different world.

So you know, there's, that, there's that factor too that there are so many invisible toxins that figure heavily into that lifestyle piece. Because you know, whether you think about it or not, if you're like using a Keurig every morning to make your coffee, you're basically drinking a hot cup of xenoestrogen. Right. I mean, you're just melting that plastic right into your coffee.

So what I would say is that this is so important to, this information that you're just talking about is so important to couple with the gene type results. Because everything that you've said is important for everybody. But if you have a higher risk, it's more important for you. So you know, you need to know if it's worth the effort to make sure there are no estrogen, like chemicals in your makeup or skin care products. You know, these are things that are f, you know, that take time, effort and energy and that have, you know, it's more expensive to buy these, you know, toxin free products. How about eating organic? I could tell you everyone should eat organic. But you know what? It's more expensive, harder to find. Well, guess what? If you're to increase risk, you have to make a better effort or make your best effort.

Yeah.

So this helps you decide how to navigate all of the different landmines that are out there.

Yeah.

In our society and how important it is. Right. And, you know, I could tell you, I mean, I, you know, I'm on the board of directors of the center for Mind Body Medicine, have been teaching meditation for 35 years. And I will tell you that everyone should meditate and learn how to handle stress. And if your genetic risk is higher, you need to do it more than someone who doesn't have that risk.

Yeah. More than most.

Yeah. And that's how we look at the personalizing recommendations, because that's what it's all about. Individualized care, personalized care, finding out what you're at risk for.

Yeah. And so what we have talked about in the past and what I think the true value of the test is for everyone, because these screening recommendations are changing and because they're talking about screening younger and younger. But we have to be very careful with those recommendations, because if you're using mammogram to screen well, that's radiation. And if you have a higher risk for developing breast cancer, that may be because you have detoxification genes that aren't as strong as others. And so you're going to struggle even more with things like radiation. So screening you early and more often may only increase your risk. This is part of why I don't believe in mammogram for screening, because it will impact those people that do not detoxify. Well, it will impact those people that. That struggle with radiation causing DNA damage. I mean, it causes it for everyone, but. But for the people that can't repair it, they really get into trouble. And so I never like to talk about a problem unless there's a solution. And that's why when we spoke, your test was so very appealing to me because it's a way of knowing how often people need to screen. Because if you are someone who is at higher risk for breast cancer, that basically means that you're more vulnerable to your environment. And as we just said, you're never going to be able to avoid all of the toxins. But we know that you're the person that we need to pay more attention to.

You're the.

You're the person that we know. We have to say you, yeah, you're gonna need some tlc. So with this. With this new QT scanning, which I'm opening up these perfection imaging centers which uses this QT scan, we are actually able to see down to the cellular level. And for most women, if we have an. For most women, if you have a normal study, we tell you you don't need another test for 24 months. So it would be, you know, two years, it would be an every other year test. But if you have an increased genetic predisposition and if you have an elevated risk breast cancer risk score, these are the people that can get into trouble in the interval. And these are the people that we want to make sure we're screening them more often with a safe screening modality. That is the key. That is the key.

I'm so excited about that. That's why I'm so excited about being here, getting to know you and learning about that wonderful, wonderful screening tool. Because it's really incredible. I think it's really the ideal.

Yeah. And it's going to be the combination of knowing your genetics and then having safe ways for assessment. So for people who are considering this, you know, everyone likes to know, like, how is it collected and you know, what do I have to do? And that kind of thing. So can you give people a little more information about the test? Test itself?

Yeah. So it's, it's really easy. We have, you know, a way to access this test. You can do it through your physician, if your physician is interested. It's called Genetype.com is the website G E N E type T y P E genetype.com and you can get your doctor to order a kit or you can go through what we call cit consumer initiated testing. And if you want to initiate this test as a consumer, you just hit on the website the button that says order now and it will be taken care of. We have a telemedicine, telehealth physician that goes through the information and automatically orders the test for you. And then we'll go over the test with you at no extra cost to go over the results and tell you.

What you need to do and how long does the testing take and what, what do you need to submit?

So it's a blood test or blood. It's very easy at this point. It's a saliva test or what we call a spit test. But in a matter of weeks it's going to be just a swab from your cheek. So it's either you know, a spit test or a swab. It takes a few weeks and, and then you get your results.

And when you get your results, is there someone to help people understand them? Because oftentimes, you know, we do these tests and we get this information. We don't know what to do with it.

Absolutely. So we go over the results, we Go over the recommendations. Unfortunately, you know, we as a testing company can't order an MRI or a qt, you know, etc, but we can tell you, you know, bring these results to your primary care doctor or, you know, this is something that's, you know, concerning and you may want to see a breast specialist or something like that. So, yeah, people are told what they need to do, their results are explained to them. And the important thing is comparing your results to the average woman. Are you at average risk? Are you lucky and you're less risk, or are you unfortunately at increased risk? And if you're at increased risk, then that's where all these factors that we've been talking about are important to address. And there's even depending on your risk and your personal philosophy, you can give consideration to different medications that are out there that can reduce breast cancer risk.

Yeah. And I also, you know, we always just kind of go to the bad place and assume that you're going to be at increased risk. But there can also be some sense of relief in that you may find out that you're at below average risk of developing a breast cancer.

I think that that's one of the important things I want to speak to when I give talks to other doctors. I call it the big exhale that women are able to do because women carry, or I shouldn't say women, some women carry a real fear concerning their breast cancer risk, whether it's because a friend has had it, possibly succumbed to it, or a relative, and they're carrying this and that's a lot to carry. And so how nice it is, as I said, to be able to say, wow, you know what? Not only you not at increased risk, not only you not at average risk, but you're at actually below average risk.

Yeah.

And you know, that's. That's the big exhale. And you know, you can't stress how much that can change almost every aspect of someone's life.

Yeah.

Because that emotional burden is horrible to carry around. And there are a lot of women doing that. A lot of women are walking around with that emotional burden and that emotion and that fear. I mean, I can tell you that just because of my family history and because literally every woman in my family gets breast cancer with the exception of my mother, who had colon cancer. I even went into my career as a breast cancer doctor not saying if I get breast cancer, saying when I get breast cancer, and was convinced for the entirety of my career up until five years ago that breast cancer was going to be an eventuality for Me. And I think a lot of women feel that way. I think a lot of people are walking around just waiting for the shoe to drop, which is also why there's so much anxiety around going to get your annual screening, Right? Because they're so. They're not afraid of the test, they're afraid of the results.

And that feeds into women not getting mammograms, right?

Yeah, yeah, absolutely. I mean, 40% of the eligible population don't screen. Now, some of them are not screening because they don't believe in getting the yearly radiation, but some of them are not screening purely out of fear and not wanting to know.

And that fear also infiltrates into the conversation or the thought process about menopausal hormone replacement, for sure. And so that's another area where this test can be so valuable, is it can help make that decision or be a factor in that decision making process for women and their doctors.

Because certainly if you're at no increased risk over the general population, there should be no reason to not explore that. And I do want to say that women on hormone replacement get breast cancer. Women not on hormone replacement get breast cancer. And nowhere do we see that better demonstrated than in the last 20 years. Because in 2003, when the women's Health Initiative results were released, the number of women who took hormones fell off precipitously. Like it went down to maybe 80 or 90% overnight, stopped taking their hormone replacement. And then no new prescriptions were written. Doctors stopped prescribing. And what happened with breast cancer incidence? It just went up. Right. So there's so much fear around that people are getting, women are getting breast cancer irrespective and unrelated to hormone replacement. And we do know that there are a lot of long term benefits of hormone replacement in terms of protecting your brain. And that ends up being really important because we have an Alzheimer's epidemic, epidemic that we're heading straight into protecting your bones. As many women die every year as a complication of a fracture, as do of breast cancer. And that's a huge, huge, huge issue. Public health issue, protecting your heart. Women die exponentially more of cardiac disease in every generation beyond the age of 30 as they do of breast cancer. And so protecting all of these things and, and in addition, the mood protection, the protection against adult diapers and you know, maintaining continence and, and, and sexual health, all of these are really important. And if you are avoiding hormone replacement because you think you're at increased risk of breast cancer, and this can solve that issue, it's going to have a huge impact on public health.

Absolutely.

And at the end of the day, that's really what all of this is about. We just want to help people to live healthier lives and live as long as possible and die young.

Beautiful.

So can you just go over again how people learn more about this test.

Website www.genetype G-E-N-E t Y-P-E.com and just press that button which is the tab which is on every page, order test, fill it out and it'll happen.

Amazing. And I'm also going to be ordering, offering this test at my Perfection Imaging Centers. We will also give you the ability to order this test on the Perfection website so that you can have your risk analysis done and so that you know how often you need to be screened for breast cancer. Because if you're at average or below average risk, then you really only need to be screened every other year. And that makes a difference. That makes a huge difference on your emotional burden, on, on the, on your financial burden, on everything. Dr. Evans, it was so nice to see you today.

So nice. Thank you.

Thank you so much for sharing this great information with us and for continuing to make the world a better place because we all need help navigating this landscape and these amazing tools which help us to do, us really do save lives and enhance the quality of the life. So I'm so grateful for this and for us connecting and for, and for the work that you're doing and I'm.

Blessing your work and progress and success as well. So until we meet again.

Until we meet again. If you like this podcast, please like it, share it, share it with someone that needs to hear it. I can't imagine that you don't have a friend or a relative or someone in your community or who wouldn't benefit from knowing about this. And I will be back here next week, same time, same place. It's Dr. Jen. Bye for now.

Bye now.

Thank you for joining me on this episode of the Keeping abreast podcast with Dr. Jen. I hope you found the discussion informative. Remember, rest, health is health. So by staying informed and taking proactive steps, you have the power to optimize your well being. My team and I encourage you to apply the knowledge gained from today's episode to make positive changes in your life and share what you've learned with others. If you enjoyed this episode, please subscribe to our podcast and leave us a review. Your feedback and support mean the world to us and help us to reach more people who can benefit from these conversations. Stay connected with me on social media where I share additional resources, advice, updates and announcements related to breast health. You can find me on Facebook, Instagram and YouTube. Dr. Jenn Simmons and remember, my Jen has two N's. So until next time, remember to stay proactive, informed and confident in your breast health journey. The key to your health is you.