Breast Cancer Is on the Rise, Mammograms Are Failing Us, But I’m Sharing the Breakthroughs in Prevention and Detection You Need to Know

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Hello and welcome. I'm Dr. Jen Simmons, a breast cancer surgeon turned integrative oncologist on a groundbreaking mission to transform the conversation around breast health. If you're seeking to redefine the way that you think about breast health, you're in the right place. Breast health isn't just an aspect of well being. It is health, integral and indispensable. Here on the Keeping Abreast podcast, we delve deep into the innovative ways to diagnose, treat, screen for, and prevent breast cancer. But it's more than that. It's about having the crucial conversations that empower, enlighten, and drive us all to a healthier place. As someone who has navigated the front lines of breast cancer treatment and now champions an integrative approach, I bring a unique perspective to these discussions, blending rigorous science with holistic health principles. Health is a journey, not a destination, and I am truly honored to accompany you on this path. Each episode aims to provide you with actionable insights and cutting edge strategies to take charge of your breast health and.

Your overall well being.

So whether you're here to learn about the latest in medical advancements or seeking tips on lifestyle changes that foster real health, then the Keeping Abreast podcast is.

Your go to resource.

Let's embark on this journey together, because when we talk health, every conversation matters. And now, stay tuned for this week's episode.

Have you noticed that breast cancer seems like an epidemic? Are you confused about breast cancer screening? Are you wondering what the latest and greatest ways to screen for breast cancer are? Well, if so, stay tuned for the answers to these questions and more on this week's episode of the Keeping a breast podcast with Dr. Jen. So let's get right into it, because absolutely, breast cancer seems like an epidemic. I mean, you literally can't go anywhere, can't look around you without knowing someone that has breast cancer. So, yes, the statistic is 1 in 8 in your lifetime, but that is who is actually getting a breast cancer diagnosis. As far as the people who are affected by breast cancer, if one in eight people are getting a diagnosis, then the likelihood is that you are either the person getting diagnosed or you have a friend, a sister, a mother, a cousin, a neighbor. It is literally everywhere, all around us. Now the question is why? Why is breast cancer so. So abundant? And the answer is that the breast, like the thyroid, this gland is the canary in the coal mine. This is a very, very environmentally sensitive gland. And the truth is that we are living in a very toxic environment. We are not living on our grandmother's Earth. We're not even living on our mother's Earth. So I want to explain just happening on a cellular level so that people understand why the breast is so vulnerable to all of these environmental insults. And when I say the environment, I'm talking about the macro environment, certainly, like, you know, the air that you breathe and what's around you. But I'm also talking about the micro environment, because what we take in from the world in terms of emotions and relationships and things like that, they matter as well, because they're having that effect on our chemist, they're having an equal effect on our chemistry. So we have to be mindful about creating our environment to serve us. So the breast itself is made up of four tissues. So it's made up of glandular tissue, this is the milk producing tissue, and then it's made up of fat cells, it's made up of connective tissue. That's what holds everything together. And that's all inside of a skin envelope. So even if you have this dense breasts, and that's definitely something that we're going to talk about today in this podcast, but even if you have dense breasts, there are still a considerable amount of fat cells in the breast. So fat cells are where we store our toxins. And any organ that's going to be abundant in fat cells is also going to be a place where toxins are housed, because our bodies are very smart, and we don't want those toxins that are circulating in our body. We don't want them to affect us. So we try to kind of store them away or hide them away in order to prevent damage. So what happens is the fat cells in our breast which are storing the toxins, they are sitting right next to you. They are the neighbor of our breast cells. And if you are next door to something toxic, it's eventually going to spill over onto you and cause damage. So we are literally getting directly damaged because of the toxins that have a proclivity to be stored in our breast, a tendency to be stored in our breast. If that alone were the problem, it probably wouldn't result in so much breast cancer. But breast cancer has two elements to it. So it's definitely the cellular damage, that transformation that's happening, that puts these cells into survival mode because the environment is toxic. And so these cells just get transformed into these survival cells. These are breast cancer cells. These are the cells that are just saying, reproduce, reproduce, reproduce, because all I want to do is survive. Now, that alone is a problem. But they wouldn't reach critical mass unless the immune system was also compromised. And in this day and age, so many of us are unknowingly walking around immunocompromised. And that is for a whole host of reasons. That is because we are stressed to the max. That is because we are busier than ever. That is because we are more on than ever, more available than ever. There's so little downtime, there's so little rest, there's so little time and opportunity for repair. And so of us just don't have the bandwidth to prioritize self care. So we're busy, we are constantly stressed, we're in survival mode. And when you're in survival mode, think about it, your body, when it's in survival mode, we really only know two states. We know rest and repair and we know fight and flight. And if you are in that fight and flight state, we are modern beings living on a very old gene code. We only understand the most basic of things at a cellular level. So at a cellular level we think a saber toothed tiger is chasing us. And if a safe saber toothed tiger is chasing you, you do not need your immune system turned on because you don't need to fight off the common cold if you're going to die in 15 seconds because it's tiger is on your tulchis. So we, so many of us are spending so much time in this sympathetic state, in this fight or flight state and we have our immune systems turned off as a result. So if you make cancer cells, and we all make cancer cells, from the very young to the very old and everyone in between, and if you make cancer cells and, and your immune system is working, it's going to recognize those cancer cells in their infancy and not allow it to form a mass. However, if you are like most of us who we are running on empty and we just simply our immune systems are not working efficiently and effectively, then that is the opportunity for cancer to develop. And that's why it seems like something such an epidemic. Because so many of us are over, toxic, overworked, overstimulated, over, over, over everything. And our bodies are just not working the way that they're supposed to. And this is why cancer seems like an epidemic. And it essentially is because there is just too much, too much of everything. And we all need to do our best to dial it back in as much as we can to get less toxins in our body, certainly to live less toxic lives, certainly, and to do everything that we can to enhance and help our immune system to function. Now, because cancer Is so abundant, and especially breast cancer is so abundant. People I know you want to know about screening. And this is something that I talk about all the time. And it seems like the more times I talk about it, the more questions there are. So let's get right into it. For the last 50 years, the cornerstone of screening for breast cancer has been the mammographic screening program. I want to talk to you about what the mammographic screening program was, what it is today, and what I envision it to be for the future. So the mammographic screening program, when it started out in the 1970s, it started out with the very best intentions. And it was built on an understanding that breast cancer growth is both linear and predictable. So what that means is a breast cancer starts small, grows to some critical size, at which point it is more likely to metastasize. And the belief was that if you could find it before that point, you could prevent metastasis, save lives, give less treatment, and save breasts. It's a lovely theory. It just doesn't happen to be true. And we have known for decades that it's not true. So let's talk about why. Breast cancer is what it is from the very beginning. And if it's going to be an aggressive process, it already has the potential to metastasize from the very start. There are also cancers in the breast, incidentally, that do not have the potential to metastasize. And those cancers rarely, if ever, require treatment. And then there's everything in between. No matter how many mammograms we do every year, the same exact number of women die of breast cancer, the same exact number mammograms are not impacting the bottom line. No matter how many mammograms we do every year, the same exact number of women present with aggressive disease, present with advanced disease. We are not impacting the bottom line with mammogram. But let's talk about what we are doing when we look at these very, very large scale studies. I'm going to talk about the Canadian breast cancer screen screening study first. So this is a study of 90,000 women. 45,000 of them had mammograms for screening. 45,000 of them had a yearly self breast exam and a yearly professional breast exam with their provider. Everyone has the same access to medical care. Everyone has the same access to, to the kind and the degree of medical care. So everything else is equal. We are just talking about women from ages 40 to 59. And one group gets screened with mammogram, one group doesn't there is absolutely no survival advantage between them. So the same number of women die of breast cancer in both groups. Here's the difference. In the group that screens, there's 20 to 30% more breast cancers. We are finding cancers with mammogram. I'm going to venture out there to say when you radiate a woman every year, you're also going to cause some breast cancers. But in any event, when you screen with mammogram, you find 20 to 30% more more breast cancers. Now, if the same number of women die of breast cancer in each group, that 20 to 30% didn't need to be identified, didn't need to be treated. And if treatment for breast cancer were benign, it would be a different story. But treatment for breast cancer is anything but benign. It's anything but benign. When we treat a woman for breast cancer, we essentially, if she wasn't already menopausal, we often render her menopausal. And the problem with that is that menopause comes with a total deterioration of health, starting from head to toe. Because estrogen is the molecule of life, because it is the hormone of life. We have estrogen receptors everywhere. So when we lose that estrogen, which is what happens along with treatment most of the time, because if you have a triple negative breast cancer, you're almost certainly going to be given chemotherapy, and chemotherapy will put you in menopause. And if you have a hormone positive breast cancer, oftentimes the treatment is to give you hormone blockade or remove your ovaries, or do something to manipulate the estrogen receptor. And when you block the estrogen receptor, you have brain fog, you have dementia, you have anxiety, you have difficulty sleeping, moving down. We talk about the effects on the heart. It accelerates cardiovascular disease. It can actually some of the treatments cause cardiomyopathy. So they affect the, the muscle of the heart and lead to palpitations, to cardiovascular disease. These are very, very serious ramifications. And then there are a whole host of other things that come along with hormone blockade which really negatively affect the health, the duration, the quality of your life. And there are multiple medications that are prescribed as a result of all of these changes that come along with hormone blockade, like anti anxiety medications, like sleep medications. People's cholesterol goes up and so they get put on statins, they have palpitations, and so they get put on beta blockade, they lose their bone density and so they get put on bisphosphonates, they have joint pain and joint aches, and so they get put on Non steroidal anti inflammatories, they lose their libido, they lose their continence, and they have gut problems, they have digestive problems, they have reflux, they get put on acid blockers, and on and on and on it goes. And treatment for breast cancer really affects the quality and duration of your life. Now, I am not saying we shouldn't treat breast cancer. I am saying that we need to do a far better job at identifying who does and who does not need to be treated. And up until now, that was a difficult question. Especially when you use mammography as the tool to identify. Because when you use mammography as the tool to identify, all you do is pick up all of these screen cancers and then you obligate people to treatment because they are so afraid, because they don't understand that many of these cancers are meaningless. Many of these cancers do not need to be treated. Now, I said in the beginning that the mammographic screening program was designed with the intention of saving lives and saving breasts. So that means that if you would find these things small and in their infancy, people would not undergo mastectomy. And if that's what it was, if it didn't save lives, but at least it saved breasts, that would be something, that would be worth something. But that also turns out to not be true. Because when you tell a woman that she has breast cancer, even if you tell a woman that she has dcis, ductal carcinoma in situ, which is a non invasive condition, meaning that no one dies of that form of the disease, no one that is 100% survivable. And yet these women, and there are 40,000 women a year in the US diagnosed with DCIS, and many of these women are opting to undergo mastectomy. And women who are diagnosed with invasive cancer that could easily be treated with breast conserving surgery are not only choosing to undergo mastectomy out of fear, but they're also opting to have the normal breast removed out of fear. So as a, as a medical community, we are not even serving these women in this instance because we are not reassuring them that there's no survival advantage to mastectomy. You don't get any bonus from getting mastectomy. And I'll tell you, having been a surgeon for 17 years, you can never prepare a woman for mastectomy. You just can't. Those scars run so much deeper than even what you see. And I'll tell you that in my experience, if you perform a mastectomy on a woman for breast cancer, There will never come a day for the rest of her life that she doesn't remember that she had breast cancer. Cancer. But if a woman is treated with breast conserving surgery and the surgeon does a good job and she is thoughtfully treated beyond that, so making sure that you are not being over treated and do not get treatment for what you don't need, there will come a day in that woman's life where that breast cancer will no longer define her. And I think that if we continue to travel down this path and use mammogram as our guide and continue to not give women the information that they need and rightly deserve in order to make decisions, we're just going to continue down this path. And as I said before, over diagnosis leads to over treatment. And this is a huge problem because you are going to affect the quality and quantity of a woman's life afterwards. And it is often not a life worth living. It's actually the topic for my next book, which is called the Forgotten Woman. And it's that woman who, who has had breast cancer and told that she should be grateful that she's alive. And it's super hard to be grateful when you have brain fog, when you can't sleep, when you're anxious, when you're depressed, when your relationship is suffering because you have no libido and sex is painful and undesirable, and you've gained weight and you're having palpitations, you have no energy, you, your bones hurt, your joints hurt, you're having incontinence. All of these things are what come along with treatment. And it's super hard to feel grateful to be alive when you don't feel alive. We need to do a much, much better job. Now listen, if you have an aggressive cancer, we have to go at that with everything we have. I am not suggesting in any way that we throw the baby out with the bathwater. But we need to do a better job of biologically understanding these cancers and treating the people with aggressive disease and the people without aggressive disease, we need to leave them alone. We need to do the least. We need to make sure that we are preserving quality and quantity of life. And if we take every single person that has breast cancer and treat them the same, which is what's happening now, and we compromise their cardiovascular health. Women who are treated for breast cancer are two to three times more likely to die of cardiovascular disease than women who are not. This is a huge problem. We cannot take a problem which is already exponentially more of an issue in every decade of a woman's life past the age of 30, she is exponentially more likely to die of cardiovascular disease than breast cancer. We cannot compromise heart health when we don't absolutely have to. We need to do a better job of looking at the biology of this disease. One size fits all has to be over. Now getting back to the mammogram issue, because I spoke about the Canadian breast cancer study, I also want to mention the study, the Nordic study of the and this is all detailed in the Cochrane report on mammographic screening. But we're Talking about now 600,000 women. 600,000 women, and they are divided again into the two groups. One group that screens with mammogram and one group that does not screen. Again, equal access to care, equal access to the quality of care and the same exact findings. If you the the same number of women in each group die of breast cancer and the only difference between them is that in the group that screens with mammogram, you have 20 to 30% more women diagnosed with breast cancer. We are over diagnosing and as a result over treating when we use mammogram, which is a very unsophisticated technology and we are actually exposing normal healthy women to radiation to the tissues of the breast. Now I've heard this argument time and time again. How can you say that radiation to the breast red by mammogram is any more dangerous than a flight cross country? If you look at the absolute number of radiation that is given when you compare a mammogram to and it's a 2D mammogram, not a 3D mammogram because a 3D mammogram is more. When you compare a 2D mammogram to a cross country flight, yes, that is probably the same amount of radiation. However, the delivery method is vastly different. And I encourage anyone who wants to learn more of this to watch Boobs, the documentary. It was fantastic. I actually interviewed Megan Smith who was the producer of this documentary. Don't google boobs. You won't get the same thing. You have to google Boobs, the documentary. But there is a vast difference between the scattered radiation that you get on an airplane and the focused coned down radiation that you get to the compressed breast during mammogram. Now I said comparing a 2D mammogram to an airplane flight is probably the same amount of radiation. But when you are having a 3D mammogram, which is what most women, women are getting these days, it's an entirely different delivery System. It is not a one size fits all delivery system in that the bigger your breast is or the more dense your breast is, the more radiation is going to be delivered in order to penetrate. So there are some women, some, some dense breasted women that are going to have up to 10 times the amount of radiation during their mammogram as compared to someone else who does not have a dense breast. And I am going to come back and talk about dense breasts, what they are, what they mean and what they don't mean, because that's another important topic. So, so I hope that in the course of this conversation you understand that mammogram is not saving lives, not saving breasts. And as far as I'm concerned, we are doing people a great disservice by exposing healthy women because that's who's in the screening population. I'm talking about women who are healthy who are asymptomatic and exposing them to unnecessary radiation. I think it's unethical. We should not be doing it. And we can talk about what to do in the high risk population because I think that that's a very important conversation. We could talk about what to be doing in the dense breast population because that can be an independent risk factor for breast cancer. But in the normal healthy population, we should not be using mammogram for screening. It's unethical. It does not save lives and it does not save breasts. It is not accomplishing what it set out to accomplish. I don't care what the commercials say, I don't care what the sluice say. All that is happening when you go have a screening mammogram is you are entering into a very broken system designed to benefit the system and in no way is it designed to benefit you. So that being said, what do I recommend for screening? Well, let's first talk about the other screening modalities because people ask me about this all the time. Is ultrasound a good screening modality? So with ultrasound, with handheld ultrasound, this is. And there are also some automated delivery systems for ultrasound. Ultrasound, which is reflective ultrasound, is still a very low resolution imaging modality. And so there are still going to be lots of false positives. These are going to lead to unnecessary biopsies. And in my opinion, this is not a worthwhile endeavor. MRI is something that has been explored and is actually the gold standard or the standard of care for women of high risk. And that's anyone who has had breast cancer in the past or you have extremely dense breasts, or you have a strong family history of breast cancer or you have breast implants. All of these people are.

Getting a.

Recommendation for or getting an allowance to use MRI for screening. But MRI relies on gadolinium. Gadolinium is a heavy metal. So we can take out all the other factors. We can take out the factor that it is expensive. Right? Because most people are getting that covered by insurance or they're opting to not do it. MRI is also difficult with access because there aren't enough MRI centers to actually screen everyone who needs to be screened with that modality. But my biggest objection to mri, they're also uncomfortable. But whatever. Like women deal with anything if it's for the good. God knows we've put up with mammogram for the last 50 years, so you know, we will deal with anything if it's for the good. But MRI uses gadolinium. Gadolinium is a heavy metal. This is toxic. This is stored in our organs and causes end organ damage. Or we can not screen healthy people, even people with a history. We should not be screening people, people who we know to not have the disease. We should not be screening people with a test that requires gadolinium, a heavy metal. Again, it's unethical. Now up until a year ago, I didn't really have a screening test that I believed in. But so up until a year ago, my recommendation for screening would have included self breast examination. And I think this is extremely important. I think that no one is ever going to know you better than you know yourself, ever. And so everyone should be doing self breast examination every month. If you are someone who is premenopausal, then you should be doing your breast examination one week after your cycle starts. That's the time of the month where your breasts are the least stimulated. If you are postmenopausal, then you want to be doing your examination the first of the month. And when you do your examination, you are going to be looking for changes in the appearance of the breast, changes in the texture of the breast. I want you to make sure that you're looking at the breast. You're looking for dimpling in the skin, you're looking for redness, you're looking for swelling, you're looking for a change in the appearance of the breast. And then you're feeling your breast and making sure that you do not feel anything that feels different to you. And in order for you to know when something's different or changed, you need to know what you feel like at your baseline. So it's very important to Know your normal so that you can know when something has changed. So I think that self breast examination is very, very important. In addition, I now recommend if you are somewhere near a QT center to have a QT scan. And I'm going to talk all about what a QT scan is and who it is for, but that is what I am recommending for screening. However, in addition, there is a new test. It's called the ARIA test A U R I A and I will put a link to how you get the ARIA test and a code in the show notes. The ARIA test measures the S100 proteins in your tears and with early breast cancer you will secrete an increased number of S100 proteins. This is a very inexpensive test. It should and can be done every year and it stratifies you into low, medium or high risk for breast cancer. And if you are low, I recommend that you do some kind of imaging every one to two years. Not mammogram, I mean either an ultrasound or a QT scan. If you have a medium or high score. Well, if you have a medium score, you should be imaged somewhere within six to 12 months and then continue to monitor. If you have a high score, then this is associated with a breast cancer 50% of the time and you should do what you need to do to find it. So generally I'm using QT to find it. But if you don't have a QT center near you, definitely you should be having a breast exam with your medical doctor and then some imaging modality which is reliable. If you have a mass in your breast, you are no longer in the screening population. So I want to be clear. While I am very against screening with mammogram and very against screening with mri, I am not throwing the baby out with the bathwater. These can be used as diagnostic tools. The mammogram, the ultrasound, the mri, these can certainly be used as diagnostic tools. I just don't think we put the healthy population in harm's way. But if you have an ARIA test which indicates that you have an increased risk of breast cancer, if you feel something in your breast, if you notice some change in your breast, you are no longer in that screening population. You, you are in the diagnostic population. So that is the major difference between screening and diagnostic. The screening population is someone who is completely asymptomatic, who is healthy, who is just going to make sure that everything is okay. That's what a screening study is. A diagnostic study is someone who is looking for disease. You are looking for disease. And you have a reason to believe that disease is there. So in terms of symptoms in the breast, you either feel a mass, you notice some skin retraction, you notice nipple inversion, you have nipple discharge, there is a change in the shape, the texture, the appearance of the breast, you have some symptom in the breast that's driving that, or you are in the diagnostic population if you have a history of breast cancer. You're also in the diagnostic population if you have breast implants, because breast implants need to be evaluated for integrity. And also when you have breast implants, you essentially compress any breast tissue that's around them. And so that that breast tissue, if it wasn't before, it's very dense now because it's completely compressed. So in that population that's also a diagnostic population, now people ask me all the time about QT and whether or not that is good for the diagnostic population. So let's first talk about what QT is. QT is both reflective and transmissive ultrasound. So essentially what it is it's three circumferential, so 360 degree sound waves, they are transmitted through a water bath. So essentially a woman's breast is submerged in a water bath and there are 360 degree ultrasound waves that are, that are transmitted through the water bath and through the breast. This creates a three dimensional true reconstruction of the breast that has 40 times the resolution of MRI. There have been head to head studies and they can all be found on QTimaging.com there have been head to head studies of QT with mammogram, QT with mri. And QT is always the better test, it is more sensitive, it is more specific. But the main goal of QT and its most amazing property is that it is volumetric measuring, meaning that we can actually measure the volume of the tissue. So if something is found, we can have someone return for a short interval study and measure the volume. We know that cancer and we measure a doubling time. So cancer has a doubling time of less than 100 days. And things that are either not cancer or not meaningful have a greater doubling time. So if we see a lesion in the breast on QT and we bring you back for a short interval study, 60 days, 90 days, we measure the doubling time. If the doubling time is less than 100 days, that's something that needs attention, that's something that should go be evaluated. You're traditionally going to have conventional evaluations at that time. You're going to have mammogram, you're going to have ultrasound in order to identify this area and then undergo biopsy. Because this is what we know as an active lesion. We know that the biology of this is such that it's growing. If you have a lesion that has a doubling time of 200 days, 300 days, we know that this is not an active process. This is not something that needs intervention. And we continue to watch it and we follow that person every year. Every year. Now I do this in conjunction with the ARIA test because I want to know where in the risk stratification does this person fall? And this is what I believe is the technology of the future. I believe that QT is going to forever change how we screen for breast cancer. And it's because of that functional component. It's because we are able to determine if things are active, if things are not active. Now, many people who are coming to perfection imaging and getting their scan and we're finding things, we're seeing them at baseline. And it is very difficult to say at baseline what's meaningful and what's not. So if you have a known something in your breast, certainly we can compare it to previous studies and say, well, it's stable from those previous studies. But in general, what we're recommending is that you come and have a follow up so that we know if that's an active thing or not an active thing and then we can follow it going forward. So I hope that people have more of an understanding now about QT imaging, about what it is. It is amazing technology. And the most important part part is its functional capability. It has the ability to determine if the volume of a lesion is increasing and if the volume is increasing. That is something that we recommend further studies for and intervention. Now, if you are going to have a mammogram, if you're going to have a CAT scan, a bone scan, a PET scan, a HIDA scan, any nuclear medicine scan, if you're going to have any of those things, I do recommend that you use the radiation protection protocol. And we will put the link to my radiation protection protocol in. It essentially combines high dose oral vitamin C. You can't really get high dose, but 2,000 to 4,000 milligrams of liposomal vitamin C and 100, 200, 300 milligrams of melatonin one hour before the study and then for three days afterwards. And that is because when you get radiation, you create free radicals. And we want to give those free radicals a lot of things to bind to so that they don't do tissue Damage. And that's why it's so important to have them in your, your body before you're imaging and not so, not equally as helpful after. So again, you're going to have any, any radiologic study and this is again, X ray, mammogram, dental X rays count, PET scan, CAT scan, HIDA scan, bone scan, any of these nuclear medicine scans, any of these things that involve ionizing radiation. I hope I said CAT scan. I think I did. Then you're going to want to do a radiation protection protocol before that. Okay, so now I'm just going to run down a list of questions which people have sent to me and hopefully you will get your questions in answered. So people are asking if they've had a mastectomy before, do they need imaging? So my answer is absolutely, positively, you do not need imaging if you've had mastectomy. And I'll tell you why. Having been a surgeon for 20 some years and in practice myself for 17 years, I can't even count how many mastectomies that I did. I don't know. Thousands and thousands and thousands and thousands and thousands. I don't know. When you take the breast off, there are margins. There's an anterior margin, and that is what's just under the skin. And there's a posterior margin, and that is the muscle of the chest wall. Now, when I trained, I was taught that when you take that posterior margin, you should also take the fascia, which is the investing tissue that kind of covers the muscle. And when you do that, and I think a lot of people do that, I wouldn't say everyone does that. And I, as I got later on in my career, I stopped doing that as much. But most of the time when you take the breasts off of the chest wall, you can see there is literally no breast tissue, no fat left. You are just looking at pure, pure muscle. That is not true of the skin side of things. The skin side of things. It's nearly impossible to remove every single breast cell. You just can't do it. It's so interdigitated, I think that's a word with the subcutaneous fat, the fat that's sitting underneath the skin. And so it's nearly impossible to remove every single breast cell. What that means is that if you have breast cells remaining, you do have the possibility that you could develop another cancer on that side. However, if you develop another cancer on that side, it's going to be fairly obvious you're going to be able to feel it when you examine your skin. So if you've had a mastectomy, do I recommend that you run your hand over your chest wall every single month? 100%. You should be feeling, you should be looking, you should be keeping track of what it looks like and what it feels like. Do you need imaging? Absolutely not. Absolutely not. In the wild, outside chance that you develop a recurrence behind your reconstruction or behind your implant, or if you didn't do a reconstruction but you just have your chest wall there, you're going to be able to feel it. Now, if it's behind a reconstruction or behind an implant, you may not be able to feel it with your fingers. However, the muscle is right there. So you're going to have some kind of symptom. I cannot recall in my career that having happened. In my experience, recurrences tend to not be subtle. So when they happen, we find them. And it does not happen because we're imaging people. And it does not happen on imaging. It happens on physical examination and being in tune with yourself and noticing any change changes, noticing any new symptoms. So if you've had a mastectomy and you have a new symptom, or if you've been treated for breast cancer and you have a new symptom that is around for two weeks that you cannot explain, this is something that needs investigation. And if it's radiographic investigation, make sure you're taking the radiation protection protocol. The only exception to that is if you are getting an MRI with gadolinium. The radiation protection protocol is not what you need. You need zinc, because high levels of zinc will prevent you from absorbing that gadolinium, and hopefully you will just pee it all out. You should not be on high levels of zinc for a prolonged period of time because it will cause electrolyte abnormalities, it will bind up minerals and in an uneven exchange. So when you take zinc, it should be, for a limited period of time, an elevated level of zinc. I generally use 60mg, but you don't want to do that for more than a few days at a time. If you are supplementing zinc because you're not getting it in your diet, you need them at around 11 milligrams of zinc every day, not 60. Okay. So I hope that helps people to understand. If you've had a mastectomy, what you should be doing for screening. It's not imaging. You should just be paying attention to symptoms. I am going to actually talk about who the QT scan was designed for, because originally what it was meant to do is replace the MRI Because MRI is not an appropriate screening tool for women at high risk or women with dense breasts. The NIH asked Dr. John Klock to come up with a suitable solution. And that's how QT came to be. That's how it was invented. If you want to hear my episode with Dr. Clock, I forget which episode it was, but just look in the keeping abreast episodes and look for the one with Dr. John Clock. It was maybe 10 or 11 or 12 or 13 or somewhere around there. In any event, when he invented this, he invented it for the women with dense breasts because they are such a diagnostic challenge. And at the same time, the women who fall into that category are women who have been treated before for breast cancer, because radiation really changes the breast tissue. So if you've had breast conserving surgery and you've had radiation, it changes the way that the breast tissue appears. And so this is another appropriate person to be using QT for screening. Also, as I mentioned before, breast implants, because breast implants also compress down the breast tissue. And so that would make the breast tissue more difficult to see through, for lack of a better word. And so that makes QT really appropriate to switch screen those women. If you are screening solely for the purpose that you want to check the integrity of your breast implant, then QT is absolutely, positively appropriate because it can see the implant, and we are able to look around the implant circumferentially and create this three 3D reconstruction. So it's absolutely a great tool to look for implant integrity. And I hope that everyone now understands what the difference is between diagnostic and screening. But when we look at the screening population, again, a screening exam is done on someone who has no history of breast cancer and has no current symptoms in their breast. They don't feel a mass, they don't notice a change in the appearance of their breasts, they don't have nipple discharge. They are having no problems with their breasts, they have no history of problems with their breasts, and they are purely just going for a screening examination. This is different than a diagnostic examination. A diagnostic examination is for someone who, who knows that they have some abnormality in their breast and they are trying to determine what that abnormality is. Now, I've been asked, is QT appropriate for a diagnostic exam? Yes, it is appropriate for a diagnostic exam. Will it be able to tell you definitively what that is? Probably not. But what we can do is estimate whether or not this is something that is suspicious or something that can be safely followed. And then again, the value of this imaging is that it can measure volumes. So if you have a finding on your diagnostic exam, we can bring you back in a short interval and reimage your breast and determine if that volume has changed. If you have a doubling time of less than 100 days, that is something that needs intervention. And then you would go on and get those traditional studies. If you have a volume, a doubling time of greater than 100 days, we know that this is something that can be safely followed. This is either not cancer or, or not active. And in the end, what we are meaning to accomplish, what is most important for us is to save people from over imaging, over biopsy, over diagnosis, and over treatment. Will QT miss some things? I mean, it will miss less than anything else. It is as sensitive, if not more sensitive than mri, but it's also more specific. We are not out to biopsy people just to know what that thing is. We are trying to not subject women to that experience because once a woman has an abnormal study, once a woman has a biopsy, it's so hard to unring that bell. And what we don't want is people running around thinking that they have abnormalities in their breast. What we don't want is women running around thinking that they are at high risk when they're not. It is very important to help people to preserve their sanity around breast imaging. And we want to change what this experience is. It does not have to be traumatic, it does not have to be uncomfortable, it does not have to be painful, and it does not have to be alarming. We are trying to take the alarm out of it and doing it in a way that is thoughtful and prompt enough so that people aren't having to go back every six months, year after year after year after year, so that people can get off of that hamster wheel of breast imaging. I want to talk about dense breasts and what it means and what it doesn't. So for women who are told that they have dense breast breasts, I think we need to be a lot more specific about that. It is absolutely normal to be of childbearing age and have dense breasts, because if you are of childbearing age, you are supposed to be prepared to feed a child. When we talk about dense breasts, we talk about the amount of glandular tissue that you have in the the breast as compared to the amount of fat tissue that you have in your breast. And as you get older and as you get further away from childbearing age, our breasts become less dense. That breast tissue undergoes atrophy. So dense breasts is only a Meaningful term. If you are no longer of childbearing age or if your breasts go from something that's less dense to something that's more dense. And what's happening there is, that is indicative of inflammation. If you are postmenopausal and you have dense breasts, absolutely positively, this is a risk factor for the development of cancer. And that is because if you are postmenopausal and you have dense breasts, now this is true sometimes of just thin women, but otherwise, or small breasted women, I should say, but otherwise it is an indication that there is inflammation in the tissue, something is overly stimulating the tissue. And in that instance, I would say think long and hard about the things that stimulate the breast tissue. Because it's not your inherent estrogen that's causing that. It is all the exogenous estrogens, it's all the inflammation in our environment. Now the exogenous estrogens, those estrogens that are coming from the outside, those xenoestrogens, they are coming in the form of plastics, herbicides, fungicides, pesticides. They are phthalates, they are fragrance, they are the things that are fire retardants, nonstick pans, all the things that we think about, and microplastics, antibiotics. I hope I said that already. All these things that we think about that are circulating in our environment, that we don't necessarily associate with estrogen, but they have estrogen like qualities in the body because they can sit on and attach to the estrogen receptor, but not the way that estrogen does. So when estrogen sits on the estrogen receptor because it's a perfect fit, when it's done doing its job, it dissociates and gets detoxified by your body. But these things that sit on the estrogen receptor that are not estrogen, they kind of have a different shape. So though they go and sit on that receptor, they get locked in, they overstimulate the tissue, they do things that they're not supposed to do. And then our body, if we have more and more of these, we struggle to get rid of them, to detoxify them. So if you are postmenopausal and you have dense breasts, this is an inflammatory state, this is a state that's at increased risk of, of breast cancer. And this is exactly the person that should be looking around their environment, seeing where the xenoestrogens are working on your detoxification practices. And there, there are so many detoxification practices that are easy to do, simple to do, easy to access, inexpensive, and all of these things make a huge difference in long run. So what I'm talking about in terms of if you have increased inflammation and you are in this postmenopausal range, then I'm talking about thinking about what you're eating and are you eating food or are you eating a lot of processed food like substances? Getting proper movement every day. Prioritizing sleep. This is so important because sleep is where the healing happens. So you want to make sure that you're prioritizing sleep, detoxifying your environment, avoiding as many environmental toxins as you can, making sure that you have detoxification practices, and then having safe methods of managing stress. So not alcohol, not pills, but having tools in in your toolbox to help you to manage the stressors of life. And these things are very important in order to reduce your risk of subsequently getting a breast cancer. So I have so many more questions that I need to go through, but we're going to have to save it for next time. So if you liked this episode, please share it with someone who you think would benefit from hearing it. If you are interested in the ARIA test to determine your breast cancer risk, it's ARIA Care Auria Care. And if you use the code D R J E N N 20 Dr. Jen 20, you will get 20% off of your ARIA test and I will be back next week, same time, same place. We'll do part two. It's Dr. Jen. Bye for now.

Thank you for tuning in to the Keeping Abreast podcast with me, Dr. Jen Simmons. I hope today's episode has inspired you and equipped you with valuable insights to take control of your breast health and overall well being. If you found our conversation enlightening, please please consider liking and sharing this podcast. Every like share and comment helps us to reach more listeners just like you who are on a journey to better health. Let's spread the word and make a collective impact. If you or anyone you know is dealing with a breast cancer diagnosis, I highly recommend picking up a copy of my best selling book, the Smart Woman's.

Guide to Breast Cancer.

It's designed to guide you through understanding the root causes of breast cancer and provides you the tools you need to to navigate the complexities of a breast cancer diagnosis, the complexities of treatment, and all the while providing you the tools you need to reclaim your health. If you or someone you know is navigating a breast cancer diagnosis and seeking integrative, personalized care, Visit us@realhealthmd.com We're here.

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Stay tuned for our next episode. And until then, remember, breast health is healthy. It.