Hi everyone, it's Katiekuric. If you're looking for smart, comfortable shoes made for the way we really live, you've got to check out easyspirit dot com. They've got everything you need for fall in extended widths and sizes. Enter the comfort Zone and shop sneakers, loafers, comfort heels, and more at easyspirit dot com. Today, listeners get twenty percent off with the code next twenty. Hi everyone, I'm Katikuric and this is Next Question. Welcome everyone to this live taping of Next Question with me Katiekuric. I am very excited to be having this important conversation produced in partnership with Easy Spirit here at the Pailey Center for Media in New York City in honor Breast Cancer Awareness Month. And in our audience are lots of breast cancer survivors, people who may be in treatment right now, and people who are trying to raise money and awareness for this disease. This, of course, is a topic that is very near and dear to my heart. Literally, as some of you might know and some of you listeners out there, I was diagnosed with stage one A breast cancer in twenty twenty two. I had spent the previous twenty four years as a cancer advocate after losing my husband when he was forty two years old to colon cancer, going as far as getting a colonoscopy on the Today Show, because let's face it, nothing says good morning like showing your calling on national television at seven thirty am. Then a number of years later, after a mammogram and a breast ultrasound, I went from advocate to patient myself. I was really grateful through my breast cancer journey to have access us to incredible care. And one of our guests today is actually my rest surgeon, doctor Lisa Newman, who held my hand and gave me a ton of confidence and reassurance throughout the entire process. I cannot say enough nice things about Lisa, who said I could call her Lisa.

Hi everyone, it's Katiekuric. If you're looking for smart, comfortable shoes made for the way we really live, you've got to check out easyspirit dot com. They've got everything you need for fall in extended widths and sizes. Enter the comfort Zone and shop sneakers, loafers, comfort heels, and more at easyspirit dot com. Today, listeners get twenty percent off with the code next twenty. Hi everyone, I'm Katikuric and this is Next Question. Welcome everyone to this live taping of Next Question with me Katiekuric. I am very excited to be having this important conversation produced in partnership with Easy Spirit here at the Pailey Center for Media in New York City in honor Breast Cancer Awareness Month. And in our audience are lots of breast cancer survivors, people who may be in treatment right now, and people who are trying to raise money and awareness for this disease. This, of course, is a topic that is very near and dear to my heart. Literally, as some of you might know and some of you listeners out there, I was diagnosed with stage one A breast cancer in twenty twenty two. I had spent the previous twenty four years as a cancer advocate after losing my husband when he was forty two years old to colon cancer, going as far as getting a colonoscopy on the Today Show, because let's face it, nothing says good morning like showing your calling on national television at seven thirty am. Then a number of years later, after a mammogram and a breast ultrasound, I went from advocate to patient myself. I was really grateful through my breast cancer journey to have access us to incredible care. And one of our guests today is actually my rest surgeon, doctor Lisa Newman, who held my hand and gave me a ton of confidence and reassurance throughout the entire process. I cannot say enough nice things about Lisa, who said I could call her Lisa.

An easy spirit.

An easy spirit.

I am very grateful they've been able to help fund some of doctor Newman's critically important life saving research. The two of us are joined by another one of doctor Newman's patients. It's like a little Lisa Newman fanclick very much. Sharon Joseph. Sharon is the CEO of Boys and Girls Club of Harlem and is still in the middle of her treatment. So thank you both so much for joining us today. And since this is a live podcast, I think it's okay to ask you all to give these ladies around ubform and our hope is that so many women will listen to this podcast, So I hope you'll spread the word because we hope to impart a lot of important, as I said, life saving information to everyone listening. So I think, Sharon, many of us our media thought after being diagnosed, is I have cancer?

I am very grateful they've been able to help fund some of doctor Newman's critically important life saving research. The two of us are joined by another one of doctor Newman's patients. It's like a little Lisa Newman fanclick very much. Sharon Joseph. Sharon is the CEO of Boys and Girls Club of Harlem and is still in the middle of her treatment. So thank you both so much for joining us today. And since this is a live podcast, I think it's okay to ask you all to give these ladies around ubform and our hope is that so many women will listen to this podcast, So I hope you'll spread the word because we hope to impart a lot of important, as I said, life saving information to everyone listening. So I think, Sharon, many of us our media thought after being diagnosed, is I have cancer?

Now what?

Now what?

And I'm hoping that today's conversation will shed some light not only on the physical changes and treatment that you undergo, but the mental and emotional toll it can also have on you. You were diagnosed earlier this year, Sharon, tell me about that day and how you felt hearing the news.

And I'm hoping that today's conversation will shed some light not only on the physical changes and treatment that you undergo, but the mental and emotional toll it can also have on you. You were diagnosed earlier this year, Sharon, tell me about that day and how you felt hearing the news.

Needless to say, I was shocked. I don't know what I thought a cancer pation looked like, but I didn't you looked like me, which is such an arrogant assumption. I had watched my mother have breast cancer and metastasized her brain. I'd taken a BRACA test and it came back negative, so I really thought I was clear. So I knew I had dense bress, and I consistently had my mammograms, and ironically, they had told me that I couldn't get my mammogram until November December of this year, and I advocated for having it earlier and I wound up having it on Mother's Day. And I remember joking around, going, this is the best Mother's Day gift I can give myself. I didn't realize how true that statement was going to become. And I always have a mammogram and ultra sound together. And so I was on my way to church and they kept bringing me back into the room and I'm like, hey, guys, what's going on here? I gotta go, And then they said we found something and I wasn't surprised. I have dense bress. And then they sent me for a buyof see and then I was joking around there too, still thinking, you know, this is just what happens when you have dense breass. And then I got the news. And when I got it, I was shocked, but I was also like, going, okay, mom, this is you right telling me now. You make your own decisions. You were judgmental, but mind, let's see how you handle this. And I remember my radiologist. I had asked her for her help. I said, well, where do I start? I need a good recommendation of a doctor. And she said, the best one I know is doctor Lisa Numan. And She's like, she's really busy, but I'm gonna, you know, tell her about you and you call her. And I called her, and from the very first moment I met her, I was like wow, but I was emotional. I went from being a little overwhelmed to then jumping into a problem solving mode. Okay, this is a problem. What am I going to do? What steps am I going to take? And realizing that I wasn't going to do this by myself, and thinking about all the people that I needed to be here for, like my daughter, a daughter's and wondering, okay, what do I do? I'm strong, I can do this, but you're alone, you're sad, you're mad, You're going why me? And then there's a why not me? And how are we going to turn this around? That I'm not a victim, I'm a victor, And how am I going to use this to bless somebody else? And that's how we started this journey.

Needless to say, I was shocked. I don't know what I thought a cancer pation looked like, but I didn't you looked like me, which is such an arrogant assumption. I had watched my mother have breast cancer and metastasized her brain. I'd taken a BRACA test and it came back negative, so I really thought I was clear. So I knew I had dense bress, and I consistently had my mammograms, and ironically, they had told me that I couldn't get my mammogram until November December of this year, and I advocated for having it earlier and I wound up having it on Mother's Day. And I remember joking around, going, this is the best Mother's Day gift I can give myself. I didn't realize how true that statement was going to become. And I always have a mammogram and ultra sound together. And so I was on my way to church and they kept bringing me back into the room and I'm like, hey, guys, what's going on here? I gotta go, And then they said we found something and I wasn't surprised. I have dense bress. And then they sent me for a buyof see and then I was joking around there too, still thinking, you know, this is just what happens when you have dense breass. And then I got the news. And when I got it, I was shocked, but I was also like, going, okay, mom, this is you right telling me now. You make your own decisions. You were judgmental, but mind, let's see how you handle this. And I remember my radiologist. I had asked her for her help. I said, well, where do I start? I need a good recommendation of a doctor. And she said, the best one I know is doctor Lisa Numan. And She's like, she's really busy, but I'm gonna, you know, tell her about you and you call her. And I called her, and from the very first moment I met her, I was like wow, but I was emotional. I went from being a little overwhelmed to then jumping into a problem solving mode. Okay, this is a problem. What am I going to do? What steps am I going to take? And realizing that I wasn't going to do this by myself, and thinking about all the people that I needed to be here for, like my daughter, a daughter's and wondering, okay, what do I do? I'm strong, I can do this, but you're alone, you're sad, you're mad, You're going why me? And then there's a why not me? And how are we going to turn this around? That I'm not a victim, I'm a victor, And how am I going to use this to bless somebody else? And that's how we started this journey.

That's beautiful.

That's beautiful.

Actually, Karen A couple of questions. So my understanding was your mom kept her breast cancer diagnosis a secret that when you were helping her and driving her to the doctor's office or driving her to the hospital, she never came out and said to you, Sharon, this is what is going on.

Actually, Karen A couple of questions. So my understanding was your mom kept her breast cancer diagnosis a secret that when you were helping her and driving her to the doctor's office or driving her to the hospital, she never came out and said to you, Sharon, this is what is going on.

Tell me about that. I left my mother.

Tell me about that. I left my mother.

My mother, and I think I inherited too, this kind of strong woman persona that many of us in this room probably also have. And we're Caribbean, and so it's not only strong woman persona, but it's keep it to yourself. And maybe she thought she was also protecting me, but she said, I have a procedure and I said where, because I'm nosy. She told me it was all the way downtown and she was going to take two buses and a train and I said, no way, Mom, I said, what's the procedure? She said, do don't worry about it. I'm okay. And so I literally drove my mother down and she got out the car, and I started calling all my relatives, including my relatives in the Caribbean, and I'm like, Mommy's having a procedure and I don't know what this is. Do you know what this is? And finally someone said, we think your mom has breast cancer and she's doing something about it.

My mother, and I think I inherited too, this kind of strong woman persona that many of us in this room probably also have. And we're Caribbean, and so it's not only strong woman persona, but it's keep it to yourself. And maybe she thought she was also protecting me, but she said, I have a procedure and I said where, because I'm nosy. She told me it was all the way downtown and she was going to take two buses and a train and I said, no way, Mom, I said, what's the procedure? She said, do don't worry about it. I'm okay. And so I literally drove my mother down and she got out the car, and I started calling all my relatives, including my relatives in the Caribbean, and I'm like, Mommy's having a procedure and I don't know what this is. Do you know what this is? And finally someone said, we think your mom has breast cancer and she's doing something about it.

And that was it. You never discussed it with her.

And that was it. You never discussed it with her.

I went upstairs and found her in the room, and when she was coming out and I'm like, mom, she's like, I'm fine, what happened today? Oh, don't worry.

I went upstairs and found her in the room, and when she was coming out and I'm like, mom, she's like, I'm fine, what happened today? Oh, don't worry.

That's so interesting. You know, culturally, it sounds like there's still a lot of secrecy surrounding cancer diagnosis, And when you think about it, it's not all that's surprising, because I think it's really within the last gosh, maybe twenty five years, and it's hard to remember how people just didn't discuss cancer and they were sort of embarrassed or secretive about it. And then, as Sharon mentioned, culturally for some black women, it's still like that. Can you describe what you've seen among your patient population with that trend or the women you've been studying?

That's so interesting. You know, culturally, it sounds like there's still a lot of secrecy surrounding cancer diagnosis, And when you think about it, it's not all that's surprising, because I think it's really within the last gosh, maybe twenty five years, and it's hard to remember how people just didn't discuss cancer and they were sort of embarrassed or secretive about it. And then, as Sharon mentioned, culturally for some black women, it's still like that. Can you describe what you've seen among your patient population with that trend or the women you've been studying?

Yeah? Thanksana.

Yeah? Thanksana.

First of all, your story sharing is just incredible. Thank you for sharing it is so so very powerful.

First of all, your story sharing is just incredible. Thank you for sharing it is so so very powerful.

Appreciate it.

Appreciate it.

But it is true that unfortunately, many women do feel this stigma associated with a breast cancer diagnosis. And I can remember in my own family similaria is a lot of the reluctance to say the word I can call my mom talking about the Big Sea. It was as if saying the word was somehow going to make it real and ignoring it was going to make the problem going go away. And one of the organizations that I work with quite a bit, the Sisters Network, Incorporated, which is an African American breast cancer survivor's organization, a national organization. Their logo is to stop the silence, specifically to counteract that pervasive impression that you shouldn't talk about breast can answer. We are empowering ourselves if we talk about the diagnosis and we share with each other how to protect ourselves against the threat of breast cancer. And we do have so many ways that we can protect ourselves. Between screening, treatment, survivorship medalities, we can protect ourselves against this disease.

But it is true that unfortunately, many women do feel this stigma associated with a breast cancer diagnosis. And I can remember in my own family similaria is a lot of the reluctance to say the word I can call my mom talking about the Big Sea. It was as if saying the word was somehow going to make it real and ignoring it was going to make the problem going go away. And one of the organizations that I work with quite a bit, the Sisters Network, Incorporated, which is an African American breast cancer survivor's organization, a national organization. Their logo is to stop the silence, specifically to counteract that pervasive impression that you shouldn't talk about breast can answer. We are empowering ourselves if we talk about the diagnosis and we share with each other how to protect ourselves against the threat of breast cancer. And we do have so many ways that we can protect ourselves. Between screening, treatment, survivorship medalities, we can protect ourselves against this disease.

And just talking about it is so critically important. I remember reading in The Emperor of All Maladies. I might have mentioned this to you before, Lisa, by Siddartha Mukherjee. It's a great book. You want to pull a surprise. It's about the history of cancer. It's fascinating and in the nineteen fifties when women who had breast cancer were looking for a support group. I think the New York Times wouldn't allow them to put in the classifies that they were looking for other breast cancer patients. They would have to say looking for women who have been diagnosed with cancer of the chest cavity, because they didn't want to write the word breast, which is just so unbelievable. And that was in the nineteen fifties. So we have come a long way, but clearly not far enough when it comes to bringing this topic out into the open. And when I heard Sharon's story, I was like, Wow, she actually is one of those women who has done everything right because she knows she has dense breast. Forty two percent of women over the age of forty have dense breast, and we're going to talk about that some more in a moment. But because of that, she got a mammogram and an ultrasound, which was your usual routine every year or every two years, or every year I guess, right.

And just talking about it is so critically important. I remember reading in The Emperor of All Maladies. I might have mentioned this to you before, Lisa, by Siddartha Mukherjee. It's a great book. You want to pull a surprise. It's about the history of cancer. It's fascinating and in the nineteen fifties when women who had breast cancer were looking for a support group. I think the New York Times wouldn't allow them to put in the classifies that they were looking for other breast cancer patients. They would have to say looking for women who have been diagnosed with cancer of the chest cavity, because they didn't want to write the word breast, which is just so unbelievable. And that was in the nineteen fifties. So we have come a long way, but clearly not far enough when it comes to bringing this topic out into the open. And when I heard Sharon's story, I was like, Wow, she actually is one of those women who has done everything right because she knows she has dense breast. Forty two percent of women over the age of forty have dense breast, and we're going to talk about that some more in a moment. But because of that, she got a mammogram and an ultrasound, which was your usual routine every year or every two years, or every year I guess, right.

A year, almost every six months if I could.

A year, almost every six months if I could.

Really And was it because of the family history that you got both of them or how.

Really And was it because of the family history that you got both of them or how.

Did you find out?

Did you find out?

By the way, this is going to be very instructive because so many women don't really know about dense breass. How did you find out you had dense breass?

By the way, this is going to be very instructive because so many women don't really know about dense breass. How did you find out you had dense breass?

Really through my doc when we talked about it. I had had a benign syst in my left breast and we've been monitoring that. And again because my mother's breast cancer atasthtsized to her brain, I was very very aggressive about trying to make sure I had my mammograms and ultrasounds both on the same day so that I could constantly test, and also doing self checks. So I was very religious about them.

Really through my doc when we talked about it. I had had a benign syst in my left breast and we've been monitoring that. And again because my mother's breast cancer atasthtsized to her brain, I was very very aggressive about trying to make sure I had my mammograms and ultrasounds both on the same day so that I could constantly test, and also doing self checks. So I was very religious about them.

That's wonderful because first of all, just so everyone knows, and Lisa should be saying this, but I'm like the dense breast lunatic now because I have dense breasts. And number one, if you have dense breast, you have a higher risk of being diagnosed with breast cancer. Number Two, a mammogram alone can't necessarily tell if you have any kind of abnormality. So I have all at and like people feel their breasts and they're kind of lumpy and big or they're whatever, and they think.

That's wonderful because first of all, just so everyone knows, and Lisa should be saying this, but I'm like the dense breast lunatic now because I have dense breasts. And number one, if you have dense breast, you have a higher risk of being diagnosed with breast cancer. Number Two, a mammogram alone can't necessarily tell if you have any kind of abnormality. So I have all at and like people feel their breasts and they're kind of lumpy and big or they're whatever, and they think.

Oh, I have dense press.

Oh, I have dense press.

You can only find out through a mammogram if you actually have dense press and as I said, nearly half of women over the age of forty fall into this category. And so you really need additional screening and we're going to.

You can only find out through a mammogram if you actually have dense press and as I said, nearly half of women over the age of forty fall into this category. And so you really need additional screening and we're going to.

Talk about that.

Talk about that.

Well, why don't we just talk about that now, because Lisa, it's very upsetting to me A that so many women don't know that. And the FDA changed their rule requiring women to be notified that they have dense press and it all has to be done in the same language now, right, that was I think done in the spring of last year, put into effect maybe in September.

Well, why don't we just talk about that now, because Lisa, it's very upsetting to me A that so many women don't know that. And the FDA changed their rule requiring women to be notified that they have dense press and it all has to be done in the same language now, right, that was I think done in the spring of last year, put into effect maybe in September.

Actually it became icial rules. Thank you. I've got all these experts in audience. I should just have asked you all.

Actually it became icial rules. Thank you. I've got all these experts in audience. I should just have asked you all.

But anyway, you know, Sharon knew this already, but so many women don't. How can we spread the word A that you need to find out if you have dense breasts and be about additional screening and see insurance companies need to pay for additional screening.

But anyway, you know, Sharon knew this already, but so many women don't. How can we spread the word A that you need to find out if you have dense breasts and be about additional screening and see insurance companies need to pay for additional screening.

It's so unfair and so wrong.

It's so unfair and so wrong.

Yeah, so you stated the main issues perfectly as you always do, Katie.

Yeah, so you stated the main issues perfectly as you always do, Katie.

Oh, thank you, Lisa, but.

Oh, thank you, Lisa, but.

It's so true. But yeah, you're right.

It's so true. But yeah, you're right.

The Foot and Drug Administration of enacted policies such that all mimography units have to now report on breast density to patients that are undergoing mamographic evaluation, and it became official for all states just a couple of weeks ago, So that.

The Foot and Drug Administration of enacted policies such that all mimography units have to now report on breast density to patients that are undergoing mamographic evaluation, and it became official for all states just a couple of weeks ago, So that.

Is a wonderful advance.

Is a wonderful advance.

However, women are then left with having to sort out what do I do next now that I've been told that my mammogram shows breast density. I would recommend that you speak to your radiologist, Sharon did. Speak to your healthcare provider, because there are options in terms of addition enhanced breast imaging, such as breast ultrasound.

However, women are then left with having to sort out what do I do next now that I've been told that my mammogram shows breast density. I would recommend that you speak to your radiologist, Sharon did. Speak to your healthcare provider, because there are options in terms of addition enhanced breast imaging, such as breast ultrasound.

Some women will need breast MRI.

Some women will need breast MRI.

There are innovative ways of performing mammograms, such as contrast enhanced mimography, and these modalities can sometimes help improve the ability to evaluate the mammogram. As you also correctly stated, having that breast density not only makes a regular routine mammogram more difficult to interpret, but it's a risk factor indicating that you're att more likely to develop breast cancer in the future. So speak with your healthcare provider if you are told that you have dense breast find out what your options are and make sure that these options and issues are documented, because the way that they're documented can influence whether or not your insurance plan will reimburse will pay for the additional testing business.

There are innovative ways of performing mammograms, such as contrast enhanced mimography, and these modalities can sometimes help improve the ability to evaluate the mammogram. As you also correctly stated, having that breast density not only makes a regular routine mammogram more difficult to interpret, but it's a risk factor indicating that you're att more likely to develop breast cancer in the future. So speak with your healthcare provider if you are told that you have dense breast find out what your options are and make sure that these options and issues are documented, because the way that they're documented can influence whether or not your insurance plan will reimburse will pay for the additional testing business.

I know that in some states it's required that they pay insurance for additional screening. I interviewed somebody in Ohio I think you were on the podcast with her actually, who really fought to have insurance pay for additional screening because she was diagnosed with stage four breast cancer. They kept missing it on the mammogram. So I really admire her and the women in other states have worked to make this happen.

I know that in some states it's required that they pay insurance for additional screening. I interviewed somebody in Ohio I think you were on the podcast with her actually, who really fought to have insurance pay for additional screening because she was diagnosed with stage four breast cancer. They kept missing it on the mammogram. So I really admire her and the women in other states have worked to make this happen.

I'll also say that even though I got the mammogram and the ultrasound, the MRI showed more. Yeah, So if we had just left it to the mammogram and the ultrasound, it would have only shown a very small portion. The MRI showed that there was a lot more than they initially thought. So that's additionally why it's important.

I'll also say that even though I got the mammogram and the ultrasound, the MRI showed more. Yeah, So if we had just left it to the mammogram and the ultrasound, it would have only shown a very small portion. The MRI showed that there was a lot more than they initially thought. So that's additionally why it's important.

Yeah, but I think wouldn't a standard of care be if someone like Sharon presented with something suspicious on both the mammogram and the breast ultrasound, she would almost automatically be given an MRI to kind of validate the findings.

Yeah, but I think wouldn't a standard of care be if someone like Sharon presented with something suspicious on both the mammogram and the breast ultrasound, she would almost automatically be given an MRI to kind of validate the findings.

Or am I crazy?

Or am I crazy?

Now, that is often the strategy, But the decision about MRIs in the base of a breast cancer diagnosis is definitely a nuanced, challenging decision to make, but often it is very, very helpful. Breast MRI is absolutely valuable in women that have known breast cancer predisposition such as a strong family history, a known genetic susceptibility, mutation carriers such as a BRCA mutation, women that have had prior therapeutic radiation to the chest wall.

Now, that is often the strategy, But the decision about MRIs in the base of a breast cancer diagnosis is definitely a nuanced, challenging decision to make, but often it is very, very helpful. Breast MRI is absolutely valuable in women that have known breast cancer predisposition such as a strong family history, a known genetic susceptibility, mutation carriers such as a BRCA mutation, women that have had prior therapeutic radiation to the chest wall.

These are all markers.

These are all markers.

Of women that will benefit from MRI in addition to MAMMOGRAHAM to early detect a new breast cancer.

Of women that will benefit from MRI in addition to MAMMOGRAHAM to early detect a new breast cancer.

You know, I know that women, white women, and black women are diagnosed at the same rate with breast cancer, but black women have a forty percent higher mortality rate. I discovered this when you were treating me for my breast cancer, and it was so disconcerting. Can you explain why this is the case.

You know, I know that women, white women, and black women are diagnosed at the same rate with breast cancer, but black women have a forty percent higher mortality rate. I discovered this when you were treating me for my breast cancer, and it was so disconcerting. Can you explain why this is the case.

Yeah, well, there are a lot of reasons at which I am happy to discuss, But first of all, I just have to say I was so struck in getting to know you through your treatment experience, how passionate you became about addressing breast cancer disparities and learning about breast cancer disparities. This woman, as she's getting ready to start her breast cancer surgery, she's talking about how she wants to use her experience to advocate for women so that all women have access to the treatment options that she was able to avail herself of.

Yeah, well, there are a lot of reasons at which I am happy to discuss, But first of all, I just have to say I was so struck in getting to know you through your treatment experience, how passionate you became about addressing breast cancer disparities and learning about breast cancer disparities. This woman, as she's getting ready to start her breast cancer surgery, she's talking about how she wants to use her experience to advocate for women so that all women have access to the treatment options that she was able to avail herself of.

It's still mind volve them.

It's still mind volve them.

To me, how gracious you are, how you think of everybody?

To me, how gracious you are, how you think of everybody?

Were getting me to sleep, you know, making me count for ten backwards, and I was like, you guys, it's terrible.

Were getting me to sleep, you know, making me count for ten backwards, and I was like, you guys, it's terrible.

So many women.

So many women.

Well, you know, I felt so lucky that I had the good fortune and honestly the financial wherewithal an insurance coverage to get the very best treatment available. And I couldn't stop thinking what would I have done if I had had to wait to get my lump back to me, if I had to wait to get my mammogram, if my doctor didn't automatically give me a breast ultrasound every time I was checked. And you know, your health should not be determined by your zip code or your bank account, and it so often is. And that's why I am so passionate about not only giving the people the information they need, but supporting them because it's just unfair that a person of means is a survivor and a person who doesn't have means is often not. And it's just the inequities are maddening to me. Well, and I'm going to talk about your research in a second, but let's talk about the reasons that Black women have a forty percent higher mortality. Some of it has to do with their breast density, right, and some of it has to do with access.

Well, you know, I felt so lucky that I had the good fortune and honestly the financial wherewithal an insurance coverage to get the very best treatment available. And I couldn't stop thinking what would I have done if I had had to wait to get my lump back to me, if I had to wait to get my mammogram, if my doctor didn't automatically give me a breast ultrasound every time I was checked. And you know, your health should not be determined by your zip code or your bank account, and it so often is. And that's why I am so passionate about not only giving the people the information they need, but supporting them because it's just unfair that a person of means is a survivor and a person who doesn't have means is often not. And it's just the inequities are maddening to me. Well, and I'm going to talk about your research in a second, but let's talk about the reasons that Black women have a forty percent higher mortality. Some of it has to do with their breast density, right, and some of it has to do with access.

Can you just talk about that, Lisa.

Can you just talk about that, Lisa.

There are many complex reasons explaining these breast cancer disparities that you described, and indeed, breast cancer mortality rates death rates are forty percent higher in African American women compared to White American women. Now, the incidents rates actually used to be lower for breast cancer and Black women compared to white women, but there's been a disproportion so interesting incidence, so that now the rates are equal. But we've had this widening of the mortality gap, and it's because of a lot of different factors. The disproportionately high prevalence of socioeconomic disadvantages in the African American community, higher poverty rates, higher rates of being uninsured or under insured, all of these factors definitely contribute to delays and breast cancer diagnosis, delays in completing treatment, and this will result in higher mortality rates.

There are many complex reasons explaining these breast cancer disparities that you described, and indeed, breast cancer mortality rates death rates are forty percent higher in African American women compared to White American women. Now, the incidents rates actually used to be lower for breast cancer and Black women compared to white women, but there's been a disproportion so interesting incidence, so that now the rates are equal. But we've had this widening of the mortality gap, and it's because of a lot of different factors. The disproportionately high prevalence of socioeconomic disadvantages in the African American community, higher poverty rates, higher rates of being uninsured or under insured, all of these factors definitely contribute to delays and breast cancer diagnosis, delays in completing treatment, and this will result in higher mortality rates.

So poverty, but it's also these social determinants of going on.

So poverty, but it's also these social determinants of going on.

Yes, yeah, so we still unfortunately continue to see discriminatory patterns in the healthcare system. African American women are less likely to be offered genetic testing, African American women are less likely to have mimmography in the highest quality centers, and African American women are less likely to be offered cutting edge breast cancer treatments, such as in the setting of clinical trials and clinical research. So we definitely have to address all of those inequities in the healthcare system, number one, if we're going to achieve.

Yes, yeah, so we still unfortunately continue to see discriminatory patterns in the healthcare system. African American women are less likely to be offered genetic testing, African American women are less likely to have mimmography in the highest quality centers, and African American women are less likely to be offered cutting edge breast cancer treatments, such as in the setting of clinical trials and clinical research. So we definitely have to address all of those inequities in the healthcare system, number one, if we're going to achieve.

Breast health equity.

Breast health equity.

But there are other factors, and there are several characteristics that describe the breast cancer burden of the African American community, indicating that there are tumor biology factors that we need to understand through research. African American women are more likely to be diagnosed with breast cancer at younger ages. We are more likely to have biologically aggressive tumors called triple negative breast cancers and male breast cancer is actually more common in the African American community. So my own research actually looks at studying the breast cancer burden of women in different regions of the continent of Africa, and we've learned that women from West Africa, which is the homeland for the ancestors of most African Americans, the triple negative breast cancers are most common in that part of the continent, and it's because of specific genetic variants that developed in the ancestors of West Africans related to having to develop resistance to infectious.

But there are other factors, and there are several characteristics that describe the breast cancer burden of the African American community, indicating that there are tumor biology factors that we need to understand through research. African American women are more likely to be diagnosed with breast cancer at younger ages. We are more likely to have biologically aggressive tumors called triple negative breast cancers and male breast cancer is actually more common in the African American community. So my own research actually looks at studying the breast cancer burden of women in different regions of the continent of Africa, and we've learned that women from West Africa, which is the homeland for the ancestors of most African Americans, the triple negative breast cancers are most common in that part of the continent, and it's because of specific genetic variants that developed in the ancestors of West Africans related to having to develop resistance to infectious.

Diseases like malaria.

Diseases like malaria.

But these variants have downstream consequences on the breast tissue immune landscape such that it predisposes to the breast to developing these triple negative breast cancers. So these international research programs will actually teach us about the genetic root cause of aggressive tumors like triple negative breast cancer, and it'll teach us how to prevent and treat these tumors better.

But these variants have downstream consequences on the breast tissue immune landscape such that it predisposes to the breast to developing these triple negative breast cancers. So these international research programs will actually teach us about the genetic root cause of aggressive tumors like triple negative breast cancer, and it'll teach us how to prevent and treat these tumors better.

The research you're doing is so interesting, So are you taking different populations globally and looking at sort of there or are you focus mostly on the continent of Africa.

The research you're doing is so interesting, So are you taking different populations globally and looking at sort of there or are you focus mostly on the continent of Africa.

We are definitely expanding more globally. We have several partners now in different regions of Africa, because Africa is a huge continent, tremendous diversity in terms of lifestyle, culture and genetics, because it's the founder homeland for all of human kind. Of course, so we do study breast cancer in East Africa, West Africa, Central Africa, but we are also expanding to study the breast cancer burden in Mexico and in South America. These genetics of ancestry definitely play a role in susceptibility for different patterns of the disease, and we have to look at all of these internationally dis patient populations to truly understand the root causes of cancer comprehensibly.

We are definitely expanding more globally. We have several partners now in different regions of Africa, because Africa is a huge continent, tremendous diversity in terms of lifestyle, culture and genetics, because it's the founder homeland for all of human kind. Of course, so we do study breast cancer in East Africa, West Africa, Central Africa, but we are also expanding to study the breast cancer burden in Mexico and in South America. These genetics of ancestry definitely play a role in susceptibility for different patterns of the disease, and we have to look at all of these internationally dis patient populations to truly understand the root causes of cancer comprehensibly.

So basically, all breasts are not created equal.

So basically, all breasts are not created equal.

I mean very true.

I mean very true.

It's true, and I'm talking at.

It's true, and I'm talking at.

A cellular level right and at a genetic level. At Easy Spirit, they know comfort isn't just about footwear. It's about empowering women to take action in their lives. That's why this Breast Cancer Awareness Month, I'm proud to support their Move for Pink initiative, helping to drive real change for women everywhere.

A cellular level right and at a genetic level. At Easy Spirit, they know comfort isn't just about footwear. It's about empowering women to take action in their lives. That's why this Breast Cancer Awareness Month, I'm proud to support their Move for Pink initiative, helping to drive real change for women everywhere.

For the third year in a row.

For the third year in a row.

Easy Spirit has been giving back, donating a portion of proceeds from their limited edition sneakers to support doctor Lisa Newman's groundbreaking breast cancer research. I know firsthand how important this work is. I've actually had my own journey with breast cancer, and doctor Newman was my doctor. Easy Spirit being a part of this important conversation helps shine a light on how women can mobilize to drive change and ultimately find a cure. I move for my health, for my family, and for all the women out there who are fighting their own battles. Walking, running, even a quick stroll. It's how I stay motivated, stay strong, and stay connected to what matters. Easy Spirit makes it easy for me to keep moving with sizes and styles for every woman. They're truly designed for the way we live. Easy Spirit is the original comfort footwear brand, proudly designing women's footwear that's comfortable, right out of the box and made to keep you moving. Easy Spirit understands every woman has her own unique needs, her own unique footprint. That's why they offer solutions like extended sizes and wits, orthoughtic friendly silhouettes, arch support, and much more like their Move for Pink initiative Cancer Awareness Month. When you step into comfort with easy spirit, you're taking a step in the right direction for breast cancer research too. Another thing, I was curious if some of the social determinants of health, you know, like higher smoking rates or obesity rates, or the fact that there are so many food deserts and the intersection sadly of poverty and race, if that is also contributing to not only access to healthcare and to preventative screening, but also is that having an impact on the specific cellular activity in breasts.

Easy Spirit has been giving back, donating a portion of proceeds from their limited edition sneakers to support doctor Lisa Newman's groundbreaking breast cancer research. I know firsthand how important this work is. I've actually had my own journey with breast cancer, and doctor Newman was my doctor. Easy Spirit being a part of this important conversation helps shine a light on how women can mobilize to drive change and ultimately find a cure. I move for my health, for my family, and for all the women out there who are fighting their own battles. Walking, running, even a quick stroll. It's how I stay motivated, stay strong, and stay connected to what matters. Easy Spirit makes it easy for me to keep moving with sizes and styles for every woman. They're truly designed for the way we live. Easy Spirit is the original comfort footwear brand, proudly designing women's footwear that's comfortable, right out of the box and made to keep you moving. Easy Spirit understands every woman has her own unique needs, her own unique footprint. That's why they offer solutions like extended sizes and wits, orthoughtic friendly silhouettes, arch support, and much more like their Move for Pink initiative Cancer Awareness Month. When you step into comfort with easy spirit, you're taking a step in the right direction for breast cancer research too. Another thing, I was curious if some of the social determinants of health, you know, like higher smoking rates or obesity rates, or the fact that there are so many food deserts and the intersection sadly of poverty and race, if that is also contributing to not only access to healthcare and to preventative screening, but also is that having an impact on the specific cellular activity in breasts.

Does that make sense?

Does that make sense?

Oh, you stated it perfectly. It is so true. That's absolutely correct. Environment definitely plays a role in breast cancer. And there is a very large, exciting, growing body of research looking at how certain neighborhood characteristics related to poverty related to nutritional insecurity and food deserts. These characteristics are not only associated with obesity rates, which is another risk factor for getting breast cancer, but these neighborhood characteristics are also inherently related to likelihood of developing certain breast cancer patterns.

Oh, you stated it perfectly. It is so true. That's absolutely correct. Environment definitely plays a role in breast cancer. And there is a very large, exciting, growing body of research looking at how certain neighborhood characteristics related to poverty related to nutritional insecurity and food deserts. These characteristics are not only associated with obesity rates, which is another risk factor for getting breast cancer, but these neighborhood characteristics are also inherently related to likelihood of developing certain breast cancer patterns.

And also another problem I know is getting women of color in clinical trials, right, I mean, it's hard enough to get anyone in clinical trials, but particularly challenging for the black community to participate. Why has that been so challenging, Lisa.

And also another problem I know is getting women of color in clinical trials, right, I mean, it's hard enough to get anyone in clinical trials, but particularly challenging for the black community to participate. Why has that been so challenging, Lisa.

Again, Katie, for so many complex reasons. They're destinately the medical communityificant distrust.

Again, Katie, for so many complex reasons. They're destinately the medical communityificant distrust.

Yes, and for appropriate reasons.

Yes, and for appropriate reasons.

In the past, there have been horrific abuses in clinical research tex Tuskegee, the Tuskegee experience, and so rightfully, many individuals, especially from communities of color, are suspicious of clinical research. But we can absolve the medical professional community from responsibility either. There are actually many studies showing that one of the biggest barriers to an African American cancer patient participating in the clinical trial is the absence of the physician offering a clinical trial to that patient. Some physicians just don't want to take the time to explain the clinical trial. Some physicians are fearful that bringing up a clinical trial will somehow alienate the patient and generate more is distrust.

In the past, there have been horrific abuses in clinical research tex Tuskegee, the Tuskegee experience, and so rightfully, many individuals, especially from communities of color, are suspicious of clinical research. But we can absolve the medical professional community from responsibility either. There are actually many studies showing that one of the biggest barriers to an African American cancer patient participating in the clinical trial is the absence of the physician offering a clinical trial to that patient. Some physicians just don't want to take the time to explain the clinical trial. Some physicians are fearful that bringing up a clinical trial will somehow alienate the patient and generate more is distrust.

But we have to get over that.

But we have to get over that.

Clinical trials are part of standard of care and we have to offer them to everybody.

Clinical trials are part of standard of care and we have to offer them to everybody.

The other thing I know that you care deeply about is to have more black doctors, because I think people feel often more comfortable when their doctor has a similar experience than they do, and that is actually increasing, but not at a fast enough rate, is it.

The other thing I know that you care deeply about is to have more black doctors, because I think people feel often more comfortable when their doctor has a similar experience than they do, and that is actually increasing, but not at a fast enough rate, is it.

Yeah, that is so true.

Yeah, that is so true.

Just as we need better gender balances in the healthcare professional community, we also need more diversity in the healthcare workforce.

Just as we need better gender balances in the healthcare professional community, we also need more diversity in the healthcare workforce.

And I do think that it's true that many.

And I do think that it's true that many.

Patients want to have a match in terms of not only the gender, but often the race, ethnicity of their position to their own experiences and identity.

Patients want to have a match in terms of not only the gender, but often the race, ethnicity of their position to their own experiences and identity.

But the patient population.

But the patient population.

Overall, I think will have greater trust in the healthcare system if they see a healthcare system that reflects their neighborhoods and their communities.

Overall, I think will have greater trust in the healthcare system if they see a healthcare system that reflects their neighborhoods and their communities.

Sharon, is that one of the reasons that going to doctor Newman appealed to you? Did you feel more of a connection with a woman of color as your surgeon? She's okay, no, I'm curious.

Sharon, is that one of the reasons that going to doctor Newman appealed to you? Did you feel more of a connection with a woman of color as your surgeon? She's okay, no, I'm curious.

I mean, did that enter into it at all?

I mean, did that enter into it at all?

Yes? But more importantly what entered into and she didn't know, was that I did research on her. I went online, and when I saw that her study what she was doing, I thought, wow, not only is she a woman of color, but also, you know, let's be honest, she is the lead person in her field at her hospital, so her expertise was important to me. The fact that she was doing research around this was important to me. But that wasn't enough for me. So I went to some other doctors at other hospitals. And then, funny enough, gender is important because when I went to the male doctor at a very nice hospital, instead of telling me I had dense bruss, he kept telling you, I had complex br us. And a woman doesn't want to know she has complex for us.

Yes? But more importantly what entered into and she didn't know, was that I did research on her. I went online, and when I saw that her study what she was doing, I thought, wow, not only is she a woman of color, but also, you know, let's be honest, she is the lead person in her field at her hospital, so her expertise was important to me. The fact that she was doing research around this was important to me. But that wasn't enough for me. So I went to some other doctors at other hospitals. And then, funny enough, gender is important because when I went to the male doctor at a very nice hospital, instead of telling me I had dense bruss, he kept telling you, I had complex br us. And a woman doesn't want to know she has complex for us.

Okay, I don't know, nice and a little nicer than I was as a woman who gets called complicated.

Okay, I don't know, nice and a little nicer than I was as a woman who gets called complicated.

I was like, okay, now my breast complicated too, So I was kind of taking that issue. But he didn't handle me with the same care that doctor Newman handled me. And then what was interesting was that he also was specializing in the same type of research, but for Jewish women, and I thought, wow, that's amazing, and I really appreciated that he was doing that. But I was like, well, he's specializing in Jewish women, and I've just talked to a woman who's a woman who's handling me with a lot of care and compassion. She has the expertise, and more importantly, she is doing research about women like myself.

I was like, okay, now my breast complicated too, So I was kind of taking that issue. But he didn't handle me with the same care that doctor Newman handled me. And then what was interesting was that he also was specializing in the same type of research, but for Jewish women, and I thought, wow, that's amazing, and I really appreciated that he was doing that. But I was like, well, he's specializing in Jewish women, and I've just talked to a woman who's a woman who's handling me with a lot of care and compassion. She has the expertise, and more importantly, she is doing research about women like myself.

So where do I go? It seems easy enough, and I already.

So where do I go? It seems easy enough, and I already.

Knew I was going to her, but I just wanted a second opinion. And then her peers in the industry kept telling me she was amazing, so she didn't even have to tell me she was amazing. Her peers in the industry at the other hospitals were like, well, if you're not going to go with us, she is one of the best in the industry.

Knew I was going to her, but I just wanted a second opinion. And then her peers in the industry kept telling me she was amazing, so she didn't even have to tell me she was amazing. Her peers in the industry at the other hospitals were like, well, if you're not going to go with us, she is one of the best in the industry.

So I'm curious, Lisa, and why you decided. I mean, first of all, you're a brilliant person. You could study whatever you wanted. I'm sure, why did you decide to really investigate the disparities in white women and women of color when it came to breast cancer.

So I'm curious, Lisa, and why you decided. I mean, first of all, you're a brilliant person. You could study whatever you wanted. I'm sure, why did you decide to really investigate the disparities in white women and women of color when it came to breast cancer.

What was it?

What was it?

Did you have an aha moment? Did you treat somebody, did you read the statistics? What made you think I need to dig deeper into this.

Did you have an aha moment? Did you treat somebody, did you read the statistics? What made you think I need to dig deeper into this.

It was actually a little bit of everything you just described. But before I get into that, I just want to thank both of you for your comments, and I also want to specifically give a shout out to Sharon for the way she kept it so real with me. She did her homework and investigated other centers and then she came back and told me what she liked about my program and what she didn't like about my program.

It was actually a little bit of everything you just described. But before I get into that, I just want to thank both of you for your comments, and I also want to specifically give a shout out to Sharon for the way she kept it so real with me. She did her homework and investigated other centers and then she came back and told me what she liked about my program and what she didn't like about my program.

She was very honest about things that we needed to work on.

She was very honest about things that we needed to work on.

Well, I'm not even going to say what they were, because I've correct to everything that she told me about it. But for me, it was a long journey to coming to where my career is today and back. I won't say how long ago, but it was more than twenty years ago. When I was first starting on my career, I was a general surgeon taking care of a lot of different types of surgical problems, and back then we didn't have an appreciation for the types of race related differences in breast cancer burden that you described today, and those are very well documented today, but that back then we didn't understand them very well. We didn't understand the fact that breast cancer is actually comprised of a whole spectrum of different subtypes, and we just didn't understand why some breast cancers were more poorly controlled than others. And my general surgery practice was based in Brooklyn, New York, where, of course we have a beautiful and robustly diverse patient population, and every day I was struck in my own practice by how my black breast cancer patients were being diagnosed at younger ages. They were often diagnosed with bulkier tumors, and they were developing recurrences of their breast cancer more frequently. And so I decided to pursue additional training and research so that I could have a dedicated career studying breast cancer and dedicated to surgical management of the disease. So that twenty year journey twenty plus your journey actually has evolved into this international breast cancer research and a lot of research looking at the genetics of the disease.

Well, I'm not even going to say what they were, because I've correct to everything that she told me about it. But for me, it was a long journey to coming to where my career is today and back. I won't say how long ago, but it was more than twenty years ago. When I was first starting on my career, I was a general surgeon taking care of a lot of different types of surgical problems, and back then we didn't have an appreciation for the types of race related differences in breast cancer burden that you described today, and those are very well documented today, but that back then we didn't understand them very well. We didn't understand the fact that breast cancer is actually comprised of a whole spectrum of different subtypes, and we just didn't understand why some breast cancers were more poorly controlled than others. And my general surgery practice was based in Brooklyn, New York, where, of course we have a beautiful and robustly diverse patient population, and every day I was struck in my own practice by how my black breast cancer patients were being diagnosed at younger ages. They were often diagnosed with bulkier tumors, and they were developing recurrences of their breast cancer more frequently. And so I decided to pursue additional training and research so that I could have a dedicated career studying breast cancer and dedicated to surgical management of the disease. So that twenty year journey twenty plus your journey actually has evolved into this international breast cancer research and a lot of research looking at the genetics of the disease.

I know that it's true in the case of calling cancer, that younger and younger people are being diagnosed, which is really upsetting people in their twenties and thirties and forties. You know, you have to get a screening, colonoscopy or some kind of calling screening at age forty five because of these numbers, they lowered the age for your first screening. And I'm curious if this is true for breast cancer, and if you have any idea why younger and younger people seem to be getting diagnosed with these diseases.

I know that it's true in the case of calling cancer, that younger and younger people are being diagnosed, which is really upsetting people in their twenties and thirties and forties. You know, you have to get a screening, colonoscopy or some kind of calling screening at age forty five because of these numbers, they lowered the age for your first screening. And I'm curious if this is true for breast cancer, and if you have any idea why younger and younger people seem to be getting diagnosed with these diseases.

Well, you are again correct.

Well, you are again correct.

We are seeing a similar pattern in breast cancer as what you described in colon cancer, with higher and increasing population based incidence rates of breast cancer in younger women, women that are still in the pre menopausal age ranges. We don't completely understand the explanations, but we are assuming at this point in time that it's related to a constellation of factors. Diet, lifestyle, environmental exposures, obesity rates are unfortunately on the rise in the United States, and all of these factors, in addition to our genetics, we'll be playing a role in.

We are seeing a similar pattern in breast cancer as what you described in colon cancer, with higher and increasing population based incidence rates of breast cancer in younger women, women that are still in the pre menopausal age ranges. We don't completely understand the explanations, but we are assuming at this point in time that it's related to a constellation of factors. Diet, lifestyle, environmental exposures, obesity rates are unfortunately on the rise in the United States, and all of these factors, in addition to our genetics, we'll be playing a role in.

I wonder when you say environmental factors, I feel like it. You know, it's frustrating to me because we've seen these numbers for a few years now, and I've talked to a lot of scientists because of stand Up to Cancer and my own cancer activism, and some say it might be the over prescription of antibiotics. Other people say maybe process foods. We're hearing a lot about alcohol consumption and cancer. I think a big study just came out about that and how closely linked they are. When do you think we're going to And I wonder about pesticides, and I wonder about these forever chemicals. What are they called p fasts? Is that what they're called? Anybody, come on audience, P fast right, pfas I guess, And everything from leggings to you know, rubber mats and all kinds of household products.

I wonder when you say environmental factors, I feel like it. You know, it's frustrating to me because we've seen these numbers for a few years now, and I've talked to a lot of scientists because of stand Up to Cancer and my own cancer activism, and some say it might be the over prescription of antibiotics. Other people say maybe process foods. We're hearing a lot about alcohol consumption and cancer. I think a big study just came out about that and how closely linked they are. When do you think we're going to And I wonder about pesticides, and I wonder about these forever chemicals. What are they called p fasts? Is that what they're called? Anybody, come on audience, P fast right, pfas I guess, And everything from leggings to you know, rubber mats and all kinds of household products.

When do you think, I know, it's.

When do you think, I know, it's.

Really hard at semiologists struggle with this, But when do you think we'll have a better idea about why this is happening because it has such a huge impact on screening recommendations and overall awareness for a younger population.

Really hard at semiologists struggle with this, But when do you think we'll have a better idea about why this is happening because it has such a huge impact on screening recommendations and overall awareness for a younger population.

Yeah, these are incredibly difficult questions to address, and yes, epidemiologists are continuing to struggle with them. It is correct that excessive and increasing rates of alcohol consumption on a daily basis will increase breast cancer risk. Obesity increases breast cancer risk. Leading a sedentary lifestyle with the lack of adequate exercise on a daily basis, All of those patterns will increase breast cancer risk. The things that do not seem to affect breast cancer risk would be wearing a brazier or not wearing a brazier, or different types of brazil If.

Yeah, these are incredibly difficult questions to address, and yes, epidemiologists are continuing to struggle with them. It is correct that excessive and increasing rates of alcohol consumption on a daily basis will increase breast cancer risk. Obesity increases breast cancer risk. Leading a sedentary lifestyle with the lack of adequate exercise on a daily basis, All of those patterns will increase breast cancer risk. The things that do not seem to affect breast cancer risk would be wearing a brazier or not wearing a brazier, or different types of brazil If.

People think that really has an impact.

People think that really has an impact.

It seems to cycle like every couple of years. There are these yet on the internet about risk of braziers and breast cancer risk, but yet non association.

It seems to cycle like every couple of years. There are these yet on the internet about risk of braziers and breast cancer risk, but yet non association.

Yeah, but sometimes when.

Yeah, but sometimes when.

I used to take walks, I would stick my iPhone and my bra and then I kind of wondered, Oh, I wondered if that actually had an impact on my breast cancer.

I used to take walks, I would stick my iPhone and my bra and then I kind of wondered, Oh, I wondered if that actually had an impact on my breast cancer.

Do you think it did?

Do you think it did?

I don't think so.

I don't think so.

I do not think so. But I asked you about the diet. Ho I think I asked you about my dietoke. I was like, drinking twenty years of di coke? Did that lead to my breast cancer?

I do not think so. But I asked you about the diet. Ho I think I asked you about my dietoke. I was like, drinking twenty years of di coke? Did that lead to my breast cancer?

But you never?

But you never?

I mean, I think what's what the problem is. There's you know, people fill in the lack of knowledge with with uh, you know, ideas and speculation, and I think we really need to focus on that.

I mean, I think what's what the problem is. There's you know, people fill in the lack of knowledge with with uh, you know, ideas and speculation, and I think we really need to focus on that.

Are people studying this.

Are people studying this.

They are very aggressively, but it's so difficult to get a consistent and definitive handle on the answers because so many of these factors are poorly recalled by individuals. They're poorly documented, so it's difficult to accurately assess the quantity of different dietary components, the exposures to different pesticides, right, things that are in the environment.

They are very aggressively, but it's so difficult to get a consistent and definitive handle on the answers because so many of these factors are poorly recalled by individuals. They're poorly documented, so it's difficult to accurately assess the quantity of different dietary components, the exposures to different pesticides, right, things that are in the environment.

You believe in breast cancer clusters, you know, where you see a lot of breast cancer like Long Island by the way. Yes, that is that there have been reported a lot of cases in certain geographic areas or in neighborhoods, and you know, but it's never quite proven. And is that something that you think warrants more study.

You believe in breast cancer clusters, you know, where you see a lot of breast cancer like Long Island by the way. Yes, that is that there have been reported a lot of cases in certain geographic areas or in neighborhoods, and you know, but it's never quite proven. And is that something that you think warrants more study.

Yeah, absolutely warrants more study. And the clusters are very real. It becomes difficult to tease out though why those clusters occur because neighborhoods exist with people living in the same environment for so many different reasons. Families like to live together if they have certain lifestyles in common, or cultures in common, race ethnicities often want to be in the same neighborhood with each other. So there are just so many factors that go behind the reasons why a neighborhood is characterized by one pattern versus a different pattern.

Yeah, absolutely warrants more study. And the clusters are very real. It becomes difficult to tease out though why those clusters occur because neighborhoods exist with people living in the same environment for so many different reasons. Families like to live together if they have certain lifestyles in common, or cultures in common, race ethnicities often want to be in the same neighborhood with each other. So there are just so many factors that go behind the reasons why a neighborhood is characterized by one pattern versus a different pattern.

But it does make you wonder, like is there an environmental fact as way here? Is it like a certain kind of plant maybe nearby that or pesticides anyway, It's as I said, it's a lot of speculation. Let's focus on for the remaining time we have on the best way to prevent breast cancer and the best way to prevent a recurrence of breast cancer, because I think both of those are so important. We're all wearing our nice, comfortable, easy spirit shoes, and that makes me want to ask you about exercise and the role of being a physical activity in terms of not only breast cancer, but a whole host of diseases.

But it does make you wonder, like is there an environmental fact as way here? Is it like a certain kind of plant maybe nearby that or pesticides anyway, It's as I said, it's a lot of speculation. Let's focus on for the remaining time we have on the best way to prevent breast cancer and the best way to prevent a recurrence of breast cancer, because I think both of those are so important. We're all wearing our nice, comfortable, easy spirit shoes, and that makes me want to ask you about exercise and the role of being a physical activity in terms of not only breast cancer, but a whole host of diseases.

Yeah.

Yeah.

Yeah, exercise and continuing to move, being on the move is good for the mind, body, and soul, and it very definitely is valuable in preventing breast cancer and in having a better outcome if you have been diagnosed with breast cancer. Now, I don't want women and breast cancer survivors to feel that everything is on their shoulders and in terms of preventing a recurrence of a breast cancer or preventing it from being diagnosed altogether, because some things are simply out of our control. But absolutely we can provide ourselves some protection against a breast cancer diagnosis with a healthy lifestyle, balanced diet, and continuing to be screened. Because there is no doubt about it that early detection of a breast cancer, regardless of the breast cancer subtype, early detection of that breast cancer is a huge factor in likelihood of successful treatment, and if a breast cancer has been diagnosed, a woman has to be vigilant about her breast evaluation for both breasts for the rest of her life. She not only could develop a recurrence of the breast cancer in that breast or in other parts of the body, but.

Yeah, exercise and continuing to move, being on the move is good for the mind, body, and soul, and it very definitely is valuable in preventing breast cancer and in having a better outcome if you have been diagnosed with breast cancer. Now, I don't want women and breast cancer survivors to feel that everything is on their shoulders and in terms of preventing a recurrence of a breast cancer or preventing it from being diagnosed altogether, because some things are simply out of our control. But absolutely we can provide ourselves some protection against a breast cancer diagnosis with a healthy lifestyle, balanced diet, and continuing to be screened. Because there is no doubt about it that early detection of a breast cancer, regardless of the breast cancer subtype, early detection of that breast cancer is a huge factor in likelihood of successful treatment, and if a breast cancer has been diagnosed, a woman has to be vigilant about her breast evaluation for both breasts for the rest of her life. She not only could develop a recurrence of the breast cancer in that breast or in other parts of the body, but.

She can develop a whole new breast cancer. And it always breaks my heart when.

She can develop a whole new breast cancer. And it always breaks my heart when.

I hear breast cancer patients say that they just didn't realize that they have to be on the lookout for a new cancer developing.

I hear breast cancer patients say that they just didn't realize that they have to be on the lookout for a new cancer developing.

There's a Lenser's key.

There's a Lenser's key.

Yeah, there's exercise, and there's exercise, like for me taking a nice walk around Central Park and looking at all the people and the squirrels and the birds. But how like how intense should your exercise be? Because I think there's a big spectrum right from lazy to intense. Right, So do you have to really get your heart rate up? And can you give us some advice on that, Lisa, or is it kind of out of your well.

Yeah, there's exercise, and there's exercise, like for me taking a nice walk around Central Park and looking at all the people and the squirrels and the birds. But how like how intense should your exercise be? Because I think there's a big spectrum right from lazy to intense. Right, So do you have to really get your heart rate up? And can you give us some advice on that, Lisa, or is it kind of out of your well.

I don't think that you have to be manic about your exercise regimen, but making sure that you walk regularly throughout the day, take a flight, or two upstairs every day.

I don't think that you have to be manic about your exercise regimen, but making sure that you walk regularly throughout the day, take a flight, or two upstairs every day.

That will help.

That will help.

And if you break a sweat, it's a good thing, right. I don't like very sweat straightforward parameter. Okay, let's just talk quickly about diet and alcohol and sort of what you recommend. Should I not be eating bacon because it is my favorite food, it is my very favorite food.

And if you break a sweat, it's a good thing, right. I don't like very sweat straightforward parameter. Okay, let's just talk quickly about diet and alcohol and sort of what you recommend. Should I not be eating bacon because it is my favorite food, it is my very favorite food.

Well, it's all about balance, because I don't.

Well, it's all about balance, because I don't.

Want to hear the answer to that one. I love bacon. Oh, but I'm good. I took off both of us, so I'm good.

Want to hear the answer to that one. I love bacon. Oh, but I'm good. I took off both of us, so I'm good.

Bacon is probably not good for a lot of different things.

Bacon is probably not good for a lot of different things.

But yeah, it's all about balance in life and not overdoing it with any type of food on a daily basis, but especially fried foods, things like and fatty foods.

But yeah, it's all about balance in life and not overdoing it with any type of food on a daily basis, but especially fried foods, things like and fatty foods.

You don't want to overdo those on a daily basis. Same with alcohol.

You don't want to overdo those on a daily basis. Same with alcohol.

There are some cardiovascular benefits to some alcohol intake, but more than a couple of glasses on a daily basis is going to be bad for a number of different health issues, including breast cancer. Risk of diet that has a lot of fresh fruits and vegetables in it is excellent fiber. Fiber isn't a fiber? Yeah, yeah, And in general, all of the dietary patterns that are good for cardiovascular health are good for breast health.

There are some cardiovascular benefits to some alcohol intake, but more than a couple of glasses on a daily basis is going to be bad for a number of different health issues, including breast cancer. Risk of diet that has a lot of fresh fruits and vegetables in it is excellent fiber. Fiber isn't a fiber? Yeah, yeah, And in general, all of the dietary patterns that are good for cardiovascular health are good for breast health.

Let me ask you about genetic testing because I feel like a lot of people don't get genetic testing. They think it's too expensive or they think, you know, honestly, they sort of don't want to know. So who is genetic testing right for? And what would you tell your patients or anyone listening to our conversation about genetic testing.

Let me ask you about genetic testing because I feel like a lot of people don't get genetic testing. They think it's too expensive or they think, you know, honestly, they sort of don't want to know. So who is genetic testing right for? And what would you tell your patients or anyone listening to our conversation about genetic testing.

Well, fortunately, the costs of genetic testing have plummeted since the Supreme Court ruling in twenty thirteen opening up genetic testing to be performed by a number of different companies. The prices have plummeted, and we have large scale panels for genes that can be evaluated to look for hereditary susceptibility for a variety of different cancers, not only breast cancer, but we can identify hereditary predisposition for ovarian cancer, colon cancer, melanoma. Now, there are some people who believe that everybody should be genetically tested, at least for certain genes when they reach adult life. We haven't quite gotten to the point where that is broadly available to the general population. At this point in time, the United States and Services Task Force does recommend that anybody with Oshkenazi Jewish background should consider getting tested for specific BRCA mutations once they reach age thirty, because there's a very high risk.

Well, fortunately, the costs of genetic testing have plummeted since the Supreme Court ruling in twenty thirteen opening up genetic testing to be performed by a number of different companies. The prices have plummeted, and we have large scale panels for genes that can be evaluated to look for hereditary susceptibility for a variety of different cancers, not only breast cancer, but we can identify hereditary predisposition for ovarian cancer, colon cancer, melanoma. Now, there are some people who believe that everybody should be genetically tested, at least for certain genes when they reach adult life. We haven't quite gotten to the point where that is broadly available to the general population. At this point in time, the United States and Services Task Force does recommend that anybody with Oshkenazi Jewish background should consider getting tested for specific BRCA mutations once they reach age thirty, because there's a very high risk.

For your risk of breast and ovarian goes up to eighty percent if you'r BRACK a positive right.

For your risk of breast and ovarian goes up to eighty percent if you'r BRACK a positive right.

Exactly, That is so true if you do have a strong family history of breast cancer ovarian cancer, I mean multiple relatives with either of those cancers. If there are any men in your family with breast cancer, if you have in your extended family tree many individuals diagnosed with even other cancers such as coerectol or melanoma, those would all be features indicating that you should consider getting genetic testing done. If there's a bilateral breast cancer in the family, breast cancer being diagnosed at younger ages, for women that are themselves diagnosed with breast cancer at young ages, or triple negative breast cancers, these are all so features indicating that you might be more likely to have hereditary predisposition. Now I am a breast surgeon, The American Society of Breast Surgeons advocates in favor of all women who've been diagnosed with breast cancer, regardless of age, racial ethnic background, regardless of their pattern of breast cancer. If they are diagnosed with breast cancer, they should be offered genetic testing. And so I do offer genetic testing to all of my patients.