#308 | Mammogram Myths: Safer Ways to Screen for Breast Cancer with Dr. Jenn Simmons

I'm Cynthia Overgard, owner of HypnoBirthing of Connecticut, childbirth advocate and postpartum support specialist. And I'm Trisha Ludwig, certified nurse midwife and international board certified lactation consultant. And this is the Down To Birth Podcast. Childbirth is something we're made to do. But how do we have our safest and most satisfying experience in today's medical culture? Let's dispel the myths and get down to birth.

Hi, I'm Jenn Simmons. I'm the founder of perfection imaging. I started off my career as a breast cancer surgeon. And people ask me all the time, how did, how did you find breast cancer? How did you, how did you become this? And I didn't find breast cancer at all. Breast Cancer definitely found me breast cancer was really part of the fabric, the thread of my family, and there really was not a time in my life where I didn't know about it. When I was growing up, I had a first cousin. Her name was Linda creed. She was a singer songwriter in the 1970s and 1980s she wrote all the music for the spinners and the stylistics. She was beautiful, brilliant, larger than life. She walked into a room and just lit the place up. She wrote 54 hits in all, and her most famous song was the greatest love of all.

Oh my gosh. So incredible song I know. Oh so she wrote that song in 1977 as the title track to the movie The greatest starring Muhammad Ali. But it really received its acclaim in March of 1986 when Whitney Houston would release that song to the world. And at that time, it would spend 14 weeks at the top of the charts. Only my cousin Linda would never know, because Linda died of metastatic breast cancer one month after Whitney released that song. I was 16 years old, and my hero died, and her life, and ultimately her death, gave birth to my life's purpose, because I never wanted another woman, another family, another community, to have to suffer the way that mine suffered. And so I did the only thing I knew how to do. I became a doctor, the first doctor in my family. I became a surgeon. I became the first fellowship trained breast surgeon in Philadelphia. I became the first uncle plastic for a surgeon in Pennsylvania, and I did this really well and for a really long time, long enough for my aunt to be diagnosed, long enough for my mother to be diagnosed, and I was about 15 or 16 years into my career with the writing on the walls, and I went from being arguably at the top of my game and one of the most productive people you could imagine to I couldn't walk across the room because I didn't have the breath in my body, and I underwent this really intensive three day workup, And at the end of those three days, found myself sitting in the office of my friend and colleague and physician, and he told me that I needed surgery and chemo and radiation, and I was going to be on lifelong medication. And believe me, I appreciated the irony, and despite the fact that these were things that I said all day, every day, without hesitation or reservation, when these words are coming at you, I assure you, no matter who you are or what you do, they land differently. And despite the fact that I knew that this was the gold standard and standard of care, I could not silence the voice in my head that was telling me there's something more. Go look for it. And so I went on a quest. This was not a quest to change the way that we treat cancer. This wasn't about helping my patients. This was about me. This was totally selfish. This was how am I going to get myself out of this predicament? How am I going to live? How am I going to raise my children? And I was very fortunate, or maybe just, God is good, that very early on in this quest, I'm sitting in a lecture hall, and this tall, lanky guy walks on stage, big toothy grin, introduces himself as a functional medicine physician. Now bear in mind, I am a very conventionally trained physician. I am living and operating no pun intended in a very conventional medical world, and my cynical self is still alive and well. So all I could say to myself at that point was, what is this quack talking about? There's no such thing as a functional medicine physician. And then I remembered that I was sick and I was there for a reason. So I checked my ego at the door, and I tune in, and thank God I did, because what this man would say over the next two hours would not only telescope how I was going to get well, how I was going to heal, truly heal, but it was also going to dictate how I was going to spend the rest of my life. Because. Because my mission from the beginning was to help save millions of lives, and I was never going to do that as a surgeon, and I was never going to do that in the conventional medical space, because what I learned on that day, especially in the world of cancer, is that all of our focus is on the symptom. It's on the tumor. But the tumor is not the problem. The tumor is the symptom of the problem. And unless you back up 10 steps and ask the question, why is the tumor there? What are we meant to learn? What is our body telling us? What is this message, what do we have that we don't need? What do we need that we don't have unless we tune in and hear that and learn that and know that we're never going to get anyone better. And I knew I wasn't going to get myself better, and I wasn't going to get anyone else better by cutting out the tumor. So this quack was Mark Hyman.

Oh, I was wondering if it was Mark Hyman

and I credit him for saving my life. But I also, at the same time, want to say that my healing was not fast and it was not linear. It took me three solid years to come back to life, and in those three years, I submerged myself in the study of functional medicine. And when I came out on the other side, I came out a very, very, very different version of myself with the same goal to help millions of women, but the way that I was going to help millions of women completely changed, and I left surgery, and I started a functional medicine practice. And from there, I started to ask the big questions, things that were taught to me in medical school, and I assumed that someone did the due diligence right, and so things that I had accepted as undeniable truth suddenly became questionable, suddenly came into question, and that is where I am right now. I am questioning the things that we do all day, every day, to women, and whether or not we are truly serving them. Because what I what my legacy is, and it's already happening, is I am forever changing the way that we diagnose, the way that we treat and the way that we screen for breast cancer, and in doing that, I am changing the lives for millions and millions of women.

Well, you said that this is now where you are, where you're questioning but I think you're farther than that. Now I have created screening tools that are safer than traditional screening tools that we've been using for decades and really pushing on women quite heavily. So I am not close to having the knowledge that you do do obviously, but it's my understanding that the jury's really not out on mammography, like it's it's helped as many lives as it's arguably hurt, right? Because you're, you're screening with radiation, so there really isn't a consensus on mammography. I always feel uncomfortable with targeted radiation. It's also my understanding that thermography, ultrasound and mammography are all mutually exclusive. So the problem is, well, one, only one of those is radiation. They all only have like an 85% chance. So if you do two of them, you're down to, like, you've covered like 98% so can you comment on what you've created in instead of mammography, and also, is it true that each of those only has about an 85% chance at catching cancer, and they're all mutually exclusive? Is that correct information, what I've created is a screening paradigm, but I did not invent the technology that I talk about. I am, without question, the the face of the company, the ambassador for the technology, but I did not create it, okay, right? The technology that I talk about, which is Qt, was created by a doctor named John clock, who is both a serial inventor. He invented the cardiac calcium score. He invented the virtual colonoscopy. He has, I think, 13 unique patents, the Qt machine being one of them. And John is my partner. I am committed to making John's dream a reality across the world. That is my mission to make his dream a reality. So in terms of screening, what I talk about is a three tiered approach, and I think they're all important, but let's start all. Off with what is wrong with screening with mammogram? So we were all told for for five decades that mammograms are safe, that when they rolled out the mammographic screening program in the 1970s it was built on this foundational understanding that breast cancer growth is both linear and predictable, so that if you find a breast cancer when it's small, that you would both save lives and save breasts. And it is a lovely theory. It's a logical theory, and it just doesn't happen to be true. So breast cancer growth is neither linear nor predictable, and finding something small, if it has aggressive biology, is not going to change the course of that disease. And finding a large tumor that has unaggressive biology, it doesn't benefit to over treat that woman, and then there's everything in between. But when you use mammography as the tool to decide who does and doesn't get treated, what you end up doing is over diagnosing and over treating a large part of the population. So how the statistics go is that for every 2000 women that you screen, you will save one life, and you will cause anywhere from 20 to 50 women to be treated unnecessarily for breast cancer.

But does it drive up their mortality, or is it simply the the nuisance and the cost of being over treated?

No, it it treats it drives their mortality. Because here's the problem, if treating for breast cancer were a benign thing, then it probably aside from the the financial toll, the emotional toll, the physical toll, it wouldn't be that big a deal. Actually. It's horrible, all of it's horrible. But if you are treated for breast cancer, you are two to three times more likely to die of heart disease. You have increased risk of dementia, you have increased risk of osteoporosis, and as many women die every year as a complication of a fracture, as do with breast cancer. Can you explain a little? Can you explain more about that with the treatment of breast cancer? Why? Yes, driving up those risks. Absolutely no. Is it?

What is it? It's chemo, it's the anti hormonal treatments. It's radiation. So when we look at cardiovascular disease, chemotherapy is both directly toxic to the heart and chemotherapy, no matter where you are in the in in, in, in the hormonal cycle of life, shuts down your hormone production. And we know that estrogen is the hormone of life. So when you turn off estrogen, everything starts to rapidly deteriorate. Your brain starts to rapid, rapidly deteriorate your blood vessels, your your joint health, your skin health, your gut health, literally everything. And so chemotherapy is both directly harmful to organs and indirectly because of its because of its effect on circulating estrogen, and then radiation is also directly harmful to everything that's in its way. And when you're talking about radiation, you're not talking about just the dose that's coming to the breast. It's what's behind the breast also. So the muscles of the chest wall become very fibrotic, and people have breathing problems as a result. They have pain as a result. Then behind the muscles are are the bones the rib cage, and those bones become very brittle, and you can have a rib fracture from sneezing. There is a there's a mortality and morbidity associated with rib fractures. People die from rib fractures, and you don't need very much trauma to break a radiated rib. And then behind that is the heart, if we're talking about radiation on the left side. And despite the fact that the radiation oncologist will say that you don't get dose to the heart that we've we've refined our techniques, and you don't get dose to the heart, the statistics and reality says otherwise, because we do have an accelerated rate of cardiovascular disease in people who have had radiation, especially on the left side. We do have an increased rate of cardiomyopathy, of dysfunction from the heart muscle in people who have been radiated. So the facts tell otherwise, and we know that if you are treated for breast cancer, you are two to three times more likely to die of heart disease as compared to the woman who was not treated for breast cancer, and it's because the treatments alone. So we know that mammograms, statistically speaking, do not save lives, and every time I say that, I get 1000 people come at me my mammogram saved my life. And people really believe this, but statistically speaking, it is simply not true. And just because your mammogram found your cancer does not mean your mammogram saved your life. And we have major, major, huge studies that say otherwise. So the Swedish studies, 600,000 women divided into those that screen with mammogram those that didn't. Everyone has equal access to care, and everyone gets the same care. When you look at the two groups and compare them, the same exact number die of breast cancer in both groups, same exact number. The only difference is that there's a 20 to 30% increase in breast cancers in the group that is screening with mammography. We are overdosing by using this test, and overdosing is not benign, and when we look at the US statistics, the same exact number of women no matter how many mammograms we do to screen. The same exact number of women die of breast cancer each year. Same exact number no matter how many mammograms we do, the same exact number of women present with aggressive disease. And the only difference as year to year goes on, as we get more and more sensitive on the mammogram, as we use lower and lower criteria to biopsy people, the only difference is that we're just diagnosing more cancers, but we're not saving lives. And they they they manipulate the statistics, because they do it as a percentage of the cancers that they diagnose, but they're just over diagnosing. Well, what just overdiagnosing tumor is not found in the population that isn't doing mammograms. What's how are they finding their cancer by physical examination? How tell us by physical examination, yeah, can you talk

to us about the value of physical examination? I mean, as a midwife, obviously, I was trained to do breast examinations, but we certainly were not told to inform women that, you know, this is the best method for screening for their own breast cancers. I personally believe, I personally believe that being very comfortable with your own breast tissue is extremely helpful. I think it's probably the most valuable thing. But nobody would ever send a woman out of her annual exam saying, Oh, just, just screen yourself. Just get to know your own breast and, you know, don't worry about mammograms and don't worry about anything else. I mean, you're saying otherwise, or tell us Yes, absolutely. Well in I am first of all saying we need to worry about mammograms. We absolutely positively need to worry about mammograms. I am in no way saying that one mammogram is going to cause breast cancer, right? But who gets one mammogram? What we're what we're talking about is a screening paradigm that we're recommending to women and starting at 40 and screening through till they're 70 or 80, that that's not one mammogram, right? And most women, if you screen them over 10 years, the callback rate is 50% it's 50% of them will get called back if you screen for 10 years. So we are not talking about one mammogram a year. We're talking about probably two mammograms a year. And when you do this over time, it is absolutely additive, and it is undeniable that we are causing some of these breast cancers without question. By screening with mammogram, we are using a test that causes cancer, to screen for cancer, and in every other arena, if you ask, does radiation cause cancer, the answer is an undeniable yes, no matter who you ask. And then you ask that same physician, that same provider, if mammograms cause cancer, and there's a resounding NO, right, right? Well, they gave it away.

Well, now the technology, oh, years ago, they always like to say, in retrospect, you couldn't have tried, but in that day you could, oh, now it's just now that it's digital. It's so little radiation you get more by walking outside or being on an airplane. I. Always, I always hear that one like, they love on an airplane. They love the airplane explanation, right? Yeah. And they love to say, well, it's this, it's the same amount of radiation, okay, even if that's true, which I'm not sure it is. But even if that's true, yes, there is a huge difference between the scattered radiation that you get when you're on an airplane and the coned down focused radiation that you get to the tissues of the breast, which, incidentally, are already under compression, so they're already traumatized, and then you're radiating them that speak to that. Because I think that's actually a really important point, that when you traumatize breast tissue and then expose it to radiation. That's a much worse scenario, of course. Of course it is. I mean, think about how you how you respond to a toxin when you're at your best versus when you're compromised. It's the same exact thing, right? We are compressing the tissues of the breast. We're causing an active, inflammatory, traumatic state, and then we're exposing it to radiation.

Gina had a recent GYN exam. My midwife said to me, we don't recommend self exams anymore. And I said, I beg your pardon. Like, are you actually telling me whether I may or may not touch my own breasts. And like, do you actually have something to say about whether I examine my own breasts? And I said, That makes no sense to me, why? And she said, because we've found it makes women too nervous to do it. And I was like, I'm good. Thanks. I mean, this is on to that Yes, about race, this is this is that paternalistic medical model of Don't worry your pretty little head, and I'm and and they want us to continue. I mean, listen, if we've learned anything over the past five years, it's that they do not want us to think. They want us to fall in line, follow if they don't want to be questioned. They just want to they want you to farm out your health to them, but they do not have your health in mind. They don't have your health and interest. Well, you always know that when anyone responds to you with rhetoric like, follow the science. Or I, for one, believe in science, and we're talking about science. You're, you just cited a whole bunch of research. It's, it's just used to silence people and but it is but, but the audacity, truly, the audacity, of officially recommending to women that they not touch their own breasts. I just be a new level. It's horrendous. It is absolutely horrendous. Yeah. And so we need to take back our medical sovereignty without question, and we need to own our own bodies. I have a friend, Dr Sachin Patel, who is famous for saying the patient is the doctor of the future. And this is not to say that you need to be solely responsible for your own care. Of course not, and we are not asking people to do that. But no one is ever going to know you better than you know yourself. And if you're a doctor who examines you once a year thinks that they are the expert on your breast exam as compared to you. That is insane. That is insane, the student is the teacher in yoga. Yes, yes, exactly.

Very respect. And we are all our own lessons. We are all our own lessons. So I absolutely 100% advocate for people doing self breast examination. I believe in it. I in my experience, most young women find their own tumors. They're not found on screening, because we're not really screening them yet, right? So this is a very good and a very reliable tool.

If you know your own breast tissue well, then you know when something is different. If you put your hands on your breast and touch your breasts in the shower, and, you know, wash your breasts, or whatever you need to do to know your breast tissue, then you know when something is different.

Exactly. My point exactly, and that includes looking at your breasts and seeing what they look like, because if you know what they look like, you'll notice when they look different. If you know what they feel like, you'll know when they feel different. And this is a very, very important part of your medical sovereignty and independence. You need to know your body. You need to trust your intuition. And we need to stop farming out our health to people who don't have our health in mind. The best intentioned doctor, and there are a lot out there who are very, very well intentioned. Trained, but they're not trained. They're not trained to make you healthy, to keep you healthy, to get you healthy. They're not trained. I've always said that it shouldn't be called health care workers. They're medical providers. But to use the word health care is about preventing disease. I would think it's not health that's right, about treating which it which has its merits and it has its place, but to conflate the two, I think affects how we think. It changes how we think. So you now have people going to doctors for something like nutrition advice when they don't study nutrition. That's not where to go for nutrition advice if you want to ask about an antibiotic to combat some bacterial infection. Yeah, they're your person. But I think Americans get very confused about whom to go to for what. So it's like all roads lead to the medical doctor. And I think that that one change would make such a difference in our society.

I couldn't agree more. And we just have to remember that doctors are trained in dysfunction. That's all they're trained for. They're trained to recognize failure, and it's it's so well elucidated in the fact that when, when you go and have labs done, standard labs, right? And you get your labs back, and you're told all your labs are normal, no one realizes that these, these values of normal, this range of normal includes 95% of the population, 95% do you think 95% of us are healthy? Do you think 95% of us are ideal or optimized like far from it. In fact, I could probably argue that it's close to 95% of us that are not ideal. I think this goes back to that are not optimized, that the tumor isn't the problem. The tumor is a late stage piece of evidence of a systemic problem. And that's, I think, point is we, just because there's no tumor found doesn't mean we're healthy, and then people go about living their same lives, eating unhealthfully, not exercising because they didn't find a tumor, and they think they're good to go.

That's exactly right. And in fact, what I spoke about at a 4m this year at the American Academy of anti aging medicine was that I think we should probably be screening for metabolic disease with the same vigor and curiosity that we're screening for breast cancer, because if instead we were screening for metabolic disease, we would prevent 80% of breast cancers. Tell us why that is. Tell us. Tell us about the connection between metabolic health and cancer. Absolutely, absolutely.

So breast cancer is kind of the end of the line for metabolic dysfunction. It is the diabetes of metabolic dysfunction, right? And if instead you recognized the dysfunction early on and corrected it, you would never get to that bottom of the line. And we know that metabolic disease is both predictive of breast cancer and predictive of breast cancer progression, breast cancer outcome and breast cancer recurrence. And all your when you're talking about metabolic disease, are you talking mainly about problems with insulin and glucose, blood sugar? Talking about insulin glucose, I'm talking about waist circumference, I'm talking about blood pressure, I'm talking about triglycerides, and your triglyceride to HDL ratio. I'm talking about all of these factors that we look at when we are trying to determine your metabolic health. So we're looking to optimize metabolic health, and in doing so, we actually create health. And if you create health, disease goes away, right?

The best, the best treatment for cancer, is prevention, right? That is literally the treatment, absolutely, and it's, it's ultimately what everyone wants, but no one knows how to get there, because they're not looking. And so you know a doctor who you go to and your glucose is creeping up. What do they say to you? Eat more, eat less, exercise more, and we'll just follow this medication. Yet, is what they Yes, not ready for it yet. Like, this is the anticipation. This is the expectation. You're on this track. I know you've been told that it's just like, so we're basically actively waiting for me to become diabetic. We're actively waiting for me to get metabolic disease and and following all of that dysfunction is cancer, and it's not just breast cancer, it's colon cancer, it's a number of cancer. Cancers that are associated with metabolic disease, it's prostate cancer. So we could do tremendous, tremendous good if we really started to screen for metabolic dysfunction and intervened early on. But we we are a society that's driven by disease. Can you comment on what I was saying earlier, and you said you wanted to just clarify, and I'm looking forward to hearing your clarification on ultrasound thermography.

Yes, I was absolutely so I actually, so here's my screening paradigm. I believe everyone should be doing self breast examination. It's once a month. You don't have to examine your breasts every day. If you are pre menopausal, then you're examining yourself at day seven. That's the time in the month where your breasts are the least stimulated. If you're post menopausal, you're just going to do it once a month, and it doesn't matter when. So everyone should be doing self breast examination. Everyone should be doing the ARIA test. So this is the test that is run on your tears. It's at Aria dot care. And what this test is looking for are two proteins that are very prevalent in the very early stages of breast cancer. So it's the s1 100 a eight and s1 100 a nine proteins, and this test, if you have a clinically significant result, my response to that is, go have imaging. If nothing shows up on imaging, you have the inflammatory breast the inflammatory proteins that are the precursor to breast cancer, and you have the opportunity to prevent it, because you know that you are at increased risk of developing a breast cancer. So this is the time when you need to ask the questions and look around to see what the what may be influencing this production of this inflammatory protein. So that's the second thing that I do. I do the ARIA test. I do it once a year if you're out of average risk. I do it twice a year if you're at increased risk, meaning that you have family members that have breast cancer, or you have the BROCA, you have the BROCA gene, or you have some reason to be at increased risk.

Are those proteins only showing up in a body when there is inflammatory are they only an inflammatory marker for breast cancer? Or can they show up in the body for other reasons. It's very rare that they would show up for other reasons. The only other thing that we have found is if you have inflammatory bowel disease like Crohn's or ulcerative colitis, and you're in an active flare. So we tell people not to do it while they're in an active flow, they are just having the disease alone shouldn't trigger it, and it only and breast cancer, not cancer in general. It's only breast cancer. It's exclusive to breast cancer. And the interesting thing is that those are very early markers, because the place that that test fails is with late breast cancer or metastatic disease, so those proteins must go away, oh, in in the course of the disease. So it is truly indicative of the early stages of breast cancer, maybe even before it is clinically apparent. But that's the part that I love about it, is that it it gives you the opportunity to intervene before you even develop the disease. But the fault of it is that if it is late stage, and God forbid, there's already some kind of like, there's a tumor, something's happening, this test will no longer serve to catch it. So there must be the next thing, yes, after that, but, but if it's a late stage, no, you you should have other signs, right, like a mass in your breast, lymph nodes underneath your arm, signs of metastatic disease, like bone pain or something like that. So that's what it's missing. It's missing late disease, but that's already clinical disease that should be diagnosed without this test. And then the third thing is imaging. So let's talk about thermography. I love thermography. I think it's a great test when you're looking to see where the source of inflammation is. I think it's a terrible test the screen for breast cancer. Most breast cancers do not have enough of an inflammatory response to be able to have that test be positive. And I have seen so many women with breast cancer. Cancer. Have a normal thermogram. I do not recommend it as screening for breast cancer. I cannot recommend it as screening for breast cancer. Yes, it's 100% safe. It's not going to hurt you, but you cannot rely on its results.

Is it true that it's 85% effective? Which is it's fair, but it's not enough. But isn't there a point where there's enough vascularity around a tumor where it's got its own blood supply like it would have to be that late? Are you saying for thermography, but the thermography say they can catch it potentially 10 years early. So can you reconcile all of this information about so maybe and sometimes, right? But as if we want a screening tool, it has to be effective across the board, and that just isn't. It just isn't. It will pick up some for sure, but I don't think it's reliable enough to use as a screening tool or not as the only one I'm hearing. It doesn't hurt, for sure. It doesn't hurt, right? It doesn't hurt, but you cannot use it you cannot use it alone. Okay? You'd right. You'd never want to use it alone. Okay? You'd never want to use it alone. What about ultrasound? If you're ultrasound, so I love ultrasound. Ultrasound is not standardized. It's perfectly safe, but the resolution of ultrasound is low, so you're still going to have a lot of false positives with ultrasound. You're going to have a lot of unnecessary biopsies if you use ultrasound as your screening tool, and that's really what I'm trying to prevent. Because remember, 80% of biopsies are benign. 80% of the time we are biopsying A woman unnecessarily, and this takes its toll, even when the biopsy is benign. You once you ring that bell for a woman, you cannot unring it. You cannot unring that bell, she will always think that there is something wrong with her breast. She will always think that she's at increased risk for breast cancer, and we're really not serving people, and I think 80% of a negative biopsy rate is way, way, way too high.

Isn't there also some risk to damaging tissues in the breast?

To me that that is the minor part of it. If it were doing a better job, maybe I I still recommend biopsy, but I recommend biopsy when I think people need biopsy. Is there truth to the increased risk if you actually biopsy a cancerous tumor, that the biopsy can cause spreading of the tumor.

I have not seen that in my personal practice, and I have biopsied 1000s and 1000s and 1000s of women for breast cancer. And my my women who have turned up later with metastatic disease is exceedingly, exceptionally low. So if biopsy alone caused metastatic cancer, we we should see huge numbers, because everyone who gets who everyone who is diagnosed with breast cancer gets a biopsy.

Why would you say in your clientele, it's been so low the coming back. What have you done differently where it's been so rare that it's come back?

Well, I, at least for the last seven years, have taken a very, very holistic approach to breast cancer. For instance, I routinely did not give antibiotics prior to surgery. I don't believe in it. Breast surgery is a clean surgery, and we know that every course of antibiotics that you have in your lifetime increases your risk of breast cancer.

Sorry, that was a really important point you just made that a lot of people probably have never heard before. Yeah. Are you talking about? Does it make a difference if it's an oral antibiotic versus an IV? Is this because of how it disrupts the microbiome and impacts the immune system? Like tell us a little bit more about the relationship between antibiotics and increased risk. It definitely disrupts the microbiome, and it doesn't matter if you're giving it rally or IV, both of them will disrupt the microbiome. They also are immunosuppressive, and so this, and this is additive over people's lifetime, so the more the more antibiotics you have, the more micro. Disruption you're going to have, the the more weakening of your immune system that is going to happen, and it's cumulative. So we know that the more antibiotics that you have over your lifetime, the higher your risk is of cancer. So that is one thing that I did very, very differently than my colleagues. The other thing that I did differently than my colleagues is I universally did not use narcotics. I was very intentional about doing blocks with lidocaine and bupivacaine and things that just did local numbing for pain control, rather than give oral narcotics as pain control afterwards, and narcotics are immunosuppressive, and they also have profound negative effects on the gut, and that made a huge difference, because we know that people who take narcotics after surgery, after cancer surgery, have higher instances of recurrence. And then when everyone else was talking to them about getting back to their life, I was talking to them about eating whole foods and making sure that you're walking and moving and thinking about mindset, and are you filtering your water and, you know, stop cooking in non stick pans and throw out those seed oils. So granted, my patient population looked different than other people's patient population, but there were also things that I did differently that made a difference in the long run.

So back to your recommendations, self exam,

the the tier, the ARIA dot care test

imaging of some kind. So imaging if you don't, if you don't have access to Qt imaging, and I have two perfection centers, one in the Philadelphia suburbs, one in the suburbs of San Francisco, and I'm opening 10 more this year. But if you don't have access to Qt imaging, then I do say, have an ultrasound, but I'm only using that in coordination with the ARIA test, because if you have a clinically significant test and a negative ultrasound, then you know that you have the inflammatory markers and you should do things to prevent a Breast cancer diagnosis. And if you have a clinically significant test and an ultrasound that finds a lesion, I want that lesion to be biopsied, right? That That, to me, makes sense, but ideally, you'll be able to go have a perfection scan. And this is using sound waves, but reflective and transductive sound waves, so the ultrasound that is done with a probe that's just reflective. So that's why our our scan is has so much more resolution and and is so much more reliable, because we are using reflective and transductive and it's all delivered through a warm water bath. So it's an incredible experience where in as little as 20 minutes in a spa like experience, you can have a true 3d reproduction created of your breast, sending sound waves through a warm water bath.

Does it catch tumors? Or what is it? What exactly does it test? So it sees everything that everything else sees. So we can see calcifications. We can see masses. We can determine if those masses are solid or cystic. But the most important thing that I think this technology has, that nothing else has, is that it has volumetric measuring. And what I mean by that is, if we find a lesion that is solid, because the cystic things we don't worry about, if we find a lesion that is solid, we can bring it. First of all, I should say that if it's suspicious for cancer, if it's borders are irregular, if it looks like a cancer, we are immediately telling that person you have a cancer, until proven otherwise, and you need to go do whatever you need to do to get a diagnosis right. And that that means traditional imaging. That means everything. Because while I don't believe in screening mammogram, I am not throwing the baby out with the bathwater. We use, everything we need, everything we have when we when we are doing diagnostic examination, not screening. But diagnostic, why not an MRI? Sorry to interrupt, but why not an MRI? I mean, you, you can do an MRI. I just don't use Mr. For screening, because it has a tremendous false positive rate, and you have to have gadolinium. Gadolinium is a heavy metal I did and for screening, I meant if the Qt test find something, yes, well, then mammogram has its place. But does would MRI still be preferable or because of that diet? No, I don't think MRI would be preferable because MRIs are cumbersome and they're expensive and you you have to do gadolinium, and it's a long test, when you can probably get your answer a lot easier, a lot faster, and you're not going to want to use the MRI for biopsy unless you have to. So my preference at that point, if we identify something is for someone to simply get an ultrasound. But most centers that are doing this won't agree to that. How effective is the Qt screening? It's very effective.

I mean, it has a 91% sensitivity and a 91% specificity. So it is both sensitive and specific, more than more than anything else, and when when used appropriately. It's an excellent, excellent tool and the best standalone tool that we have out there. I don't think that anything should be standalone in that. I still think everyone should be examining their breasts. I still think everyone should be using the ARIA test. And if you have the ability to use Qt to scan to screen, you should be doing that. And mostly because there's no downside to it. It is 100% safe. It's more reliable than anything else, and it does have volumetric measuring. So if we find a lesion that we we don't, we don't think that it's cancer, we can bring someone back in a couple of months, re scan them and measure the volume and measure a doubling time. And we know that cancers have a doubling time of less than 100 days, and things that aren't cancer or aren't meaningful have greater doubling times. So we know exactly what we can follow and what needs a biopsy. So this will actually forever change that paradigm of who does and doesn't get biopsied, and it's going to make a huge difference, because we're mostly going to be biopsying the people that need a biopsy. The false positive rates will go down significantly. And that's what we want, because we don't want to put women through this roller coaster of emotion. We don't want to tax them with their time and their and their emotional energy. It's very painful to put women through this process again and again and again, but when you are using unsophisticated tools like mammogram to screen, that's exactly what you get outside of what we just talked about, as far as screening, can you give our community, maybe your top two or three tips, maybe four tips for what they can do in their life to reduce their chances of breast cancer or breast cancer development?

Yes, absolutely. So first is 80% of our exposure to the outside world is through what we eat and what we drink. It's through what we put in our mouth every single day. And so when you think about what you're eating, we ought to I don't get into the diet wars, like I'm not about vegan and I'm not about carnivore and I'm not about Paleo. I am about eating real food, mostly plants. So I think that everyone benefits from a whole food plant based, low glycemic diet. Everyone and where you get your protein from is where you get your protein from. I don't want to, like get into the politics of it all. It's not necessary, but we all need to be eating a whole food diet, all of us, that everyone in the diet space can agree, or the nutrition space can agree, processed foods are bad for everyone, end of story. I think that we all need to be thinking about the water that we drink and not drinking out of plastic bottles or plastic vessels. And filtering your water. And you can either have a Berkey filter that sits on your counter and use that for drinking and cooking, or you can have a reverse osmosis system that sits underneath your sink. Or if you're fortunate enough to have one to have for your whole house, amazing, but we need to be drinking clean water. So what you eat and what you drink is really important. Toxin avoidance is really important, and the two biggest toxins that actually influence who does and doesn't get breast cancer are alcohol and tobacco. And I think it's easy for everyone to say, Oh, well, you know, we all know smoking is bad for us, and it's so obvious, just don't smoke, and that same person is having a cocktail every day, and we have completely normalized alcohol and alcohol use and alcohol is probably aside from being overweight, the biggest modifiable risk factor we have for breast cancer. So according to the American Cancer Society, there is no safe amount of alcohol for women, no safe amount. This is one of those areas, and there are several where men and women are not equal. Our livers do not have the detoxification capability that a man's does. So a man can probably have a drink every day and not develop the pathology that a woman would. We simply cannot tolerate it. I think it has to do with we have a far more complicated hormonal system, and all of our hormones have to be detoxified by the liver. And if your liver is busy detoxifying the alcohol that you're putting in in your system, it cannot do the work that it's supposed to do, and it takes eight hours for us to detoxify alcohol. So I believe that that's the reason. But in any event, alcohol avoidance is so important. I'm not saying never have a glass of alcohol ever again. I'm just saying it should not be part of your daily routine. Maybe shouldn't even be part of your weekly routine. And if you are going to drink, it's one drink and no consecutive days, because once you get into that, your body simply cannot catch up, and it does a lot of damage. So what you eat and what you drink, alcohol and tobacco avoidance, and then cancer is a normal response to an abnormal environment. And it's those environmental shifts that happen that change our chemistry. They literally change our chemistry, and there are a number of things that are leading to that. So it can be changing our chemistry due to chronic emotional stress, it can be due to trauma, it can be due to the things that we're putting in on and around us. And so really, I included all of this in my book, The Smart Woman's Guide to breast cancer, which, quite frankly, is for everyone. That book is for everyone, because it is basically the guide to not getting breast cancer. If you have breast cancer, of course, it is an invaluable resource, but it's also for the woman who is looking to prevent a breast cancer diagnosis, because you will learn so much in the course of this book and so really thinking about your environment and avoiding those things that we know are going to disrupt your hormonal system. So looking around your kitchen, not cooking or drinking out of plastic, not cooking in with non stick pans with coated surfaces, and, you know, not storing your food in plastic and minimizing the amount of chemicals that you're consuming in your in your body, and then looking in your laundry room, what are you cleaning your clothes with? What are you not using dryer sheets, but instead choosing to have like wool dryer balls with with essential oils put on top and what are you washing your face with? What are you washing your hair with? What moisturizer are you using? Those kinds of things when you start to look around you and make better choices, it makes a huge difference, because our livers are charged with detoxifying so much, and the less work, the less work. Burden we can put on them, the better. And then the last two things that I'll talk about are movement. Movement is so very important, and if you don't move your body, you lose your body. So when we think about movement, we think about it in so many ways. I mean, we think about it certainly for cardiovascular health, but we think about it in terms of we have such stressful lives, and we're building up all of this cortisol, and if you're not moving your body constantly, you're not build burning off that cortisol, and you're actually changing your chemistry in your body to the chemistry of stress, which is the pathway to breast cancer. The other thing about movement is that our our muscle to fat ratio is actually dictating our metabolic health, and so we want to make sure that we maintain muscle mass, and the way to do that is to lift heavy things, so including that in your daily not your daily routine, but a few times a week, making sure that you're lifting heavy things to maintain muscle mass, which is not so hard when you're young, but if you can build it up when you're young, it's so Much easier to maintain it when you're older, and then having doing balance work and flexibility, work is the connection between your mind and your body, and that becomes of Uber importance as you age. So that's another thing that you want to build when you're young and maintain when you're old is flexibility and balance, so that you can maintain that, that amazing connection between your mind and your body, and then sleep is where the healing happens. So we all want to prioritize sleep, because if you're not sleeping, you're not healing. And we know that short sleepers, people with insomnia, people who even, even if you're getting the right amount of sleep, but you're sleeping at the wrong time, like shift workers, people who work during the night and sleep during the day. If you're not getting that restful sleep at the right time, your body is not able to repair, and this is where a lot of chronic disease comes from, especially breast cancer. So breast health is health, and the same exact things that you're going to do to drive breast health are going to give you a healthy brain, a healthy heart, healthy bones, healthy joints, healthy gut, healthy skin, healthy vagina, healthy mood, healthy appetite, all of it. So at the end of the day, we have so much more power than we think. Don't give your power away to someone who doesn't have your best interest at heart. The only person that can make you healthy is you. So do what you deserve and dedicate yourself to your health.

Thank you for joining us at the Down To Birth Show. You can reach us @downtobirthshow on Instagram or email us at Contact@DownToBirthShow.com. All of Cynthia’s classes and Trisha’s breastfeeding services are offered live online, serving women and couples everywhere. Please remember this information is made available to you for educational and informational purposes only. It is in no way a substitute for medical advice. For our full disclaimer visit downtobirthshow.com/disclaimer. Thanks for tuning in, and as always, hear everyone and listen to yourself.