This is the Ben and Ashley I Almost Famous Podcast with iHeartRadio.
Hey guys, welcome to the Almost Famous Podcast. To this week, we got, you know, very sad news that Katie Thurston has been diagnosed with breast cancer at the age of thirty four, and she said in her Instagram post that she wants to share her story to help others. So we hope that we are supporting her and doing that by having on Doctor Ammani Jambacar, thank you so much for coming on our podcast.
You guys.
She is a board certified surgeon who first got her Bachelor of Arts in English, which I'm interested about your switchover, and then a bachelor's in science and psychology, and then you went over to the biology side and you ended up getting your Doctor of Medicine at the University of
Texas Health Center. And you have been on you know, you speak a lot about breast cancer, and you were on Shannon Doherty's podas who of course sadly passed away this year, and you spoke with her about breast cancer. She was part of the iHeart family, So we just want to thank you for coming on and talking to the Almost Famous Bachelor audience about something that has affected
one of our favorites so sadly. So first off, I kind of want to ask the to me, it's obvious, why should that we're hearing more women in their thirties being diagnosed with breast cancer?
And should we?
I think we should start getting mammagrams earlier.
Earlier than forty or earlier earlier than forty.
Yeah, so that's an interesting question, and I do. I have quite a few patients that are in their thirties. I've seen patients in their twenties, and the youngest patient I've had with breast cancer is nineteen.
Actually, Holy molly.
Yes, so it is definitely something that impacts younger women as well. I think that overall, we're seeing cancer incidents go up in younger people, which is why ages for
things like colonoscopies are going down. I think that everyone who has a family history of breast cancer, pancreatic, ovarian, really any kind of cancer does need some kind of risk assessment, and some people, yes, should start getting mammograms and potentially MRIs as well earlier, you know, in their twenties and thirties, because they are high risk for developing a future breast cancer.
When we say family, are we talking parent grandparent? Does it go further back than that? Does it should be two grandparents? Because so I'll share a little bit of a personal story in a bit. But my paternal grandfa grandmother high breast cancer in her seventies. Oktal's totally fine, but the doctors say that I'm much more at high risk because of that.
Yeah, So when we're talking about a family history, we're talking about first degree relatives, which is like your mom, or if you're older, your daughter or one of your sisters, or second second degree relatives, which include grandparents as well as aunts and uncles or half sisters, half brothers, and yeah, to speak to your family history. Generally, people who are high risk have family members who have been diagnosed at a younger age, usually before menopause. So that's usually like
in their forties, thirties, et cetera. Usually being diagnosed in your seventies is not something that particularly increases, you know, you as the granddaughter, your risk of a future breast cancer.
But it is something that I think everyone who has a family history needs to have a conversation with either their primary care doctor, their obgyn, or with you know, a breast surgical oncologist like me, just to figure out where you are in the spectrum of risk, especially if you've also pre obviously had a lump, you've had a biopsy for some reason. All of those things matter.
So you are a breast oncologist surgeon, So this is basically what you're doing all day long is taking out cancer out of breast.
Yeah. So I'm a breast surgical oncologist that did my fellowship in breast surgical oncology at Columbia, and there I also did a lot of melanoma. So my practice is a mix of taking out breast cancers, also counseling patients about their risk in our high risk breast clinic, and also quite a bit of melanoma as well.
What inspired you to go into that department.
That's an interesting story. So I was the only I was one of a handful of women who chose the surgery route from my medical school class, and then I was the only woman in my graduating class in general surgery. And I really wanted to be in a field that I thought would enable me to how are women. And I also wanted to be in a field that I thought was really evidence based and for that, you know, doing both breast cancer and melanoma fit the bill for me.
And then I was lucky to get into my fellowship at Columbia and I'm now in my six year of practice and I absolutely love it. It's definitely where what I was meant to do.
Congratulations, that's amazing, Thank you so much. Good obviously.
All right, so we're all told to do our examinations at home starting at what age.
So it's kind of like, you know, this is gonna be a little bit controversial, but I'm kind of like, you know, a lot of times I'll see people in the office and they'll have been diagnosed with a breast cancer and it might have been a breast cancer that they felt, but they will say something to me like, oh, you know, doctor Jambicar. I know I'm supposed to be doing like monthly self breast exams, and I just haven't
done them. I've missed a few, So this is my fault because I didn't do them, and I always have to tell them like, actually, really like self breast exams don't make as much of a difference as breast imaging, and so I recommend breast awareness to my patients like generally just knowing, you know, especially when you're in the shower you're soaping up, knowing what your breasts feel like.
Especially for younger women, that may mean that your breasts are kind of lumpy because they're dense, and that's okay. And then really, the thing I hammer home all the time and literally all the content I put out there on social media is if you have a lump, it
needs to have some kind of imaging follow up. So you have a lump, you go and see exactly like Katie did you know, You go and see your doctor and then you get an ultrasound or a mammogram or both ordered, not just a doctor saying, oh, you're too young to have breast cancer, so this is probably nothing.
So when I was twenty two, I was just you know, I've always had a pretty dense breast.
Yeah, I don't know that you call it.
Would you call them cystic?
I mean, I think that word gets used a lot, but I think that like, really virtually everyone who's in their twenties has dance breast that a lumpy okay.
So there was one spot where it was like particularly like it was it was a lump, okay, but it was smooth and it moved and it was very marble like oh, which is all good signs, but still signs of course that it should probably be checked out. Yeah, so I did. I got a mammogram at twenty two and got an ultrasound and then they biopsied it. Okay, they tagged it and they said and then it was fine.
And then I got it checked up. Probably probably too late, I mean probably later then I may have should have, but like around thirty I did it. I got it checked out again, and my doctor, knowing that history and then knowing my grandmother had it, she was like, okay, well I want to just send you in for another ultrasound and mammogram. Did that found some calcifications that they ended up biopsying again. That biopsy I like basically fanted during Yeah.
Those are the mamogram buses are rough.
Yeah, it was crazy.
I was like, there is an instrument inside my body right now. And then just last month I went and I got my check like four years later on all of that again ultrasound and mammogram, and I'm all good. But there's always there's like a lot of women out there that are young and like things are flowing around, and it's it's best that they take action, right.
It's definitely best that they take take action. And I mean I see it all the time, like lots of young women like you have, you know, these kinds of benign findings or a lump that moves around and is
something that doesn't really need to be removed. But I also see, you know, as a cancer surgeon, I also see the other side of that, women who went to some doctor or an urgent care or something like that and said, hey, I've got this new lump and it's not going away, and it's not changing with my periods. It's just there all the time. I don't know what to do with that. And then someone examines them and says, well, it's probably just a cyst. It's probably nothing because you're
too young to have breast cancer. And then the thing keeps growing. They go see another doctor and someone says the same thing, and then by the time they finally get breast imaging ordered, at that point it sometimes isn't
early stage anymore. And so just very very important that if you feel something or you see skin changes, you have new nipple discharge, anything that concerns you that you take it to your regular doctor, your obgyn and ask them, you know, hey, can you order some breast imaging for me?
So when you're checking like mine was, as I said, a little bit less alarming because it was smooth marble, I can moved around. It's basically the opposite that you're really looking out for correct like edged and then discharge and then it's kind of stays in one spot.
Yeah, it stays in one spot now. I it kind of depends on the depth of you know, the thing, the lump in the breast, Like there are some that could be deeper in there that do move around because there's a lot of breast tissue in front of it, and there's some that you know, I've even seen patients say this feels hard like a marble with the edges aren't like a marble, And so, you know, I think what you're looking for really is something that is there and it's hard, and it's not going away on its
own after a week or so. And if it's not going away on its own after a week, then you know it needs to be checked out. And sometimes people tell me something like you know, I fell, or you know my dog bit me or something like that. You know, I had some kind of trauma here and it started after that, but then it never went away, and now here we.
Are interesting, okay.
And then what's the proper pose when you're checking yourself out? Isn't it with your arm up like over your head?
Yeah, your arm up and then just kind of going in circles, starting from the nipple going working your way out, but with your arm up or down. It doesn't really matter, you know. I think it's kind of whatever's comfortable for you. Just sort of be aware of what your breasts feel like. Everyone should be aware of what their breasts feel like. But I do see the ones that are lumps of either the cancerous kind or the benign kind. I see
a lot like that. They found it when they were in the shower, you know, they're soaping up, and they were like, oh, this is this is new. I haven't felt this before, and so that kind of vigilance. I definitely recommend, you know, doing a monthly self breast exam or setting you know, a calendar appointment for yourself to make sure that you check them. I don't think women should be held to that because it's so hard to do.
Life as a woman as it is, there's so many extra responsibilities on our plates, and so you know, I don't want anyone coming into my office and feeling some kind of guilt or shame that like, oh I should have checked myself earlier and this would have you know, solved the problem, right.
I want to pick your brain about what you think is maybe a correlation. So lots of people are thinking that maybe birth control increases your odds. What's your opinion of so birth control, like hormonal birth control interesting?
Yeah, it's kind of interesting because it's like it does slightly increase the risk for breast cancer, but it also decreases the risk for ovariant.
Carey cancer, you know, if you're right.
So it's kind of like, yeah, so like in terms of modifiable risk factors for breast cancer, I mean I would say, like not drinking an excess is one of them, and that's kind of it. You know, most of the time breast cancer boils down to bad luck. That's what I tell my patients all the time, because I have patients who you know, have never taken hormonal birth control, who have no family history, who are super healthy, never drink, never smoke, exercise, you know, forty minutes a day, every
single day, and they can still end up with breast cancer. Conversely, I've had patients that have all those risk factors that never end up with breast cancer. And so it's really the most important thing is like, if you do have a family history, to get that checked out and to figure out what your future breast cancer risk is, so you could see if you do need to start your imaging earlier than forty. But then if you are forty, you need to be getting a mammogram every single year.
It might mammogrant plus an ultrasound might just be a mammogram by itself, could be a mammogram and an MRI, but mammogram has to be in there and definitely definitely definitely not a thermogram because those are not evidence based and cancers get really missed on those.
What about soy? I know people are considered about soy even deodorant.
Yeah, there's a lot of stuff out there about those, SOI like, it's kind of there's not a very strong study that says like if we cut out soy from our diets, it means that you won't develop, you know, an estrogen responsive breast cancer. And so there's not really like there's really no preventing it, so to speak. You know, I think it's just living a healthy lifestyle, and you know,
minimizing drinking I think is important. But you know, any people who avoid all of those things, who kind of see any study that has sort of a weak link to breast cancer, and you know, there was a study that talked about hair dye, for example, recently, and people who are like, Okay, I'm gonna stop dying my hair, like in the end, Like that amount of difference is so small compared to the biggest risk factors for breast cancer, which is being a woman and having breasts and getting older.
This is maybe a little bit off of the breast cancer question, but you did mention that younger women have denser breasts in their twenties. So I had two kids over the past three and a half years. One is literally screaming his head off right now. So if I seem a little elsewhere, I don't know what's going on. But didn't you have breastfeed and my breasts are now not at all dense, They're like squashy.
What happened?
Yeah, that happens. You know, I've seen that before, well, that does happen, you know, it's breastfeeding. That's one of those things that I think they really don't tell women before they like choose to breastfeed or.
Choose not to breastfeed.
Though. Yeah, so breastfeeding definitely does make your breast less dense. Interesting, and pregnancy also like you know, formal impacting the breast, the breast expanding, filling and then unfilling, filling and then unfilling. Yeah, so a lot of women tell me that, you know, and I can even tell you know at this point because I see a lot of patients in my office and do a lot of breast exams, I can tell
you know who has breastfed and who hasn't. And that's something that really they should tell a lot more women that, like, hey, your breasts are going to be changed after this, and sometimes that can be a little bit surprising to people. But in general, breasts also get less dense as you get older. It's very uncommon to see people with very very dense breasts, you know, in their seventies and eighties, although rarely I do see it.
I wonder I'm reading Katie's caption right now. Yeah, so she has invasive ductal carcinoma.
Mm hmm, it's invasive ductyl mean.
So there's two parts of the breast. There's the ducts that deliver the milk out the nipple because the breasts were the whole function of breasts is to breastfeed. That's what they were designed for, right, And so there's two parts of the breast, the duct that leads the milk out the nipple in order to do breastfeeding, and the lobules which actually makes the milk. And that what she's saying is that her cancer started in the ducts of
her breasts and not the lobules. It's that's the more common type of breast cancer rather than the lobules, and that that's it's invasive, meaning that it is now forming a mass outside of that duct.
Okay, I don't want to speculate on what stage she's at or you know, the intensity that she's going to have to go through. I just want to say that again, we're thinking about her and we're sending all of our love out to her. Is there anything that I missed in this conversation that you think is critical for women out there to know?
I think we pretty mu covered it. You know, I think she is doing women such a service by putting all of this out there and really almost in real time, being so transparent about you know, I know that she had a biopsy of the breast, a biopsy of the lymph node, and that's probably why you mentioned chemote therapy. That's probably why she's getting chemote therapy is because the cancer has spread from the breast to the lymph nodes.
And so I really commend her for putting this information out there for women, especially for other young women to see and to know that you know there's steps ahead. These are the steps ahead, and that you know she's a strong person who can get through it, and if God forbid that happens to them, they will also be able to get through it. So it's really what she's doing is so incredible because it can be such a terrifying time for people. So I really commend her me too well.
Doctor Jan mccarr, thank you so much for being here and answering all these questions.
Thank you for what you do. You're incredible.
And you know, if we ever encounter anything like this again, or if Katie has any more updates, we'd love to have you back.
Yeah.
Absolutely, I would be happy to share. Thank you so much for having me on today.
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