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Welcome back to We Can Do Hard Things. We're back with Dr. Rachel Breb, who's sharing with us all the information we need in order to advocate for ourselves with doctors when it comes to detecting breast cancer as early as possible. Because that's the key. We got to know about it as early as possible when it is curable and treatable. So how to become our own best advocate? She shares with us what to
say and when to push to make sure our care is what it needs to be. Okay, Dr. Breb, I want to ask you about something really important. Black women and breast cancer. Black women have a 40% greater chance of dying from breast cancer than white women. What do black women need to know to do differently? Or is it the entire medical establishment that is failing black women and they don't need to do anything differently? The medical establishment needs to do things
differently. Yes and yes and yes. So a black women die 40% more frequently than white women stayed by stage of breast cancer. It is a multiple complex issue. One is that there are increased population risk. In fact, the American College of Radiology two years ago identified them as a high risk population. But there are other high risk populations like Ashkenazi Jewish women who have a 10-fold increased risk of having a genetic mutation that affords them a much higher
risk of developing breast cancer. So in the general population it's one in 400 who have this kind of mutation in the Ashkenazi Jewish population it's one in 40. So if you're in a room with 40 women one of them at least one of them is likely going to have a mutation that gives them a 60, 70, 80% lifetime risk. But black women it's multiple factors. One is access. We have to be cognizant of that. Now the good thing is that that's becoming more known and we're talking about that more. But the
thing that worries me is we can't just give black women additional access to mammography. And you might be surprised at unsaying that. But when we're doing this we have to be careful to make sure that we give them excellent care because we know that centers of excellent excellent care, sub-specialized care, radiologists who are dedicated breast imagers end up with better outcomes because the care is better, that they're cared at centers of excellence. So as we become more aware of
the health care disparity, breast cancer is not an equal opportunity disease. And you know we have to be mindful that all high-risk populations have the conversations with their doctors, but also that we educate them. And you know that's why you know what a wonderful thing you're doing. Because if you think you know there's so many people who have come up to me and said but I don't
understand why is it my primary care doctor telling me all this right? And you think about they've got to tell you about cholesterol and high blood pressure and exercise and nutrition and
breast cancer and lung cancer screening. It's a lot. And that's why at the Brem Foundation with the book No Longer Radical, we are putting some of the responsibility on women themselves and doing all we can to educate them so that if their visit to their primary care physician doesn't discuss, you know, essential additional screening, we have helped them understand that that is critical. That you know if they have a family member they have to start five to ten years
earlier. That if they have dense breast they need additional screening and that is not tomosynthesis. That is not essential additional screening. But we know that black women's pain and risk and all of that is routinely dismissed by the medical profession. So put us in the room and what do these women say and do in the face of institutional dismissal? I don't understand
how we could dismiss anyone, let alone a population that we know died at a high rate. One of the things that we're trying very hard to do and we are as a healthcare community doing is increasing the number of black women in clinical trials. And there has been a well-deserved distrust of clinical trials in some black populations and some black communities. And that's well-deserved, right? But we have to move beyond that because we have personalized medicine. You know, we have
personalized drugs. We have drugs for ER positive, ER positive breast cancer for her two positive breast cancer with incredible outcomes and results. We are now developing and one or two have been FDA-cleared drugs for people with mutations. People who have advanced breast cancer with black mutations, but if we don't know what your genomic makeup is or response to drugs, then we can't develop drugs that are as directed, personalized and targeted. So there is a big effort
and that is paying off, including more black women in clinical trials. And the awareness of the healthcare disparity is helping us to begin to alleviate these healthcare or impact the consequences of healthcare disparities. And we have some technology that's going to help us to like artificial intelligence at GW where I work. Every single mammogram is evaluated by artificial intelligence
and we use a wonderful AI called Transparabyte, company called Screenpoint. It's the only AI that's used as a second reader in Europe, in Europe, screening programs, government sponsored breast cancer screening programs, two radiologists have to read every mammogram to try to capture the earliest cancers. But now because of the paucity of breast imagers, they're allowing this particular AI to function as the second reader. And we know that it can find breast cancer earlier and it can
help general radiologist function as well as subsidized radiologists. So and the military, actually, our service people is another really underserved community where the healthcare is by generalists and there isn't enough of it. And so, you know, one of my projects now is trying to get AI into the military and into veterans hospitals because they really deserve that as well. And you said that the density that there's a new rule passing that will be when will it be effective that everyone
will be told their density? September 24th. So the FDA's mandate will go into effect with specific language, September 24th, 2024. And that will tell everyone whether they're dense or not dense or will tell them specifically if they're extremely dense or heterogeneously dense. Dense or not dense. Dense or not dense. Okay. And that will be it within the context of a mammogram. You go get a mammogram and then on the results of that mammogram, it will tell you your density.
Right. By law, every woman who has a screening mammogram is required to get their results in late terms within 30 days of their mammogram. And on that report will be their breast density. And although it doesn't say ABC or D as you point out, but all women, whether they're heterogeneously dense or extremely dense, should get additional essential screening to find these hidden cancers. Because even with women with heterogeneously dense breasts have hidden cancers.
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this, they say, oh, do you want a lump back to me? Or maybe you weren't offered that, but many women are, right? I know you were saying, do you want a lump back to me or a mastectomy? Well, I really don't want either. I don't really want breast cancer. And how could I possibly integrate enough information with all the nuances to make that decision? You need to know, yes, you might be for most people who lump back to me is enough, but your risk of recurrence is about a half a
percent per year. So if you're 40, by the time you're 80, you know, you've got a very significant chance of a recurrence and that might be okay, but it's got to be made eyes wide open, right? You've got to know that if you don't have bilateral mastectomies, if you have one, that your reconstructions not going to be the same. That's okay. But we have to embrace the differences of women, of people,
of choices. Even though some choices look so obvious to us, having done this for as many years with as many people, I've learned that everybody is different and we have to embrace that as long as it's done, eyes wide open with information. They're all good choices as long as they're medically sound. They're many different choices and the choices for different women are different. And that's okay. I love it. One thing I took from which Dr. Tiswick is saying, but one thing I took from
the book is that everyone has a bias. You as the patient, I have a bias going in, either I want to be as aggressive as possible or I want to be as conservative as I can be while still addressing the medical issues. Your doctor has a bias. There is no robot doctor. They are either on the side of there is over treatment going on and we are treating too many cancers and we shouldn't even be looking for certain cancers because they're not going to arise to be catastrophic or they're over here
with a super aggressive approach or somewhere in the middle. So your job as a patient is not to pretend like your doctor doesn't have a bias and your job is to sus out what is the bias of your doctor and is that bias aligned with yours? Because what they're telling you is not gospel, it's their approach. Right. So you need an approach that matches your approach by educating yourself by reading, by listening, by what feels warm to you and match up with a doctor that feels the same
because it is not they are not all the same. That's exactly right. And it turns out that if you have
a male breast surgeon, you are 35 or 40% more likely to have a lumpectomy than a woman. And I have to say many of my friends and colleagues who are physicians who have had breast cancer, you know, more than the general population have opted for mastectomy and even contralateral as you did the other side proactively because we have seen women who have made educated decisions with recurrences on the other side and maybe in hindsight, they would have made a different decision.
But it's very important to understand that there is a tendency now for minimal surgery. And that's okay, but understand that if you choose a lumpectomy that very likely you're not going to be equal, you're not going to be symmetric, that every time you look in the mirror or you run around naked that you see the consequences of being a cancer patient, I love my reconstruction. They're symmetric, they're wonderful. I love them and never for a second, even though the surgery
upfront was much longer and more difficult, do I regret that? So I think there is a bias now towards less is more and that might be good for some, but it's not good for others. And as you say, sus out the one, the doctor that sees the world as you do and you will find that doctor, there's so much on a woman diagnosed with breast cancer and this is one more on her must do list, but it is a must do. I just want to talk about over diagnosis for a second. Can I talk about that?
Please do, I'd love to, especially in the era of Viagra on demand, I'd love to know about our theory of over medicalization of women's in breast cancer. So I don't know how does Viagra work. Well, I just think it's like a man wakes up in the morning and it's his birthright to be prescribed Viagra and any other thing that might ale him for 30 seconds. Women, it's the idea of removing a breast cancer from you is like, whoa, that's a little much. Don't you think we're being
a little aggressive there? I just think it's an interesting double standard that we have about what constitutes over medicalization and okay, proceed. That's my bias. Yeah, that's interesting. I agree and that's why I love that. I'm going to borrow that if that's okay. Please do. Okay, so over diagnosis, there are some cancers that don't have the biological potential to kill. All right, and on Dr. Carson O'Men say to some of the low grade ones, a smaller percentage of them
will never develop the biological potential to kill. And that's over diagnosis. The problem that we forget to add as a breast cancer survivor, patient, whatever, we don't know which ones they are. Right. Right. So really, it's not over diagnosis, it's under information. Right. We will develop biological markers, genetic information that will eventually allow us to say, oh, that cancer has the potential to become a killer cancer, but that one doesn't.
And until we do, if someone said to you, you know, you have a cancer, two thirds likelihood, you're not going to die from it. One third, it might become an aggressive invasive cancer. We don't know which one it is. Do you want to treat it? Do you not want to treat it? And to me, that isn't over diagnosis. That's under information because someone who's stood in those shoes of having a disease that might, can maybe will shorten your life. I don't know. I kind of
want to live. I love life. It's under information, not under diagnosis. Some of those will become bad actors. We know that. So again, it's the bungee jumping versus crossing the street. If you like to bungee jump, maybe you don't want to treat it. Right. If you look both ways before you cross the street, well, maybe you'd like to treat it because you will have the best opportunity for a cure. Love it. Is there any way you could give us an overview of what all this genetic testing is? And how
sure, I don't even Abby is more of a guide for us on this, which I'm so great before. Well, sister actually was the real guide for us on this. Right. So what is genetic testing? Why is it important? Where do we get it? What the hell is Brocka? Love that question. So we have cells in our body every day that go awry. And we have proteins in our body that clean up those awry cells. So if we didn't have this cleanup mechanism, then we would get cancer a whole lot. But we don't
because we have this a barred cell cleanup mechanism like a zamboni. It's like a zamboni. Like it goes like it's like a zamboni. Okay. Okay. Great. But these are proteins and people who have genetic mutations have proteins that are malfunctioning. So the gene that codes them has a mistaken it. It's misspelled. So it doesn't do what it's supposed to do. The cleanup mechanism is broken. And so cells can become cancer a whole lot more often. And there are now actually 70 genes that
have been identified as a result of large data. And in fact, we tell women who were tested more than five years ago to get retested because we have so much more information. And you know, as Amanda had a variant of unknown significance, right? We're learning the significance of those every day, every year. So the protein malfunctions. And so your cell goes awry. And we don't have a way to clean it up. So the cancer grows. So it's a tumor suppressor gene that malfunctions. And
therefore, the cleanup mechanism doesn't work. It's important to understand like maybe in your family, it can come from your father as much as your mother. So if you have no cancer on your mother's side of the family, but a lot of cancer on your father's side of the family, breast, prostate, early, both breasts, other cancers, every gene is associated with various different cancers, then you can get it from your father as much as your mother. It's an autosomal gene. So
how do you get tested? Right? Very easy. It's not a blood test anymore. You can spit in a tube. You can get it online. There are a lot of different 23 and me. The Brem Foundation has an association with color genomics. When it first came out, it was thousands of dollars. Now it's 200 dollars. If you put the code Brem into color genomics, you get 50 bucks off. We're trying to
partner with lots of different entities to be able to offer everybody this opportunity. The best way to do it is to see a genetic counselor because then if the results come back, something that you need help understanding, you will have that help. But color genomics, which is what I know the best, has genetic counselors that will help you if you do come back with the gene. You know, this is by no means an advertising, but I'm sure the places that test have it or you
can go to your doctor or you can go to a breast physician who can help you get that. So that's what that gene is. Okay. And then what do you do? So you get your results back. You go to your doctor or you go to the website, you get the test for genetic testing, you spit in the thing, you get it back. It's a list of a lot of letters and different. No, it says there is or there isn't a deleterious mutation. That's the word they use. Oh, but it will tell you which one it is.
Okay. But you know, you'll understand everybody will understand it. Then what do you do? So if your genetic testing comes back and shows a deleterious mutation is what they usually say, you should definitely call your primary care provider as well as go to a place that has a high risk surveillance program. So usually cancer centers in your neighborhood make an appointment to see
one of the breast cancer doctors. You don't have to figure out the path most of us have patient navigators that will take you along this journey because it's way too much to integrate all that right up front. So we know that we have patient navigators go someplace that has a high risk, a cancer center or your doctor will send you to a cancer center that has what we call a high
risk surveillance program. And almost invariably there are patient navigators that will help you make the appointment for you or give you a list of what you need to know to start on this journey. That's exactly what happened with me. I was at my gynecologist and I said, I've been recently thinking about my grandmother and great-grandmother having either a variant or uterine. We don't really know. Is there genetic testing? She gave me the
genetic test. When she got the results back, she sent them to me and she said, I recommend that you go to one of these cancer prevention centers. I went there, then they took all my family history and looked at the density and plugged that all into a little formula and said, okay, you're three times the average likelihood of developing the cancer. So we want the extra screenings. So it was very
very simple in my case. It's very important to see an expert because they can help you understand both what other cancers, what surveillance approaches, what you can do to prevent cancers, prophylactic mastectomies, o-ferrectories, getting your ovaries out, or what kind of testing you need to find the earliest cancer for the genetic mutation you need. It's not a one-size-fits-all. So Brackle 1 and 2 were the first. And the other thing is for people to know that we still have a lot
of genes we haven't understood. We don't have them all to find. So, Kristi Tiel comes from a family that makes every sense that there may be a mutation. But in fact, there isn't. And is it that there isn't or that we haven't identified that mutation yet? My family, we do have a mutation. And we come from a family that looks like has a mutation. But it's important to realize a couple of things. One is
that some families don't have a lot of women. A lot of Ashkenazi Jewish families that might have lost a great parts of their family during World War II, that may not have large families, or you may come from a family that's largely men for whatever reason. So it's important to factor that in and a genetic cancer can help you. So that's what you do. You get professional advice because it's overwhelming. And there's a lot of information. And every gene has a different
strategy. But you also have to sus out people that have your approach as well. Aggressive or not. Both right, as long as it's information infused and eyes wide open. Okay. And I think it's so important when we talk about breast cancer, you know, I work at George Washington University. I can't tell you how often a professor at the university and some other department, I have the very difficult task of telling them they have breast cancer. And they say
to me, Rachel, I can't have breast cancer. I go to the gym every day. I'm vegan. I'm just the right way. Nobody in my family has breast cancer. You must be mistaken. And the answer is that we talk a lot about risk. We talk about density. We talk about family. Three quarters of women who have breast cancer have no other risk factor except being a woman. So I really have three quarters of women who have breast cancer have no other risk factor other than being a woman. That is correct. Sometimes
you're at the airport and you see how do you prevent breast cancer? We're really just on the threshold. We really can't yet prevent breast cancer. We have to minimize our risks to getting it, but nobody's immune. And that's a really important point to share with the people who are listening to this because just because you don't have any of the things we talked about, doesn't mean you can't get breast cancer. So then is the suggestion of that? And by the way, being a woman, men get breast
cancer, non-binary people get breast. It's really just anyone with breast. But does this point to the idea then that if 75% of people who get breast cancer, it doesn't have to do with genetics or dense breast, is it environmental? The American Cancer Society says that somewhere between 40 and 60% of breast cancers are environmental or at least have environmental component. But we really can't do much about that. And that's why we have to screen everyone. We can't just screen people
that have dense breasts or have family history. And in fact, we have to go further than that. So that's very important. But some people think that every woman should be tested for genetic mutation because Mary Clark King, the woman who identified the first mutation, said that any woman who dies of a genetically induced breast cancer is a failure of medicine. Because had we known early enough, had we followed early enough, had we done considered prophylactic mastectomies, we could have saved
the life? So that's a really important thing. And for me, breast cancer has been every part of my fiber. It's been what I do every day, my vocation, my avocation. I actually feel very fortunate that I sit on the board of a number of companies that develop new technologies. I've had been privileged to take technologies through FDA. So one of the thoughts that I really like to share is growing up, a really hated breast cancer. And then in my 30s, a really, really hated breast cancer. But now,
I have some new perspectives that, you know, I have passion and that's a gift, right? And I've been given a gift, a lifetime gift of trying to help others of taking something that's been very, very difficult for me as a child, as a daughter. I mean, Lord knows as a mother and trying to find the good in it and flipping it as much as possible. So, you know, I think there's many life lessons for me for everyone who's your one family has been impacted by breast cancer. And you will never
not be impacted by it. But, you know, I really have the highest admiration for what you're doing. You're taking a very difficult situation and you're helping others. And, you know, I'd like to think that there is some good in it. Better not to have it, all right? You don't have to have every disease to know what I'm helping people. But I am very grateful as both someone whose breast cancer is infused in every fiber of for being I'm very grateful for what you're doing.
Mm-hmm. Likewise, thank you for everything that you've done or doing and really great for all this information. Absolutely. We've all been there. You have a question about your credit card. You call the number for help and can't get a hold of anyone. If only you had a discover card. With 24-7 US-based live customer service from discover, everyone has the option to talk to a real person anytime, day or night.
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say, okay, so like if I were your daughter, what would you tell me to do? And it's always an interesting little teeny shift that often works and sometimes doesn't. For your children, what testing exactly do you tell them to do? What do they do yearly at what year did you start? I just want like you mom, what do you tell your kids to do in terms of testing? Secondly, I know we can't control environmental things and we don't know what the hell is causing the
cancer even. So what do you suggest to your children? They avoid or include in their lives that you suspect might be environmental triggers? Pretend the pod squad's just sitting in your living room. Okay. What are you saying? So I love that you asked that question and I often say to my daughters, it's a blessing and a curse to be my daughter. So I don't talk about them to respect their privacy. Sure. But so obviously from my mother had breast cancer, I had breast cancer, my aunt had breast
cancer, and we're Ashkenazi Jews. You don't have to be a genius to figure out where we're coming. So I'll talk about you and we can be family. So first of all, for Glenin, I'd say you should get an MRI, right? And I don't know if you're I tried to figure that I don't know if you know who's the older sister. So I know Amanda's age. I don't know your age 48 48 48 48. I'm for you. I'd say you should get an MRI, right? I think you should consider getting an MRI every year. Okay. I think you
should get genetic testing because I know Amanda has a variant of unknown significance. Maybe that will be one of those variants that will learn is significant. Maybe not. If you don't have it, you don't quite have it. Get out of jail free card, but you kind of have it. Get out of jail free card. I do have it. I do have it. I got tested. I do have it. So so that I think you should definitely get an MRI. I think she should get a mammogram every year and an MRI every year. And with a high degree
of confidence that if you do develop a breast cancer, hopefully we'll find it early. If you said to me, you know, Rachel, I want to do everything I can with the family, you know, you have a sister who had 45 had breast cancer. You have a variant of unknown significance. And you said to me, Rachel, I want to think about options for prophylactic mastectomies. I don't think you're off the table on that. Right? It's a big thought, but I think you're going to be safe with annual MRIs. I don't know
Abby's history. So it's very hard for me to address that. But, you know, I would say the algorithm for everybody is if you don't have dense breasts and you have no other risk factor, a mammogram finds way north of 90% of breast cancer. Okay? If you have a dense breast, get a mammogram every year and an MRI probably separated by six months, but that's kind of weak data.
Doesn't matter if you get it at the same time, six months, you know, or if you have dense breasts and you have the opportunity to get an ultrasound or molecular breast imaging or contrast enhanced mammography, that's probably enough if you don't have a family history. If you do have a family history and you have dense breasts, particularly if the breast cancer was early, or if you have upgraded than 20% lifetime risk of developing breast cancer, you should have an MRI every year.
That's pretty clear and that is what the American Cancer Society recommends. So it's not that complicated. It does get complicated when insurance doesn't cover it, things like that. But, hopefully, we address some of that that I can publicly say, I'd say think about reading no longer radical, it alludes to some of these things. There are ways of trying to stack the odds in your favor and I'll just leave it at that. Thank you. But always with truths, always with truths. You know, I want to
be very clear about that. And always with evidence-based medicine, we can't make things up, we can't make blank up, you know, you can't extrapolate from one study to the next, we really have to practice the best evidence-based medicine. And the other thing is, and Amanda, this speaks to you, but to everybody, we have to make the best decisions we have at the moment, right? And we can't feed ourselves up that in two years from now, we learned something new that would have changed
our decision. So for instance, I'm lack of positive. I had bilateral mastectomies and I had chemotherapy, right? The chemotherapy that I chose to have, and that's another thing, right? In what other universe of medicine do people ask you what chemo do you want? Right? But we still do with breast cancer, and there's so many other things about breast cancer that I wish I could share with you, but nobody would give a bracket person the chemo that I had. Obviously, it worked well, it's been
north of 25 years, but we have to make the decisions that we have now. And we have a lot of good things too, like there's something called cold capping now. So women who get chemotherapy can wear these cold caps. We were the first in DC to have it. Other places do gratefully as well. What it does is it puts very cold water around you know, on your circulates in a cap on your cap. So it makes the blood vessels close down so the chemo doesn't get to your hair follicles, so less hair falls out.
And you don't have to be the chemotherapy cancer patient, you know, that constantly reminded that you're bald. So, you know, we are trying to get personalized therapy, directed therapy, immunotherapy, but also trying to help with the emotional piece of it and understanding that that's really different for everybody. Thank you. Beautiful. Thank you for your generous sharing of all of this. Thank you. All of this information is so important.
And thank you. Really so grateful. Yeah, I feel the same. I feel very grateful for this opportunity and our paths across and I feel very lucky for that. So thank you. Thank you. We will link to your book and to the foundation and hopefully that will be a wonderful resource for people who want to learn more and want to help their friends learn more and because there's like this
pressure to self advocate and it's important and true. It's also so cruel that the moment we need to self advocate is the moment we're in the most trauma and the most confusion and the most flight of flight. And so there's also this feeling I have of wanting to like others advocate while we are healthy and not in the moment. What do we do to advocate for those who maybe won't be their
best self in the moment of their trauma. So all of us should go research this so that we can be informational study touch point when our friend or our sister or when it's really just a when the person comes to us. Yeah. And at the Brent Foundation, whenever we have an educational event, you know, we ask for three things at the end. We ask for you to advocate for yourself. We ask that if you learn something new, you share it with five people you love. That's how we're going to get
that information. And of course, we ask for support. But the most important thing is if you learned anything, share it with five people. And you know, and I'd be very grateful. There is a lot of information at Brent Foundation dot org. It's a way of really educating very useful information and also no longer radical. So there's a lot of information there and people can reach out to me directly as well. It's always a privilege to be able to help. Okay. And I just want to say this.
What do you want to say? Pod Squad. I know you're listening on your phones. And I know you've got friends. Get your phone right when you turn this off. Text your friends. Get five people on a text thread and say, my mammogram was this date or my mammogram is this date. When is yours? And let's start a tree, a pod squad texting tree of accountability and accountability. There she goes. There she is. This is what all of our dinners sound like. Is somebody says a word
and then she'll smush them together. Anyway, I think that one of the things is that we get really stuck inside of our heads. And the fear of I don't want to get this test or I'm afraid to get this test because I don't want to even get the results and have to go down that road. But it's easier for in groups. It's easier if we can feel that community even in the testing process. So here we
are for me the way my brain works. It's like mammography ultrasound MRI, right? And so get on a text chain with some of your friends figuring out which ones you've had if you've got dense breasts or not. If you need extra testing with the ultrasounds with the MRIs, do it, get your phone out now, do it now. You literally might be able to save one of your friends lives. Yeah. It can be the new. What's your sign? It's like, so what's your breast?
Boom. Yeah. What's your density? And remember that not knowing doesn't mean you don't have it, right? Knowledge is power. Not knowing is never good. Right? And if you have it, you can do something whether it's cancer, genetic mutation, higher risk. But if you don't know, you can't do anything about it. Right. Thank you. You're wonderful. Thank you. I am so grateful that our paths cross. Amanda, there are so many things, so many firsts that will come your way. I remember the first time
I bike road. I love to bike ride. So the first time I bike road after my surgery, I'm in I thought I'd never do that again. It's just like the world can seem a little sweeter. Hmm. I'm hardship. Thank you. Thank you. Thank you. All right, Pod Squad, go text five people. If you're like me and can't think of five, start with three. Five. You can think of five people. Fine. You're just show off with all your favorites list. Okay. We love you. We can do hide things.
Bye. Bye. Pod Squad, thank you for investing in your health and your future and your family by receiving and listening to this information. Please do do the loving and protective thing that Abby suggested and text five friends. You can share these two episodes with them to make sure they know about breast density and the screenings we need and then tell them when your appointment is and ask them to check back when there's a scheduled. I can't imagine anything a friend
could do that would be more important and loving than that. Before we end this episode, please know how deeply grateful and amazed I've been with your outpouring of love and support through this whole process. It really does feel like we're all connected in a family. And we have to look out for each other like family. And that's what so many of you did when you called in to share your hard one wisdom from walking through this so that we could all learn from
your experience. Here's just a few of the beautiful voicemails you've been sending. Thank you, thank you, thank you for being in this community and for sharing your love, advice and stories so openly. It truly is a gift and a service. Here they are. Amanda, thank you so much for the podcast about your diagnosis and encouraged me to call my doctor because I have dense breast tissue. And my dad had breast cancer which is kind of rare. My aunt and my cousin all had breast cancer.
So I feel like I'm a little bit more high risk and I didn't know what kind of density I had. So I called and found out the 40% but I still should be getting something besides the 3D mammogram. So I'm going in next week to get a ultra they said start with an ultrasound screening. So I'm doing that next week and I'll thank you and it was quite funny when I called my doctor and said yeah I think I want to find out what kind of breast tissue I have. I have a friend. That was so funny. I mean
that just sounds so funny. I refer to you as my friend. Oh my gosh I just I listened to your podcast all the time and I feel like you guys are friends. I know we've never met but anyway thank you. Thank you. Thank you. Hi, Susie. It's Katherine. I wanted you to know that I'm a cancer researcher and based on everything that I heard that you have shared I believe that you have such a great prognosis as somebody who has a immediate family member who's a cancer survivor and then
as somebody who really cares about you because they really identify with a lot of the things that you're working on and the growing that you're doing I just wanted you to know that I'm in your corner along with all of the rest of the week and do hard to expand and I'm just thinking about you. Thank you so much for sharing what you're going through with us. Hi this is Paula. I'm 52 and I have been a listener since episode one. I just wanted to respond to Amanda to tell her I have
processed my cancer exactly the same way. Do not have any shame about it. You are the same exact person that I am that you were in the test full approach of getting things done for everyone else. You will process the emotion. I am once into this journey and it takes a while but as you all the best it is a scary thing to have little kids through my children were six and nine when I was diagnosed and I have a very rare form of lymphoma that was found in my breast tissue.
So a lot of the somewhere things with MRIs the mammograms you don't see it we see it. Anyway I just wanted to say I wish you all the best prayers are being sent and you ride this cancer ride however you will and that is there's no right or wrong way to do this at all. There's no right or wrong way. You do you and you will climb at this and even bigger warrior. Love you guys.
Hi my name is Katie and I just want to say thank you. I was recently diagnosed with early state breast cancer and just had them affect me and I'm going to reconstruction and have a very similar journey to Amanda and I'm so thankful that people like you were putting this out there because it's so important that people and women know about this happening to younger and younger women all the time. So scary I'm 49 years old and this came out of less field for me so best of
less and things again. My name is Jenny and I just wanted to say a big thank you to all three of you but specifically Amanda for sharing where you're at the missing middle of this breast cancer diagnosis we're all sharing for you. I so appreciate your candomis and openness and I thought it was so beautiful in the second episode where you were all kind of doing a repair around that moment of Amanda saying that she refuses to take any shame for not feeling her feelings right
now. I just thought that moment and that all of this so powerful and then also I just appreciate so much because I just got a call back that I need to go for a more thorough mammogram and that I have dense breasts but now I already know more of what to ask now because so many people are just told dense breasts and so now I know so many more questions asked so I just wanted to thank you for that you by sharing this are also saving lives and helping other women advocate for what they
need. Thank you thank you thank you thank you I'll be thinking about you. My name is Rebecca. I am a writer in San Francisco and a big fan of your podcast. I was diagnosed with breast cancer in 2021. One thing I like talking about is what to say to someone with cancer and how to help for me the most valuable thing anyone ever said to me was when one day my husband took me to chemo he just turned to me and said simply thank you thank you for doing all of this for us thank you
for having surgery and going to chemo. I've been working on writing about how useful that was for me to hear and I've made sure to thank other cancer friends for all they were doing to stay alive and persist. Thank you Amanda we need you. I thought that might be a helpful tip for going in the abbey as I'm sure you must be wrestling with what exactly to say to Amanda who as she pointed out in the end has to go through this alone. Thank you all for what you do.
Hello my name is Becky and I'm sure that you have received hundreds of thousands of not millions of calls that people wanting to give their well wishes to all three of you and tell their cancer story. I am a 10 year cancer survivor and I have to say that I processed much like Amanda so far what we've been told is processing. I was never emotional about it. I didn't cry about it. I was just like
in planning mode as Amanda and I are a lot of like in that way. I had a unilateral respect to me on the left side and they actually removed seven lymph nodes in the chain that had also been infected with the cancer but I know you guys will all get through this. I know everything is going to be okay best wishes to all of you especially Amanda and for family. Thank you so much. I really love the pod just in all the time. Don't know what I did before you guys came into my life.
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