cover of episode #278 ‒ Breast cancer: how to catch, treat, and survive breast cancer | Harold Burstein, M.D., Ph.D.

#278 ‒ Breast cancer: how to catch, treat, and survive breast cancer | Harold Burstein, M.D., Ph.D.

2023/11/6
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Harold Burstein: 本期节目讨论了乳腺癌的广泛话题，从乳房解剖结构和内分泌因素入手，涵盖了从癌前病变到浸润性乳腺癌的各个方面。他介绍了乳腺癌的三大类，并深入探讨了各种筛查方法（包括自检、乳房X光检查、超声和MRI），以及早期筛查和检测的持续性争论。他还探讨了癌症治疗的最新进展，为个人理解其独特情况提供了宝贵的指导，并阐述了遗传学在乳腺癌中的作用，以及较少讨论的男性乳腺癌问题。 Peter Attia: 与Harold Burstein博士的对话深入探讨了乳腺癌的各个方面，包括乳房解剖结构和内分泌学、乳腺癌发病率的上升、女性一生中乳房的变化、不同类型的乳腺癌（包括导管原位癌和小叶原位癌）、乳腺癌筛查方法（包括自检、乳房X光检查、超声和MRI）、不同类型乳腺癌的治疗方法、遗传学在乳腺癌中的作用以及男性乳腺癌。对话还探讨了关于积极筛查乳腺癌的争论，以及如何理解乳腺癌的三大类及其治疗方法。 Harold Burstein: 乳腺癌是女性第二大癌症死因，美国女性患乳腺癌的终生风险约为八分之一，但只有少数病例会致命。乳腺癌发病率的上升可能与女性青春期提前、月经期延长、生育子女较少以及哺乳时间缩短有关。乳腺癌主要分为三种类型：雌激素受体阳性、HER2阴性乳腺癌；三阴性乳腺癌；HER2阳性乳腺癌。不同类型的乳腺癌具有不同的流行病学风险因素和预后。

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El cáncer de mama es la segunda causa principal de muerte por cáncer en las mujeres. En este episodio, el Dr. Harold Burstein analiza el cáncer de mama, incluidos la anatomía de la mama, los factores endocrinológicos, los tipos de cáncer de mama, los métodos de detección y los últimos avances en el tratamiento del cáncer.
  • El cáncer de mama representa aproximadamente el 12% del riesgo de por vida de una mujer estadounidense.
  • El cáncer de mama se origina principalmente en el tejido glandular.
  • La nutrición, la pubertad temprana, la cantidad de embarazos y la duración de la lactancia pueden influir en el riesgo de cáncer de mama.

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Harold (Hal) Burstein is an internationally renowned breast cancer expert. In this episode, Hal discusses a broad range of topics related to breast cancer, starting with the intricacies of breast anatomy and the endocrinological factors at play. He covers the spectrum of breast cancer, from precancerous lesions to invasive breast cancer, classifying these conditions into a helpful framework. He delves into various screening methods, including self-exams, mammograms, ultrasounds, and MRIs, and addresses the ongoing debate surrounding early screening and detection. Hal provides insights into the latest advancements in cancer treatment, offering valuable guidance for individuals to understand their unique circumstances within the three primary categories of breast cancer. Finally, Hal delves into the role of genetics in breast cancer and brings attention to the less commonly addressed issue of male breast cancer.

We discuss:

  • The prevalence and mortality rate of breast cancer in women [4:15];
  • The anatomy of the breast and the complex factors behind breast cancer development [6:30];
  • The three main categories of breast cancer [16:45];
  • Breast cancer risk: the impact of menopause, estrogen, breast density, obesity, and more [21:15];
  • Finding and evaluating lumps in the breast [25:30];
  • Identifying and treating precancerous lesions like ductal carcinoma in situ (DCIS) [31:00];
  • Post-lumpectomy for DCIS: standard of care, future risk of cancer, and pros and cons of radiation and other preventative options [41:15];
  • Lobular carcinoma in situ (LCIS): how it differs from DCIS in terms of treatment and future risk of invasive cancer [55:00];
  • Breast cancer screening: mammography, ultrasound, MRI, and more [1:03:45];
  • Invasive breast cancer: pathology report, surgery, and survival [1:11:00];
  • The argument for aggressive screening for breast cancer [1:22:15];
  • Advances in the treatment of breast cancer, adjuvant therapy, and neoadjuvant therapy [1:27:00];
  • The use of hormone replacement therapy in women who are in remission from breast cancer [1:41:15];
  • The role of genetics in breast cancer [1:44:45];
  • The importance of multidisciplinary care delivered by cancer centers [1:53:15];
  • Breast cancer in men [2:03:30];
  • Parting thoughts and takeaways [2:05:45]; and
  • More.

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