I Choose...Breast Cancer Awareness
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New episodes every Monday and Wednesday. Come watch along on the Wake and Jake YouTube channel or listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Hey, friends. I'm Jessica Capshaw. And this is Camilla Luddington. And we have a new podcast. Call it what it is.

You may know us from Graceland Memorial, but did you know that we are actually besties in real life? And as all besties do, we navigate the highs and lows of life together. Big or small, we're there. And now here we are opening up the friendship circle to you. Listen to Call It What It Is on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. You're listening to I Choose Me with Jenny Garth.

Hi everyone, welcome to I Choose Me. This podcast is all about the choices we make and where they lead us. October is Breast Cancer Awareness Month and I know that many of us have been affected by breast cancer and as women I think it's something that has crossed all of our minds at some point. Breast cancer is something that I believe every woman thinks about

At some point in her life, I know it has personally touched my life. And because of Breast Cancer Awareness Month, I wanted to make sure that we had this conversation because if we can get one woman listening today to go out and get a mammogram or ask for a mammogram, then this episode has served its purpose.

My guest today is the Medical Director of Surgical Breast Oncology at Christus St. Vincent in New Mexico. Please welcome Dr. Amani Jambakar to the I Choose Me podcast.

What a pleasure it is to meet you. It's so nice to meet you, too. Who knew we'd be here together? Yeah, I never imagined I would meet Jenny Gorth ever. So that is amazing. Oh, my gosh. It's so funny that you say that. You never imagined that we would meet. But here we are, and we're talking about something so, so important. Yes.

And I'm really grateful that you're here because we're going to just break all of these myths down. We want to know all the details, all the things that we need to know. I think a lot of women don't get mammograms because maybe they think they're too young or they're concerned that it's going to hurt or they just don't want to think about it. But for someone listening today who's never had a mammogram before, let's talk about the process. I

I mean, I've had many mammograms at my age. I can speak to the level of uncomfortability. But from your perspective, why does that scare women away and what is it like? So full disclosure, I'm 37. So I haven't yet gotten a mammogram myself. Amazing to know. Yeah.

But wait, that brings me to this question. What is the age where women I've forgotten it's been so long? It's 40. It's 40. And so for someone who is of average risk, 40 is the age. That's when you should definitely start getting your mammograms. Someone who is high risk, who has a high risk family history should come see someone like me, a breast specialist and get established in a high risk breast clinic and potentially start imaging sooner in the 20s even or 30s.

Okay. That's funny because I was just talking to someone who is 37 today and she said she hadn't gotten a mammogram and I was concerned. But now I know that we don't start this process until we're 40. So that is already, I've learned something and I'm very, very grateful, but I can sort of speak to the uncomfortability of it. I mean, it's not like I want to go get a mammogram. It's not pleasant. Right.

But it's not the worst thing ever either. And it's so quick. Like when they do, yeah, they do put your boob in a machine and flatten it down like a pancake. Yeah. But it's momentary. And we women have endured way worse. So even if you're uncomfortable for, you know, five seconds while they're taking the image, it's,

So it's invaluable, the information that you are going to get and the peace of mind that you're hopefully going to get knowing that you're all clear. Okay, so we learned already something super, super big. How long does it take to get results? Like in my experience, it's taken about a week maybe.

Yeah, usually a week. So I'm here in Santa Fe, New Mexico. And oftentimes, if patients need a biopsy, the radiologist or one of the techs will tell them right then and there. Like, hey, we see something on your mammogram, you need a biopsy. Or hey, we see something on your mammogram, you need another mammogram or maybe an ultrasound. And so...

usually the turnaround is pretty quick. If it's a normal result, then they may get like a letter or a notification through their phones, you know, their chart on their phone that everything's normal within like a week or so. Yeah, I've never had that moment where they say, oh, yeah, we need to take this again, or I need to call somebody and have them come look at this. Well, that's great. That's awesome news. Yeah, that would be a little scarier. I

I want to talk to you about the BRCA1 and BRCA2 genes. Yeah. How do we test for those? That is a great question because that's something that I'm extremely passionate about. Good.

So we have a blood test that looks at 81 different genes, BRCA1 and 2, as well as other genes like CHECK2, PALB2, other genes that really increase the risk for breast cancer, but also other types of cancers like ovarian cancer, pancreatic cancer, prostate cancer, colon cancer. And that's a blood test that can only be ordered by a physician specifically.

It's not the same thing as a medical 23andMe or something like that. It has to be ordered by oftentimes a genetic counselor, or it can be ordered by an oncologist like myself, a surgical oncologist or a medical oncologist.

And I see patients for that in the office all the time. And people who have a high-risk family history should talk to their primary care doctors about it and say, hey, I have a high-risk family history. I have someone in my family diagnosed with one of those cancers, especially one of those cancers under the age of 50, right?

where do I go next for testing? And it may be different in every community. In a lot of places, they might say you need to see a genetic counselor. But here in Santa Fe, I do a lot of that. And I moved to Santa Fe about nine months ago, and I've probably done genetic testing for over 120 patients so far. That's amazing. Yeah. Yeah, I think it's so important because you need to know what your risks are. You need to know what you're

what you're starting with. I mean, exactly. And what you're inheriting from people, you know, I spoke to a patient in the clinic today who didn't really have a very convincing family history, but then ended up having a BRCA1 mutation. And so it's a scenario where we can't guess and

And so the only way to know for sure is to do the genetic testing. And it does get approved by insurance for people who meet the NCCN criteria to get tested. And so I don't see a lot of problems with insurance coverage not being there for that kind of testing. And if you do find out you have a mutation like BRCA1 or 2, then you could be eligible for things like breast MRIs.

to do more screening and just to make sure that if you do develop something that we do in fact catch it early. Oh, thank God the insurance is taking care of us in this respect. Okay, so if you test positive for the BRCA gene, what does that mean in terms of your risk of getting breast cancer?

So that risk depends on which BRCA gene that you inherit and kind of also on your family history. But in general, for the BRCA1 and 2 genes, the risk for future breast cancer can be anywhere between 40 and 80%.

And so that's a pretty high level of risk. And as you know, you probably know Angelina Jolie had a BRCA1 mutation as well. And sometimes people do choose to remove both breasts prophylactically or before they develop any kind of cancer. Sometimes they choose to remove the ovaries for similar reasons to reduce that risk as much as possible. And like you said, those options are only really available to you if you know that you have one of those mutations, if you know your risk. I

I mean, that's the key. Education, awareness, advocacy for yourself is the key. Absolutely, 100%. Because it's hard enough as women, right, to get...

get our complaints taken seriously and to get heard. And, you know, going back to your earlier point about mammograms, I know that they're uncomfortable. And for patients who have had medical trauma, they may even be traumatic. And if that was the way that we screened for testicular cancer for men, we would have something better by now, right? Oh, my God.

Right. That's a good point. It is. And so we, you know, we have this kind of squishing the breasts sort of archaic technology. We have mammograms because it's something that mostly women need to get done. And people, women are very strong. And so we sort of just

We deal with it. Do you think there's anything in the pipeline of making this experience better for us? Absolutely. So I can see that there are some studies being done of some new technologies that can work as well as mammograms. And then also of things that are a little bit more curved, like the human breast, which

So it's a little less of the squishing involved. And so some of those technologies are being trialed right now and I think are going to come out in the future. Not quite there yet. So right now, a mammogram is still the standard of care. And it is uncomfortable. You know, it sucks. It's not a fun thing to do. No one looks forward to it. That's for sure.

But you're right, like the information it gives you in just like a few minutes of discomfort or even pain is so invaluable and it's peace of mind or figuring out what's next and if you need some kind of surgery. What you need to do, what you need action, you need to take action.

I just want to be clear, if you test negative for the BRCA gene, does that mean that you won't get breast cancer? So that's a great question. It doesn't mean that you'll never get a future breast cancer. It just means that your risk is average, like along with the rest of the population. It's not elevated because of a bad gene that you inherited from one of your parents. And something else that I hear oftentimes about the BRCA mutation is that

Like women are the only ones who can inherit it. And that is totally not true. You can get that mutation from your dad as well. Really? What happens with men when they have it? Same thing? Men? So they're,

Men can get breast cancer, actually. BRCA1 does increase the risk for male breast cancer. For men, we worry a little bit more about aggressive prostate cancers. Prostate cancer is typically not a very aggressive thing in men, but in people who are BRCA mutation carriers, it can be. And we also still worry about the pancreas as well, and as well as like skin cancers like melanomas. And so

Men who have the BRCA mutation also need to be watched carefully in a cancer-specific screening clinic. So that way, an oncologist can keep a closer eye on them as well. So you heard it here. Men and women are both affected by the BRCA. And both men and women should get tested. Absolutely. Absolutely.

Wow. I didn't know that. Thank you. I'm going to go to a question from one of our listeners. This is from Rewest524. Why has there been such a huge increase in breast cancer cases in the past 20 or so years?

That is a great question that I get all the time in clinic. And I will say there's a lot of different research that's being done about it. Some of it may relate to environmental exposure. Some of it may relate to microplastics. Some of it may relate to more processed food because, you know,

it's not just breast cancer that we're seeing. We're seeing it in like colon cancer as well. We don't have a really great answer for it right now. We're still trying to figure that out. Yeah. I mean, I've heard a lot of discussion about microplastics lately. And then you start thinking about moment to moment in your life and how much you're exposed to plastics like all day long. I just literally yesterday threw out my plastic cutting boards that I've had for a minute and

Because I saw that when you chop into it, it releases little microplastics and then you cook that up with your sauteed vegetables. Yeah, it's I mean, I think the research on the microplastics is pretty compelling and the

There's a lot of things that we need to do to be a little bit more environmentally sound that I think will help our health as humans, not just with not developing cancer and especially cancer at younger ages, but also in a lot of other disorders as well. And so I think that research is going to pan out and show that.

Being climate conscious will help our health in the long run. I just heard Katie Couric talking about breast density. I have a question from a listener here, Ashley Hollaback. Where can women get an ultrasound if they have dense breasts since you now need one when a mammogram isn't enough?

So this is the question I get a lot in the clinic. Now, as I'm sure you've heard, when you get your mammogram results, they have to report on how dense your breasts are. And that just happened in the last month or so. So people who do have dense breasts or category C or D breasts, they are recommended to also have an ultrasound. Sometimes they may even be recommended to have an MRI for screening. Yeah.

Usually the same mammography place that does the mammogram can also do an ultrasound. It just depends on your regional location on if they can also do the MRI. The tricky part is getting the insurance to approve it because insurances haven't 100% caught up with those recommendations yet. And so...

A lot of times I see patients like this who do have dense breasts and then I order the ultrasound with the mammogram and I order both of them going forward so that way they can just get both done in one visit. But typically the same place where you got the mammogram can do the ultrasound. You may still need to have a doctor like your primary care doctor or your OBGYN order it and write that dense breasts is the reason why. Okay.

Hi, this is Jenny Garth from the I Choose Me podcast. If you're managing a challenging mental condition, weekly therapy can sometimes feel like it's not enough. You may be looking for a way to spend more focus time on you. That's where Amend Mental Health Treatment Center comes in. I recently took a tour at Amend in beautiful Malibu, California, and the facility is so gorgeous and serene.

The dedicated team of doctors and therapists with deep clinical expertise were amazing. Designed to give you the time and space you need to have that breakthrough. They have two unique locations in Malibu that surround you in natural beauty and pure calm. Find out more at amendtreatment.com slash start.

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I have a question going back to the age that we should start getting mammograms. You said it was 40, but what if...

Breast cancer runs in your family. Maybe it runs in both sides of your family. Should you start getting screened earlier? Yeah, absolutely. So I have seen many patients who have a risk of breast cancer because they have, you know, their mom, for example, passed away of breast cancer when she was 36. So that kind of patient doesn't need to wait until they're 40 to start getting imaging. Right.

Usually we don't start doing breast MRIs for someone who is high risk for breast cancer until the age of 25. That's the earliest we typically do those. But sometimes we'll do a clinical breast exam with an oncologist like myself earlier than that, depending on what the family history is.

So if you do have young people in your family in their 30s and 40s who have been diagnosed with breast cancer, my recommendation is to check out a high-risk breast clinic in your area and talk to them about when you should start that screening because you're right, Jenny, it could be earlier than 40 and waiting until 40 may be too late for some people. Yeah, I mean, they say that with heart disease too.

if you're genetically dispositioned to it, then you need to start having checks more frequently earlier on. You said 25 was the age that you usually start? Yeah. So 25 is the earliest recommendation I've seen for any kind of breast imaging, even for someone with a known BRCA mutation. Usually they'll say start MRIs at 25, no earlier than 25.

rarely I would say there probably are people out there who have had mothers and sisters who have had breast cancer in their 20s. And for that, I think that we would have to take on a case-by-case basis. Yeah. I mean, the statistics are crazy that, you know, breast cancer is affecting women much younger today. It is. And it used to. Absolutely. And it's...

It is surprising. You know, the youngest patient that I've heard of, not that I've personally seen, but that one of my colleagues has seen with breast cancer was 19. Yeah. And it's especially hard at that age because, you know, you go and see a doctor at 19. You may not have a primary care doctor. So you go see someone at an urgent care and they say, you're too young for breast cancer. This is a cyst. Right.

And so my recommendation for anyone, really any age, if you feel a lump in the breast, no one's physical exam is good enough. I'm a surgical oncologist who primarily examines patients with breast cancer all day long, every day. And even I can't tell the difference between something that is a cyst or something that's a cancer or something that's some other type of lump in the breast. And so...

No doctor, no nurse practitioner, no PA, no one's physical exam is enough. So if you feel a lump, ask them to order some kind of imaging. A mammogram, if you're too young for a mammogram, typically they won't do a mammogram for somebody who's under 30. Ask for an ultrasound. But some sort of breast imaging is needed to look at that lump in more detail. Don't let anyone reassure you that by physical exam, a lump is nothing. Absolutely. Such good advice.

Such good advice. And listen to your instincts too. I mean,

Absolutely, absolutely. And I see it with my young patients. I see this really often where they are bounced around. You know, they see someone at some urgent care, then they go somewhere else. And that person says, you're too young for breast cancer. This might be an infection. And they put them on some antibiotics. And this whole time, things are progressing. The lump is growing. And then they finally get established with a primary care doctor. And the primary care doctor says, whoa, and then they get sent to me. Mm-hmm.

If you have no history with family breast cancer, none. I have very, very little family history of breast cancer. And I don't remember what age. I must have been 40 when they ordered me to get my first mammogram. And you're saying that's the age if you're not worried that you have it in your family. Yeah.

Yeah, 40 is the age. And there were kind of differing recommendations on that as well. Like one governing body in the U.S. said 50 and one said 40. And now everybody says 40 because we are seeing, as you commented, the incidence in young women rising. And so it's really worth it to start it at 40.

It's a pretty safe test to do. Very, very, very small radiation dose that is totally worth it for the benefit. Yeah, I was going to ask you that. I get concerned about my exposure to so much radiation. One, because I travel a lot. So I always get worried going through those machines. Yeah. And everybody says, oh, it's fine and don't worry. But I do worry. And so getting some sort of a screening...

can cause concern for people that they're going to get too much radiation. For sure. And I get told that often, you know, people are like, what about the radiation risk with a mammogram? So here in Santa Fe, New Mexico, we are at 7,000 feet. So we're at pretty significant. We have a higher radiation risk anyways, because we're a little bit closer to the sun. Okay.

But in order to actually see a problem from the radiation that you get from doing a mammogram, you'd have to get a mammogram every single day for an entire, really actually every day for the rest of your life. And then you might have a slight increase in the risk of developing a future cancer due to that radiation. But as long as you're not getting a mammogram every day, which no one is, it's pretty safe.

The scanners in the airport are even less radiation than a mammogram. So totally safe. I mean, you could probably, I mean, you could get like probably, I would say you could get like easily 10,000 of those and you'd be fine in terms of your annual radiation dose. If you travel like 13,000 miles, you know, you travel from LA to Europe and back and

in a year, then that's about the same amount of radiation that you're getting from a mammogram. And a mammogram is totally safe. If you live at sea level, the amount of radiation you get from a mammogram is about the same amount you would get from seven weeks of just background radiation, just living at sea level. So totally, totally safe, not really significantly increasing your radiation exposure. And

worth doing despite that risk. Yeah. What you're saying about this, would you just call it background exposure? Radiation. Yeah. Background exposure. Yeah. That is scary. Well, it's just, you know, it's, we all get some radiation from the sun, right? If we're living at high elevation, like I am, or if we're living at sea level, we also get radiation from minerals in our own body breaking down and that's totally normal and okay. Right.

It's a really small dose. And so there's actually the EPA, the Environmental Protection Agency, has a radiation dose calculator that you can use, which I recently used because I was making a TikTok on the radiation exposure you get from a mammogram. And you can calculate how much radiation...

radiation exposure do you get in your home based on like where you live and how many miles you travel a year if you're an avid traveler and if you have veneers and if you have radon in your home and things like that. And overall, it's the amount of radiation you get. There are different sources you can get it from, you're right, but it's a really, really, really low dose that is not going to increase anyone's risk of having problems from the radiation at all.

I recently decided that I didn't want any of my dog. We have a microwave, right? That is under the cab counter level. It's down below, like right where ovaries are.

And so I recently put a big sign up on the floor. Nobody stand right here when the microwave is on. Yeah, that's I mean, that's fair. Although I will say in that calculator, how close you stand to your microwave is not in there. So, oh, my gosh, I'm going crazy. I'm trying all the things. Wow. Another question I have for the women who are giving the mammograms, the technicians, I know they go behind that little wall, but they're still right there all day long, every single day.

That is a great question, too. So they typically for those ladies, they have like it's a little badge, a thing on their badge. And it's something that their ID hangs from. And what that does is it actually like kind of measures the radiation dose that they get exposed to. And that's something that they have to like turn in and it gets counted. So that way we can be sure that their radiation exposure is safe.

And then, you know, any kind of job in the hospital where you're giving x-rays of any kind, they wear those little badges that will actually help calculate that dose and make sure that no one's getting to a point where, you know, they're getting too much radiation exposure. And so it's, that's pretty tightly regulated by like hospitals, by mammography centers. And so they are totally safe too. Don't worry. Yeah. That's, that's good to know. I was worried. What you were saying before we were talking about before about the,

the age being much younger now that women are discovering that they have, it's so alarming. And you're right, they get shuffled around and they get discredited and people don't believe them or want to do anything. And you said that advocating for yourself, but what if you're a young girl and you're wanting to know more about your health, even if you don't have any

breast cancer in your family genes that you know of. How do I get my voice heard as a young woman in a doctor's office? Also an excellent question. So

It is harder for women, right? The things that get diagnosed mostly in women get longer to be diagnosed because they get diagnosed mostly in women. So things like endometriosis that I'm sure you've heard of, it's basically can cause pretty debilitating pain, abdominal pain. It takes an average of eight years to get diagnosed in women.

Why? Because people will discredit women like what you're saying. They'll say, oh, you're just anxious. Oh, that pain is just in your head. And that we see it all the time with many different diagnoses. Breast pain. That's one that I get asked about a lot as well. We don't have great answers for what causes breast pain or how to stop it because it's something that almost exclusively impacts women. Mm hmm.

And 70% of women in their lifetime will experience breast pain at some point.

So it's hard. It's a really challenging thing, even for me as a female surgeon, going to the doctor and having the doctor listen to my concerns as a healthcare professional can be challenging. So I think it goes back to what you said earlier, Jenny, trust your gut, listen to your instincts. If you feel like something's wrong and no one's listening to you, then find another physician that will. And studies have shown that like,

Patients who are women tend to be heard better by physicians who are women. So finding a physician who is a woman who is going to take the time and listen to you. Studies have also shown that women physicians spend longer listening to their patients and are more empathetic. I think that will make a huge difference as well. If you're able to, choose to see women physicians because it will help you be heard. It will also help us be heard. Oh my gosh. I know no one really ever talked about that, about...

choosing a female physician that, you know, that wasn't really a conversation. It was just go to the doctor and it was usually a man and it was even more uncomfortable because it was a man and you're talking about sensitive things and it just never feels right. Exactly.

Nowadays, we have those options, though, because like more than 50% of medical students are women. And so there are more and more women in a lot of different specialties. Now, surgery is not one of them. Still overwhelming majority are men. But there are more coming up through the ranks now. And so I think we'll see those numbers shift soon. And so choosing women physicians or women who are nurse practitioners, women who are PAs, like

Women are more likely to listen to other women when it comes to symptoms like a lump in the breast that just won't go away. That's also very valuable information. So how does eating a healthy diet and not drinking alcohol and exercising change?

does that actually decrease the risks of getting breast cancer? Because we talk so much about being healthy and eating healthy and getting exercise. And I know that all of those things directly affect heart disease, but what about breast cancer? It's kind of a mixed bag. So, um,

Have I seen patients who follow a, you know, vegan, plant-based, completely organic diet, exercise every day? You know, I'm here in New Mexico, as I mentioned, so everyone here is in amazing shape because they live at high elevation and they're also very outdoorsy. Have I seen lots of those patients who do end up with a breast cancer? Yes, I have. And I've also seen patients who are

you know, who didn't live a healthy lifestyle at all, who also end up with breast cancer. I think living a healthy lifestyle is important for, as you mentioned, things like heart disease and not having a heart attack or a stroke or

I think it can slightly decrease the risk of a future breast cancer, but there's no one diet that can prevent breast cancer because if there was, then we would all be on it, right? And we would have studies that definitively showed be on this diet and you'll never develop breast cancer or some other type of cancer. And I think modulating

moderation is really important. You know, not drinking alcohol or drinking it in small quantities when you do is important. Yeah. I was going to ask you about alcohol. Like does drinking alcohol put you in a higher risk?

Slightly, but not a lot. You know, it's I think it puts you at higher risk for things like pancreatic cancer, for example, but not as much for breast. So, I mean, that's not saying that, you know, go out and drink whatever you want. I think it's moderation is key to having a good long life with a good quality of life.

But I don't think that, you know, living the healthiest lifestyle is something that can definitively prevent breast cancer. And so something I talk about often with my patients in the clinic is sugar. You know, I hear the myth all the time that sugar feeds cancer. And so someone will get diagnosed. Oh, it's a myth. Yeah.

There's no definitive study that like, you know, if you cut out sugar, it will help diminish the size of your breast cancer or help shrink it, help treat it, anything like that. And so there are some studies that have been done that will show some kind of association, but it's not a very strong one. And so.

I see patients all the time that have been diagnosed with a breast cancer and their family members will say, well, you have to cut out all sugar right now. Like that's it. You know, you're, you have to be done with it because it's going to feed your cancer and then your cancer is going to grow. And that's, that's really, that's, it's, that's a very simplistic way of looking at it. And that's not it.

There's no definitive causal relationship where if you eat a lot of sugar, then you're definitely going to get cancer because otherwise then you would see a higher incidence of cancer in people who are diabetic, for example.

And that's, we don't see that. And so if I have a patient who's asking me like, hey, how should I change my diet? After getting diagnosed with breast cancer, I say a healthy diet is important. But, you know, if you have something that you really love eating, you know, you love ice cream, you love flan, whatever, I'm never going to say don't eat that don't eat the things that are going to bring you joy while you're going through treatment, because treatment is hard enough as it is.

First of all, who would ever say, I love flan? Sorry. I love flan, actually. You do? You love flan? Oh, my God. I love it. That jiggly texture, I am so for it. It's like a pudding, right? Yeah, okay. Yeah, it's a pudding.

It's great. And in New Mexico here, we have like really, really authentic flan. Okay. Maybe I just need to go to New Mexico and try the good stuff. What about soy? What about soy? Because I've always heard, I mean, I fed my babies once they were off breast milk. I gave them the only option back then was to give them a soy formula. Right. And I wasn't sure if I was doing the right thing. Also a great point. I hear that one too. Like

soy and the estrogen link is there. People will say, well, if you eat a lot of soy, then it might increase your risk for an estrogen-related breast cancer. And really, the studies are not definitive about that either. So I don't advise people to cut out soy. I think if you like soy, great, enjoy soy. I don't think that there's a real reason to cut anything specific out of your diet if you've been diagnosed with a breast cancer to keep it from growing or spreading.

or, you know, to keep, to prevent breast cancer. I think if you want to prevent breast cancer or catch it early, really the most important thing to do is to get your mammogram once a year. Okay. So speaking of estrogen, let's talk about hormone replacement therapy, HRT. Yeah. Does it increase your chances of breast cancer? And what do we need to know associated with that?

It does increase the chance very slightly based on pretty large studies that have been conducted. So when I'm talking to patients, I have patients who are even in my high-risk clinic because they have a family history that I do think that HRT is worth trying for them.

I think that menopausal symptoms are like many other things that are almost exclusive to women, not talked about enough. And sometimes they can be extremely miserable and really alter the quality of your life, right? And so it's a risk versus benefit situation. Like, okay, the risk of breast cancer is slightly higher, but the benefit is that, you know, I'll get to sleep at night. I won't have these terrible night sweats.

You know, I won't wake up in the middle of the night and wonder what it is I'm doing. I won't have menopause brain, those kinds of things. And so oftentimes I think that the benefit of HRT really outweighs the risk because

The only patients that I really say should not be on HRT are the patients who have already been diagnosed with breast cancer and it is a breast cancer that responds to estrogen. In that case, not a good idea to be on hormone replacement therapy. But for others, I do feel that in general, the benefits outweigh the risks. And I think that it's something that more women should be on. Mm-hmm, mm-hmm, I agree. Mm-hmm.

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Do you ever wonder where your favorite foods come from? Like what's the history behind bacon-wrapped hot dogs? Hi, I'm Eva Longoria. Hi, I'm Maite Gomez-Rejon. Our podcast, Hungry for History, is back. Season two. Season two.

Are we recording? Are we good? Oh, we push record, right? And this season, we're taking an even bigger bite out of the most delicious food and its history. Saying that the most popular cocktail is the margarita, followed by the mojito from Cuba and the piña colada from Puerto Rico.

So all of these Latin cultures. We thank Latin culture. There's a mention of blood sausage in Homer's Odyssey that dates back to the 9th century B.C. B.C.? I didn't realize how old the hot dog was. Listen to Hungry for History as part of the My Cultura podcast network, available on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

Hey, I'm Jay Shetty and I'm the host of On Purpose. My latest episode is with Jelly Roll. This episode is one of the most honest and raw interviews I've ever had. We go deep into Jelly Roll's life story from being in and out of prison from the age of 13 to being one of today's biggest artists. We talk about guilt, shame, body image, and huge life transformations.

I was a desperate delusional dreamer and the desperate part got me in a lot of trouble. I encourage delusional dreamers. Be a delusional dreamer. Just don't be a desperate delusional dreamer. I just had such an anger. I was just so mad at life. Everything that wasn't right was everybody's fault but mine. I had such a victim mentality. I took zero accountability for anything in my life. I was the kid that if you asked what happened, I immediately started with everything but me. It took years for me to break that, like years of work.

Listen to On Purpose with Jay Shetty on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Trust me, you won't want to miss this one.

Hey, I'm Jack Peace Thomas, the host of a brand new Black Effect original series, Black Lit, the podcast for diving deep into the rich world of Black literature. I'm Jack Peace Thomas, and I'm inviting you to join me and a vibrant community of literary enthusiasts dedicated to protecting and celebrating our stories. Black Lit is for the page turners, for those who listen to audiobooks while commuting or running errands.

for those who find themselves seeking solace, wisdom, and refuge between the chapters. From thought-provoking novels to powerful poetry, we'll explore the stories that shape our culture. Together, we'll dissect classics and contemporary works while uncovering the stories of the brilliant writers behind them. Black Lit is here to amplify the voices of Black writers and to bring their words to life.

Listen to Black Lit on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

Hey, it's Mike and Ian. We're the hosts of How to Do Everything from NPR's Wait, Wait, Don't Tell Me. Each week, we take your questions and find someone much smarter than us to answer them. Questions like, how do you survive the Bermuda Triangle? How do you find a date inside the Bermuda Triangle? We can't help you, but we will find someone who can. Listen to the How to Do Everything podcast on iHeartRadio.

Breast implant illness has been getting talked about more openly. More and more women are having their implants removed. Are there any correlations between breast implant illness and breast cancer? Not that I know of. I have not seen any correlation between breast implant associated illness and breast cancer. Breast implant associated illness is kind of, you're right, it's getting a lot more traction in these last few years.

But it's still a diagnosis that they will do a full workup and make sure that there's not something else that's causing these symptoms before removing implants. But I think there's a growing body of evidence that it's its own thing and should be considered earlier, you know, before doing the whole million dollar workup in women who have implants. I can't believe I was, I would remember hearing messaging when I was younger that said, if you get breast implants, it reduces your,

your chances of getting breast cancer. Yeah, I've heard that as well from a few patients. It really, it doesn't change the risk at all. Yeah, I think it doesn't, right? And when someone has an implant and then they get a mammogram, they sort of move the implant out of the way and then get the native breast tissue in for the mammogram and they're still able to see what's going on.

Sometimes having an implant, you know, that was placed for an augmentation purpose can change the treatment options that are available to you if you do get diagnosed with breast cancer. But it's not, that's not a reason not to get an implant for someone who wants one. Speaking of moving the implant around, if someone's considering or having to face being considering a mastectomy or a double mastectomy, Mm-hmm.

Can you walk us through that process and what that entails and the recovery? I mean, there's, that sounds very scary. Yeah, sure. I'm happy to do that. So, um,

I do see a lot of patients who have chosen to remove one breast or both breasts. And that decision is really a very personal decision. You know, I think that there's some patients that have a larger cancer for which it would be a good idea. But there are some who have small cancers that just, you know, they don't want to get a mammogram on that side again, or they don't want to get mammogram on either side. And they just want to, you know, for their own peace of mind, they tell me, you know, Dr. Jambakar, I'm going to be awake at night.

thinking about potentially having to get another biopsy sometime in the future. And I want to remove both breasts. And if that's the case, then, you know, that's your decision. Now, you know, for me, I have a lot of different tools to help my patients have the best recovery possible. And one of them is something called an expiral pec block. And

which is like a numbing injection that gets done to the muscle, the pec muscle, which is the muscle that's behind the breast. And that medication lasts for like seven days. And so typically my patients go home the same day after a two to three hour surgery and they're able to do their normal activities, shower,

wash their hair, et cetera, the next day. And most of them take zero opioid pills at all because of that medication. - It blocks the pain receptors or what? - It blocks the muscle, it numbs the whole muscle and so it numbs the breast tissue in front of the muscle. And it's really something that's being used at most places in the country, but not everywhere.

should be used everywhere in New Mexico. Mine is actually the only hospital and the only surgeon who's doing it. And I'm hoping to spread that message. So more people do it. I know in LA, quite a few people are doing it. But I think that it is, it's something that has been a huge game changer, especially in the last couple of years since the pandemic started to make the recovery better for patients who have breast cancer. And

Then, you know, the next day you could be walking around, showering, moving your arms, doing all of your normal stuff. Usually you will feel kind of sore for probably two or three weeks, but this helps tremendously because it really takes the edge off the first few days.

And patients do sometimes need ice packs or Tylenol and Advil to kind of get them through that. And then the reconstruction process, which sometimes can be started at the same time as removing one or both breasts, sometimes needs to be done in a separate surgery. It just sort of depends on what type of reconstruction the patient chooses. I see. So in some cases, if you have to have your breasts removed, you can have the reconstruction done in that same operation. Yeah.

You can. But something I always counsel patients is even if you're able to start it at the same time, oftentimes there is a second surgery or maybe an office procedure or something that's needed because remaking breasts is a work of art. And making sure everything's symmetric, either with the side you still have left or making both sides the same like this and not like this. Right? Like that's a work of art and it takes...

It takes a very skilled plastic surgeon who's extremely dedicated to reconstruction to do a good job. And sometimes it can take up to a year to do all the procedures that are done to where the patient and the plastic surgeon, everyone's happy with how things are. And so it's an art. We don't want to rush that process. But sometimes it can be started and most of it done at the time of the mastectomy.

Wow. So interesting. Well, first of all, how often should we be giving ourselves self-exams, which means feeling around the breast for any unusual lumps that are new, right? I'm kind of like, I'm

I'm not a huge proponent for self breast exams. I think that it's important to be kind of aware of what your breasts feel like, you know, once every few months, kind of examine yourself in the shower. But, you know, I think that the old teachings that you should be doing a self breast exam once a month isn't,

really what we follow now because self breast exams don't catch cancers very often. And more often than not is the imaging that catches it. So for me, you know, with my patients, I really stress the importance of

regular mammograms. And if you are high risk, getting enrolled in a high risk breast clinic where they can watch you more often. But just in general, having an awareness of what your breasts feel like, you know, once every few months, I think is totally okay. And I also often have patients that come see me

after having been diagnosed with a breast cancer say, you know, doc, I didn't feel anything. I don't really do breast exams. And I tell them, you know, no reason to feel bad about that. Like, that's okay. You went and got your mammogram and now we're here. So I'm really happy that you got your mammogram. Mm-hmm. Mm-hmm.

Yeah, because sometimes it is an indicator to someone that something might be awry. So it is the impetus for them to go into the doctor. What are some other warning signs? Say we're not checking our breasts, even if we do, we didn't feel a lump. Are there other signs that women should be aware of?

Yeah, so nipple discharge, like new onset nipple discharge on one side in particular, especially if it's bloody, that's something that you need to get some breast imaging for. And oftentimes breast pain, you know, if you feel a new pain somewhere, especially if it's just in one spot, not the whole breast,

Whenever I see patients with breast pain, I go ahead and order an ultrasound just to check it out and make sure there's nothing going on as well. And then also if you have any kind of skin changes, so skin looks kind of thick in one spot, nipples kind of itching and scaling, all of that stuff should be checked out with breast imaging. Such good information. I didn't know any of that. Thank you.

What is the one thing you would say that you hope our listeners take away from this conversation that we've had today? I think you've already sort of touched on it, which is that it's so important for women to advocate for themselves, right?

So if you have a high-risk family history, ask your primary care doctor to refer you to a high-risk breast clinic so you can talk about genetic testing, maybe get diagnosed with something like BRCA1 and 2 if that's running in your family or just be watched more closely. And if you feel a lump,

advocate for yourself to get some type of imaging, a mammogram, an ultrasound, something because no one's physical exam is good enough. So it's really important for women to use our voices because we already don't get heard enough. Um, so advocate for yourself, educate yourself, uh,

And that's really my mission. I try to post a lot of stuff on social media so that way I can help women advocate for themselves. Yeah, I mean, it's so easy. I've been in this position to be in the doctor's office and then to tell you whether something's wrong or something's not wrong either way. Right.

And I think to myself, well, they're the doctor. They must know. I guess I'll just go with that. Well, here's the dirty little secret. We don't know. And as a doctor, like we, you know, physical exam and looking at how a patient looks and trying to put the pieces together with what they're telling you. Those are great tools, but they're not everything. And if you, as someone who's seeing a doctor, feel in your gut that,

you know, they're not hearing me. They don't know the whole story. Something must still be wrong. Like, don't be afraid to get a second opinion. You know what we talked about earlier? Find a female physician that will be willing to listen to you. Yes, go ladies. We need more female doctors, more female surgeons, more females everywhere. We do. We absolutely do in every field. We will benefit from having more women. Before I let you go, Dr. Amani, I want to know,

What was your last I choose me moment? I would have to say that it was today doing this podcast. So I spoke to my clinic team and I was like, listen, I have this really exciting opportunity to be on Jenny Gart's podcast. I'm really excited about meeting her. So if you can just make sure that I can get home on time so I can participate and that's how I'm choosing me.

And they made it happen. And I was able to be here today. So I'm so excited for this opportunity. Thank you so much for having me on. Oh, I love that. I love that because this is the greatest opportunity for you to educate more women. And I know that that's so important to you. Yes, it is. That's definitely my mission, not just in my clinic, but also the women out there on social media to try to help them and help empower them to advocate for themselves.

As the mother of three women, I thank you from the bottom of my heart for all that you do and the education that you're dispensing to people. Well, I really appreciate everything you're doing and all of the information you're providing through your podcast and helping me have this platform to talk to women and so we can get more women to get their mammograms. Yes, yes. Thank you so much for your time. I hope you have a great night.

You too.

All right. Take enjoy your flan. Oh, thank you. Just delicious. You got to give it another chance. I'll come and see you and we can have some flan together. I think that would be a good idea. That you haven't been to Santa Fe recently. I've never been to Santa Fe. Oh my gosh. You're missing out. It's such a magical city. I got to tell you, I moved here from Houston and I was like, oh my God, I strongly recommend you come. I love that. A ringing endorsement. Yeah. Santa Fe. Yeah. Okay. And mammograms. Yes. Both. Oh,

Okay. Thank you so much. Thank you for having me on. I want to thank Dr. Romani Jambakar for coming on our podcast today. I know none of us like to talk or think about cancer, but it is important for all of us to understand the warning signs and understand why it's crucial for us to get our mammograms. As we continue to choose ourselves each week, I want to challenge you this week to

It's going to be an obvious one, but maybe this conversation has inspired you. I want to encourage you to have that I choose me moment and get your mammogram. Or maybe you and a friend or you and your sister or you and your daughter, go get them together. Make a mammogram date out of it.

I encourage you to share your story and your mammogram experience on our social media and use the hashtag I choose me. Let's all inspire each other and be brave and look out for each other and for our bodies. Thanks for listening to I choose me. You can check out all of our social links on our show notes, rate us, review the podcast, give us your comments, tell us everything you want to tell us. And don't forget to use the hashtag. I choose me. I'll be right here next week. I hope you choose to be here too.

John Stewart is back in the host chair at The Daily Show, which means he's also back in our ears on The Daily Show Ears Edition podcast. Join late night legend John Stewart and the best news team for today's biggest headlines, exclusive extended interviews and more. Now this is a second term we can all get behind. Listen to The Daily Show Ears Edition on the iHeartRadio app, Apple Podcasts or wherever you get your podcasts.

Hey friends, I'm Jessica Capshaw and this is Camilla Luddington and we have a new podcast. Call it what it is.

You may know us from Graceland Memorial, but did you know that we are actually besties in real life? And as all besties do, we navigate the highs and lows of life together. Big or small, we're there. And now here we are opening up the friendship circle to you. Listen to Call It What It Is on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.

Hi, everyone. It's me, Katie Couric. You know, lately, I've been overwhelmed by the whole wellness industry. So much information out there about flaxseed, pelvic floor, serums, and anti-aging. So I launched a newsletter. It's called Body and Soul to share expert-approved advice for your physical and mental health. And guess what? It's free. Just sign up at katiecouric.com slash bodyandsoul.com.

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All of it.

New episodes every Monday and Wednesday. Come watch along on the Wake and Jake YouTube channel or listen on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts. Daphne Caruana Galizia was a Maltese investigative journalist who on October 16th, 2017, was assassinated. Crooks everywhere unearthed the plot to murder a one-woman WikiLeaks. She exposed the culture of crime and corruption that were turning her beloved country into a mafia state.

Listen to Crooks everywhere on the iHeartRadio app, Apple Podcasts, or wherever you get your podcasts.