Dr. Naomi Ko discusses the statistics and findings surrounding breast cancer, who may be at risk, why mammograms are important, treatment options and support available within BMC.
Naomi Ko, MD is a Medical Oncologist with Boston Medical.
Melanie Cole (Host): Welcome. Today, we’re talking about breast cancer facts, and it’s so important for women to know the facts so that they can be their own best health advocate. My guest is Dr. Naomi Ko. She’s a medical oncologist at Boston Medical Center. Dr. Ko, explain a little bit about breast cancer. What are you seeing as far as incidence and awareness? Do you feel that more women are aware and getting screened as a result?
Naomi Ko, MD (Guest): Well, first, I’d like to say thank you for having me on the show. It’s really a pleasure to be here to talk about breast cancer, largely because awareness is so important. Breast cancer is a very common cancer for women in the United States. About one in eight women will get diagnosed with breast cancer, so if you don’t know someone who has had breast cancer, that’s extremely rare. A lot of people have either been affected themselves or have family or friends that have had breast cancer, and so good information and awareness is critically important. So, thanks for having me today.
Host: So, while we’re learning facts, tell us who is at risk? I mean, are we all at risk as we get older, but are there some people for whom there’s more of a risk because of maybe genetic predisposition or the BRCA gene? Tell us about risk factors.
Dr. Ko: Sure. So, it’s a question that comes off quite often because in my practice, I strictly see women who’ve been diagnosed with breast cancer, and so there are many risk factors to be aware of, but it’s also important to know that it could really happen to anyone, and sometimes you don’t have the risk factors, and you still develop breast cancer. So, first and foremost, I would say age is your number one risk factor. As you’re getting older, your chance of having breast cancer goes up. So, just by getting older is something you need to be thinking about, not just in breast cancer, but other cancers like colon cancer as well. So, that’s one. The other one is family history, and as you mentioned, some women do have a genetic predisposition for developing breast cancer. It’s not the majority of breast cancers that are diagnosed actually, but it’s an important contingent, and so if you do have a strong family history—if your mother, sister, aunt, grandmother had breast cancer, and you’re concerned, it’d be really important to talk to your doctor to get more information. Other risk factors for breast cancer would include things like your exposure to estrogen, and so women who have had a lot of exposure to estrogen do have sort of an increased risk of breast cancer. That would include either having—getting your periods or menses early in life or going through menopause later in life or never having carried a child. So, anyone who has not had children or been pregnant before, do have an increased risk of breast cancer, or if people have taken any hormone replacement therapy for any reason at all, they would also be at an increased risk. Then, there’re about two or three lifestyle changes that you could do to decrease your risk for breast cancer. One is obviously smoking. Smoking’s associated with a lot of negative health ramifications. So, we always advise women not to smoke. Another one would be to keep as close to a normal weight as possible because of the links between obesity and cancer—and breast cancer as well, and then finally, alcohol is also known to be a risk factor for breast cancer. So, the more alcohol you drink, the more you increase your risk for breast cancer. So, there are many things that are out there that you could do—stop smoking, try to stay normal weight, eating healthy, and exercising more, and if you drink, maybe to cut back a little bit on what you are drinking.
Host: Wow. What a comprehensive list you just gave us—
Dr. Ko: (laughs)
Host: —doctor. I mean, that was really great, and that’s what—women—we need to hear these things. So, now let’s jump right into it because we talk about mammograms on these shows all the time. If someone is diagnosed with breast cancer, tell us how do you stage it? What are the next steps because that’s terrifying? We know that sitting, getting your mammogram, waiting to see if becomes a diagnostic mammogram—the whole thing is unnerving for women, but then you get those terrible words. What’s the next step? What do we do?
Dr. Ko: A great question, and I would say, if you do get a diagnosis of breast cancer, the first thing I would want you to do is to just take a deep breath. Take a deep breath and try to know that there are a lot of other women who are diagnosed with breast cancer, and they do amazingly well. They do really, really well. Then, I would say, get your social support together because this is going to be typically—it can be a long journey for some women after diagnosis where you’re required to go through a series of different tests and to meet a series of different doctors, and so we like to talk about breast cancer as a disease that requires a multidisciplinary and well-coordinated medical team. So, I would recommend finding your home, and that would include finding a place where you feel that you’re seen and valued and where you can get the best care and that would include getting a medical oncologist, a surgical oncologist, often a radiation oncologist—from a plastic surgeon to a genetics counselor to a nutritionist or even a patient navigator. There are many different people involved in your breast cancer journey, and most centers will have a lot of resources to help you through it, and make sure you come with questions and to come as comfortable and feel safe—as safe as you can when you go to see your doctors and advocate for yourself and bring a friend or a partner, a family member and get ready because typically it’s a long journey, but it’s one that’s well worth it, and something that we can get through to the end and often see a lot of survival and a lot of good cures.
Host: Well, that was very encouraging and uplifting Dr. Ko. I can hear the passion for what you do. So, now tell us what’s exciting in the field of breast cancer as we look at targeted therapies or intraoperative radiation. There’s all these, you know, we hear about breast conserving surgeries and reconstruction after mastectomy. There’s so many adjuvant therapies. Tell us what’s exciting that you are seeing and doing right now.
Dr. Ko: Breast cancer is an incredibly robust, rewarding, and exciting field to be in right now. There are so many new discoveries happening and so many hardworking scientists and researchers trying to figure out a way to make breast cancer cure available for everyone. We are looking at things down from the cellular level and different molecular changes and biology of tumors, about the tumor microenvironment. What is it around the tumors that make them the way they are and creating therapies for that all the way from the cellular level all the way up to the policy level. How do we change insurance status so that women have access to the medical care they need and the drugs they need to get through for their cures, and so, it takes a village, truly. It takes a society to do everything that we’re doing in breast cancer now, and I’d say at every level, there are—there’s exciting research pushing and moving the frontier of this field forward that is extremely exciting.
Host: Well, it certainly sounds like that. Wrap it up for us. What would you like women to know so that we can be our own best health advocate about whether it’s self-exams, making sure we’re in contact with our providers, getting our annual screenings? What would you like us to know?
Dr. Ko: Well, I guess my wish for women would be to be aware of your bodies. Advocate for yourself. Go see a doctor that you feel will take the best care of you and trust yourself and trust your instinct and trust your judgement and make sure you’re taking care of yourself, and that’s a really important thing to be doing.
Host: Well, it certainly is, and if we don’t take care of ourselves, put our own masks on first, we can’t take care of the ones we love. Thank you so much Dr. Ko. Really a great segment and such great information, and that wraps up this episode of Boston Med Talks with Boston Medical Center. Head on over to our website at bmc.org/breast-cancer for more information and to get connected with one of our providers. If you found this podcast as inspirational and informative as I did, please share on your social media. Share with other women you know. Share with friends and family because that’s the way that we all learn together—from the experts at Boston Medical Center and don’t miss all the other fascinating podcasts in our library. Until next time, I’m Melanie Cole.