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Speaker 1: This is the Ben and Ashley I Almost Famous Podcast

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Speaker 1: with iHeartRadio.

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Speaker 2: Hey guys, welcome to the Almost Famous Podcast. To this week,

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Speaker 2: we got, you know, very sad news that Katie Thurston

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Speaker 2: has been diagnosed with breast cancer at the age of

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Speaker 2: thirty four, and she said in her Instagram post that

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Speaker 2: she wants to share her story to help others. So

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Speaker 2: we hope that we are supporting her and doing that

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Speaker 2: by having on Doctor Ammani Jambacar, thank you so much

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Speaker 2: for coming on our podcast.

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Speaker 3: You guys.

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Speaker 2: She is a board certified surgeon who first got her

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Speaker 2: Bachelor of Arts in English, which I'm interested about your switchover,

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Speaker 2: and then a bachelor's in science and psychology, and then

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Speaker 2: you went over to the biology side and you ended

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Speaker 2: up getting your Doctor of Medicine at the University of

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Speaker 2: Texas Health Center. And you have been on you know,

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Speaker 2: you speak a lot about breast cancer, and you were

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Speaker 2: on Shannon Doherty's podas who of course sadly passed away

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Speaker 2: this year, and you spoke with her about breast cancer.

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Speaker 2: She was part of the iHeart family, So we just

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Speaker 2: want to thank you for coming on and talking to

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Speaker 2: the Almost Famous Bachelor audience about something that has affected

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Speaker 2: one of our favorites so sadly. So first off, I

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Speaker 2: kind of want to ask the to me, it's obvious,

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Speaker 2: why should that we're hearing more women in their thirties

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Speaker 2: being diagnosed with breast cancer?

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Speaker 3: And should we?

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Speaker 2: I think we should start getting mammagrams earlier.

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Speaker 3: Earlier than forty or earlier earlier than forty.

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Speaker 4: Yeah, so that's an interesting question, and I do. I

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Speaker 4: have quite a few patients that are in their thirties.

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Speaker 4: I've seen patients in their twenties, and the youngest patient

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Speaker 4: I've had with breast cancer is nineteen.

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Speaker 3: Actually, Holy molly.

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Speaker 4: Yes, so it is definitely something that impacts younger women

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Speaker 4: as well. I think that overall, we're seeing cancer incidents

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Speaker 4: go up in younger people, which is why ages for

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Speaker 4: things like colonoscopies are going down. I think that everyone

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Speaker 4: who has a family history of breast cancer, pancreatic, ovarian,

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Speaker 4: really any kind of cancer does need some kind of

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Speaker 4: risk assessment, and some people, yes, should start getting mammograms

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Speaker 4: and potentially MRIs as well earlier, you know, in their

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Speaker 4: twenties and thirties, because they are high risk for developing

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Speaker 4: a future breast cancer.

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Speaker 2: When we say family, are we talking parent grandparent? Does

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Speaker 2: it go further back than that? Does it should be

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Speaker 2: two grandparents? Because so I'll share a little bit of

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Speaker 2: a personal story in a bit. But my paternal grandfa

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Speaker 2: grandmother high breast cancer in her seventies. Oktal's totally fine,

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Speaker 2: but the doctors say that I'm much more at high

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Speaker 2: risk because of that.

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Speaker 4: Yeah, So when we're talking about a family history, we're

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Speaker 4: talking about first degree relatives, which is like your mom,

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Speaker 4: or if you're older, your daughter or one of your sisters,

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Speaker 4: or second second degree relatives, which include grandparents as well

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Speaker 4: as aunts and uncles or half sisters, half brothers, and yeah,

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Speaker 4: to speak to your family history. Generally, people who are

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Speaker 4: high risk have family members who have been diagnosed at

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Speaker 4: a younger age, usually before menopause. So that's usually like

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Speaker 4: in their forties, thirties, et cetera. Usually being diagnosed in

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Speaker 4: your seventies is not something that particularly increases, you know,

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Speaker 4: you as the granddaughter, your risk of a future breast cancer.

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Speaker 4: But it is something that I think everyone who has

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Speaker 4: a family history needs to have a conversation with either

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Speaker 4: their primary care doctor, their obgyn, or with you know,

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Speaker 4: a breast surgical oncologist like me, just to figure out

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Speaker 4: where you are in the spectrum of risk, especially if

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Speaker 4: you've also pre obviously had a lump, you've had a

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Speaker 4: biopsy for some reason. All of those things matter.

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Speaker 2: So you are a breast oncologist surgeon, So this is

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Speaker 2: basically what you're doing all day long is taking out

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Speaker 2: cancer out of breast.

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Speaker 4: Yeah. So I'm a breast surgical oncologist that did my

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Speaker 4: fellowship in breast surgical oncology at Columbia, and there I

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Speaker 4: also did a lot of melanoma. So my practice is

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Speaker 4: a mix of taking out breast cancers, also counseling patients

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Speaker 4: about their risk in our high risk breast clinic, and

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Speaker 4: also quite a bit of melanoma as well.

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Speaker 3: What inspired you to go into that department.

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Speaker 4: That's an interesting story. So I was the only I

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Speaker 4: was one of a handful of women who chose the

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Speaker 4: surgery route from my medical school class, and then I

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Speaker 4: was the only woman in my graduating class in general surgery.

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Speaker 4: And I really wanted to be in a field that

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Speaker 4: I thought would enable me to how are women. And

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Speaker 4: I also wanted to be in a field that I

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Speaker 4: thought was really evidence based and for that, you know,

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Speaker 4: doing both breast cancer and melanoma fit the bill for me.

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Speaker 4: And then I was lucky to get into my fellowship

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Speaker 4: at Columbia and I'm now in my six year of

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Speaker 4: practice and I absolutely love it. It's definitely where what

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Speaker 4: I was meant to do.

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Speaker 3: Congratulations, that's amazing, Thank you so much. Good obviously.

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Speaker 2: All right, so we're all told to do our examinations

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Speaker 2: at home starting at what age.

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Speaker 4: So it's kind of like, you know, this is gonna

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Speaker 4: be a little bit controversial, but I'm kind of like,

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Speaker 4: you know, a lot of times I'll see people in

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Speaker 4: the office and they'll have been diagnosed with a breast

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Speaker 4: cancer and it might have been a breast cancer that

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Speaker 4: they felt, but they will say something to me like, oh,

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Speaker 4: you know, doctor Jambicar. I know I'm supposed to be

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Speaker 4: doing like monthly self breast exams, and I just haven't

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Speaker 4: done them. I've missed a few, So this is my

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Speaker 4: fault because I didn't do them, and I always have

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Speaker 4: to tell them like, actually, really like self breast exams

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Speaker 4: don't make as much of a difference as breast imaging,

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Speaker 4: and so I recommend breast awareness to my patients like

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Speaker 4: generally just knowing, you know, especially when you're in the

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Speaker 4: shower you're soaping up, knowing what your breasts feel like.

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Speaker 4: Especially for younger women, that may mean that your breasts

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Speaker 4: are kind of lumpy because they're dense, and that's okay.

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Speaker 4: And then really, the thing I hammer home all the

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Speaker 4: time and literally all the content I put out there

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Speaker 4: on social media is if you have a lump, it

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Speaker 4: needs to have some kind of imaging follow up. So

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Speaker 4: you have a lump, you go and see exactly like

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Speaker 4: Katie did you know, You go and see your doctor

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Speaker 4: and then you get an ultrasound or a mammogram or

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Speaker 4: both ordered, not just a doctor saying, oh, you're too

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Speaker 4: young to have breast cancer, so this is probably nothing.

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Speaker 2: So when I was twenty two, I was just you know,

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Speaker 2: I've always had a pretty dense breast.

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Speaker 4: Yeah, I don't know that you call it.

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Speaker 3: Would you call them cystic?

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Speaker 4: I mean, I think that word gets used a lot,

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Speaker 4: but I think that like, really virtually everyone who's in

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Speaker 4: their twenties has dance breast that a lumpy okay.

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Speaker 2: So there was one spot where it was like particularly

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Speaker 2: like it was it was a lump, okay, but it

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Speaker 2: was smooth and it moved and it was very marble

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Speaker 2: like oh, which is all good signs, but still signs

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Speaker 2: of course that it should probably be checked out. Yeah,

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Speaker 2: so I did. I got a mammogram at twenty two

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Speaker 2: and got an ultrasound and then they biopsied it. Okay,

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Speaker 2: they tagged it and they said and then it was fine.

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Speaker 2: And then I got it checked up. Probably probably too late,

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Speaker 2: I mean probably later then I may have should have,

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Speaker 2: but like around thirty I did it. I got it

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Speaker 2: checked out again, and my doctor, knowing that history and

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Speaker 2: then knowing my grandmother had it, she was like, okay,

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Speaker 2: well I want to just send you in for another

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Speaker 2: ultrasound and mammogram. Did that found some calcifications that they

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Speaker 2: ended up biopsying again. That biopsy I like basically fanted

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Speaker 2: during Yeah.

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Speaker 4: Those are the mamogram buses are rough.

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Speaker 3: Yeah, it was crazy.

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Speaker 2: I was like, there is an instrument inside my body

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Speaker 2: right now. And then just last month I went and

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Speaker 2: I got my check like four years later on all

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Speaker 2: of that again ultrasound and mammogram, and I'm all good.

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Speaker 2: But there's always there's like a lot of women out

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Speaker 2: there that are young and like things are flowing around,

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Speaker 2: and it's it's best that they take action, right.

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Speaker 4: It's definitely best that they take take action. And I

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Speaker 4: mean I see it all the time, like lots of

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Speaker 4: young women like you have, you know, these kinds of

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Speaker 4: benign findings or a lump that moves around and is

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Speaker 4: something that doesn't really need to be removed. But I

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Speaker 4: also see, you know, as a cancer surgeon, I also

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Speaker 4: see the other side of that, women who went to

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Speaker 4: some doctor or an urgent care or something like that

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Speaker 4: and said, hey, I've got this new lump and it's

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Speaker 4: not going away, and it's not changing with my periods.

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Speaker 4: It's just there all the time. I don't know what

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Speaker 4: to do with that. And then someone examines them and says, well,

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Speaker 4: it's probably just a cyst. It's probably nothing because you're

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Speaker 4: too young to have breast cancer. And then the thing

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Speaker 4: keeps growing. They go see another doctor and someone says

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Speaker 4: the same thing, and then by the time they finally

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Speaker 4: get breast imaging ordered, at that point it sometimes isn't

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Speaker 4: early stage anymore. And so just very very important that

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Speaker 4: if you feel something or you see skin changes, you

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Speaker 4: have new nipple discharge, anything that concerns you that you

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Speaker 4: take it to your regular doctor, your obgyn and ask them,

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Speaker 4: you know, hey, can you order some breast imaging for me?

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Speaker 2: So when you're checking like mine was, as I said,

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Speaker 2: a little bit less alarming because it was smooth marble,

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Speaker 2: I can moved around. It's basically the opposite that you're

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Speaker 2: really looking out for correct like edged and then discharge

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Speaker 2: and then it's kind of stays in one spot.

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Speaker 4: Yeah, it stays in one spot now. I it kind

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Speaker 4: of depends on the depth of you know, the thing,

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Speaker 4: the lump in the breast, Like there are some that

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Speaker 4: could be deeper in there that do move around because

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Speaker 4: there's a lot of breast tissue in front of it,

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Speaker 4: and there's some that you know, I've even seen patients

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Speaker 4: say this feels hard like a marble with the edges

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Speaker 4: aren't like a marble, And so, you know, I think

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Speaker 4: what you're looking for really is something that is there

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Speaker 4: and it's hard, and it's not going away on its

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Speaker 4: own after a week or so. And if it's not

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Speaker 4: going away on its own after a week, then you

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Speaker 4: know it needs to be checked out. And sometimes people

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Speaker 4: tell me something like you know, I fell, or you

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Speaker 4: know my dog bit me or something like that. You know,

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Speaker 4: I had some kind of trauma here and it started

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Speaker 4: after that, but then it never went away, and now

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Speaker 4: here we.

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Speaker 3: Are interesting, okay.

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Speaker 2: And then what's the proper pose when you're checking yourself out?

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Speaker 2: Isn't it with your arm up like over your head?

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Speaker 4: Yeah, your arm up and then just kind of going

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Speaker 4: in circles, starting from the nipple going working your way out,

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Speaker 4: but with your arm up or down. It doesn't really matter,

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Speaker 4: you know. I think it's kind of whatever's comfortable for you.

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Speaker 4: Just sort of be aware of what your breasts feel like.

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Speaker 4: Everyone should be aware of what their breasts feel like.

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Speaker 4: But I do see the ones that are lumps of

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Speaker 4: either the cancerous kind or the benign kind. I see

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Speaker 4: a lot like that. They found it when they were

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Speaker 4: in the shower, you know, they're soaping up, and they

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Speaker 4: were like, oh, this is this is new. I haven't

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Speaker 4: felt this before, and so that kind of vigilance. I

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Speaker 4: definitely recommend, you know, doing a monthly self breast exam

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Speaker 4: or setting you know, a calendar appointment for yourself to

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Speaker 4: make sure that you check them. I don't think women

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Speaker 4: should be held to that because it's so hard to do.

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Speaker 4: Life as a woman as it is, there's so many

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Speaker 4: extra responsibilities on our plates, and so you know, I

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Speaker 4: don't want anyone coming into my office and feeling some

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Speaker 4: kind of guilt or shame that like, oh I should

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Speaker 4: have checked myself earlier and this would have you know,

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Speaker 4: solved the problem, right.

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Speaker 2: I want to pick your brain about what you think

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Speaker 2: is maybe a correlation. So lots of people are thinking

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Speaker 2: that maybe birth control increases your odds. What's your opinion

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Speaker 2: of so birth control, like hormonal birth control interesting?

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Speaker 4: Yeah, it's kind of interesting because it's like it does

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Speaker 4: slightly increase the risk for breast cancer, but it also

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Speaker 4: decreases the risk for ovariant.

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Speaker 3: Carey cancer, you know, if you're right.

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Speaker 4: So it's kind of like, yeah, so like in terms

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Speaker 4: of modifiable risk factors for breast cancer, I mean I

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Speaker 4: would say, like not drinking an excess is one of them,

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Speaker 4: and that's kind of it. You know, most of the

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Speaker 4: time breast cancer boils down to bad luck. That's what

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Speaker 4: I tell my patients all the time, because I have

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Speaker 4: patients who you know, have never taken hormonal birth control,

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Speaker 4: who have no family history, who are super healthy, never drink,

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Speaker 4: never smoke, exercise, you know, forty minutes a day, every

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Speaker 4: single day, and they can still end up with breast cancer. Conversely,

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Speaker 4: I've had patients that have all those risk factors that

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Speaker 4: never end up with breast cancer. And so it's really

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Speaker 4: the most important thing is like, if you do have

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Speaker 4: a family history, to get that checked out and to

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Speaker 4: figure out what your future breast cancer risk is, so

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Speaker 4: you could see if you do need to start your

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Speaker 4: imaging earlier than forty. But then if you are forty,

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Speaker 4: you need to be getting a mammogram every single year.

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Speaker 4: It might mammogrant plus an ultrasound might just be a

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Speaker 4: mammogram by itself, could be a mammogram and an MRI,

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Speaker 4: but mammogram has to be in there and definitely definitely

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Speaker 4: definitely not a thermogram because those are not evidence based

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Speaker 4: and cancers get really missed on those.

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Speaker 2: What about soy? I know people are considered about soy

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Speaker 2: even deodorant.

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Speaker 4: Yeah, there's a lot of stuff out there about those,

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Speaker 4: SOI like, it's kind of there's not a very strong

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Speaker 4: study that says like if we cut out soy from

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Speaker 4: our diets, it means that you won't develop, you know,

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Speaker 4: an estrogen responsive breast cancer. And so there's not really

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Speaker 4: like there's really no preventing it, so to speak. You know,

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Speaker 4: I think it's just living a healthy lifestyle, and you know,

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Speaker 4: minimizing drinking I think is important. But you know, any

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Speaker 4: people who avoid all of those things, who kind of

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Speaker 4: see any study that has sort of a weak link

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Speaker 4: to breast cancer, and you know, there was a study

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Speaker 4: that talked about hair dye, for example, recently, and people

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Speaker 4: who are like, Okay, I'm gonna stop dying my hair,

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Speaker 4: like in the end, Like that amount of difference is

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Speaker 4: so small compared to the biggest risk factors for breast cancer,

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Speaker 4: which is being a woman and having breasts and getting older.

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Speaker 2: This is maybe a little bit off of the breast

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Speaker 2: cancer question, but you did mention that younger women have

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Speaker 2: denser breasts in their twenties. So I had two kids

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Speaker 2: over the past three and a half years. One is

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Speaker 2: literally screaming his head off right now. So if I

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Speaker 2: seem a little elsewhere, I don't know what's going on.

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Speaker 2: But didn't you have breastfeed and my breasts are now

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Speaker 2: not at all dense, They're like squashy.

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Speaker 3: What happened?

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Speaker 4: Yeah, that happens. You know, I've seen that before, well,

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Speaker 4: that does happen, you know, it's breastfeeding. That's one of

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Speaker 4: those things that I think they really don't tell women

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Speaker 4: before they like choose to breastfeed or.

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Speaker 3: Choose not to breastfeed.

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Speaker 4: Though. Yeah, so breastfeeding definitely does make your breast less dense. Interesting,

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Speaker 4: and pregnancy also like you know, formal impacting the breast,

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Speaker 4: the breast expanding, filling and then unfilling, filling and then unfilling. Yeah,

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Speaker 4: so a lot of women tell me that, you know,

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Speaker 4: and I can even tell you know at this point

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Speaker 4: because I see a lot of patients in my office

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Speaker 4: and do a lot of breast exams, I can tell

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Speaker 4: you know who has breastfed and who hasn't. And that's

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Speaker 4: something that really they should tell a lot more women that, like, hey,

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Speaker 4: your breasts are going to be changed after this, and

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Speaker 4: sometimes that can be a little bit surprising to people.

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Speaker 4: But in general, breasts also get less dense as you

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Speaker 4: get older. It's very uncommon to see people with very

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Speaker 4: very dense breasts, you know, in their seventies and eighties,

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Speaker 4: although rarely I do see it.

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Speaker 2: I wonder I'm reading Katie's caption right now. Yeah, so

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Speaker 2: she has invasive ductal carcinoma.

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Speaker 3: Mm hmm, it's invasive ductyl mean.

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Speaker 4: So there's two parts of the breast. There's the ducts

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Speaker 4: that deliver the milk out the nipple because the breasts

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Speaker 4: were the whole function of breasts is to breastfeed. That's

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Speaker 4: what they were designed for, right, And so there's two

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Speaker 4: parts of the breast, the duct that leads the milk

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Speaker 4: out the nipple in order to do breastfeeding, and the

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Speaker 4: lobules which actually makes the milk. And that what she's

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Speaker 4: saying is that her cancer started in the ducts of

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Speaker 4: her breasts and not the lobules. It's that's the more

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Speaker 4: common type of breast cancer rather than the lobules, and

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Speaker 4: that that's it's invasive, meaning that it is now forming

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Speaker 4: a mass outside of that duct.

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Speaker 2: Okay, I don't want to speculate on what stage she's

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Speaker 2: at or you know, the intensity that she's going to

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Speaker 2: have to go through. I just want to say that again,

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Speaker 2: we're thinking about her and we're sending all of our

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Speaker 2: love out to her. Is there anything that I missed

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Speaker 2: in this conversation that you think is critical for women

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Speaker 2: out there to know?

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Speaker 4: I think we pretty mu covered it. You know, I

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Speaker 4: think she is doing women such a service by putting

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Speaker 4: all of this out there and really almost in real time,

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Speaker 4: being so transparent about you know, I know that she

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Speaker 4: had a biopsy of the breast, a biopsy of the

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Speaker 4: lymph node, and that's probably why you mentioned chemote therapy.

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Speaker 4: That's probably why she's getting chemote therapy is because the

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Speaker 4: cancer has spread from the breast to the lymph nodes.

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Speaker 4: And so I really commend her for putting this information

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Speaker 4: out there for women, especially for other young women to

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Speaker 4: see and to know that you know there's steps ahead.

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Speaker 4: These are the steps ahead, and that you know she's

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Speaker 4: a strong person who can get through it, and if

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Speaker 4: God forbid that happens to them, they will also be

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Speaker 4: able to get through it. So it's really what she's

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Speaker 4: doing is so incredible because it can be such a

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Speaker 4: terrifying time for people. So I really commend her me

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Speaker 4: too well.

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Speaker 2: Doctor Jan mccarr, thank you so much for being here

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Speaker 2: and answering all these questions.

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Speaker 3: Thank you for what you do. You're incredible.

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Speaker 2: And you know, if we ever encounter anything like this again,

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Speaker 2: or if Katie has any more updates, we'd love to

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Speaker 2: have you back.

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Speaker 1: Yeah.

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Speaker 4: Absolutely, I would be happy to share. Thank you so much

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Speaker 4: for having me on today.

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Speaker 1: Follow the Ben and Ashley I Almost Famous podcasts on iHeartRadio,

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Speaker 1: or subscribe wherever you listen to podcasts.