Dr. Elizabeth Comen

speaker

796 appearances 2 recordings 2 series first heard Apr 2025 last heard 13 Jan

Dr. Elizabeth Comen’s voice in public audio — every appearance, attributed to the second.

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recordings per month · last 12 months

Recordings per month over the last 12 months — 1 in all, peaking in Jan 2026 with 1.

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The Tamsen Show · Mammograms, Dense Breasts and Hormones: What Every Woman Needs to Know · 16 Apr 2025 podcast

Das bedeutet nicht, dass Sie das Mammogramm nicht machen. Sie fangen mit dem Mammogramm an. Das ist der Goldstandard. Jetzt, wie weißt du, ob du einen höheren Risiko für Breastcancer hast? Du musst mit deinem Arzt sprechen über deine eigenen individuellen Risikofaktoren. Das betrifft eine Familiengeschichte, nicht nur deine immediate Relative.

Und viele Leute denken manchmal, oh, wenn niemand auf meiner Moms Seite Breastcancer hat, bin ich nicht auf Risiko für Breastcancer. Du musst wissen, was deine Familiengeschichte ist, ob es irgendein Krankheit ist, auf deiner Mothers Seite, aber auch auf deiner Vaters Seite. Any cancer? Any cancer, right? And you need to bring that to your doctor.

You may need to talk to a genetic counselor, because there are different genetic hereditary syndromes that aren't necessarily just associated with breast cancer. For example, prostate cancer can be linked to breast cancer. What if your father only had brothers, they all had prostate cancer, and you're missing an increased risk for breast cancer, because that hasn't been delineated?

Yes, so what you want to do is talk to your doctor about both sides of your family history. Your doctor will then take that into different algorithms to better understand your breast cancer risk. If you need to start sooner than age 40, it may also mean that you need to screen with things like breast MRI if you have a greater than 20% increased lifetime risk of breast cancer.

How do you find out if you have that 20%? So, In Part by looking at your family history and potentially with genetic testing, which we can go over in a moment. There's also the breast cancer risk assessment tool, which is something that you can do online. Olivia Munn was very public about that, about how that pushed her to get a breast MRI that caught her breast cancer.

So that's something that all women should be doing online. They can do it with their doctor, bring that information to their doctor and help determine, do I need to start screening before the age of 40? Genetische Testung, es war historisch so, dass wir nur zwei genetische Mutationen testeten oder zwei Genen, die Mutationen in ihnen haben könnten.

BRCA1 oder BRCA2, otherwise known as BRCA1 oder BRCA2. Es gab so viel Forschung über Hereditary Cancer Syndrome seit der Erfindung von BRCA1 und BRCA2. If appropriate, you're tested for a broader panel of genetic mutations that could be associated with breast cancer or other cancers as well.

What should happen is, is there should be a broader view of your family history on your mother's side and your father's side. Okay. And potentially visit with a genetic counselor who can then help determine what's the best genetic panel for you to be tested for.

So if your mom is diagnosed at 45, you probably want to talk to your doctor about screening 10 years prior to that. But again, it depends on not just your mother. What's the rest of the family history? What else is going on?

Du weißt, was du willst.

Ich meine, ich habe Eltern, die ich helfe, mich zu kümmern. Ich habe drei kleine Kinder. I have a full job and a big life. I don't know other than let's keep talking about it and keep reminding ourselves and saying, maybe today is the day I'm going to make my appointment for my mammogram or follow up with that ultrasound or get that colonoscopy, start at age 45. Let's talk about that. Klonosomie?

Unless you have a family history. Make sure you're also getting checked for cervical cancer. Pap smears?

Okay, that's your decision. Yeah, totally my decision. So let's break down one of the biggest myths about breast cancer. There are two big ways that we treat breast cancer that contribute to the confusion in the public. So when you are diagnosed with breast cancer, Wir fokussieren uns auf zwei große Dinge, lokalen Kontrolle und systemische Kontrolle.

Lokale Kontrolle bezieht sich auf das, was wir für die Brüste tun und vielleicht die Lymphnoten, die unter dem Armpit sind. Es gibt zwei verschiedene Wege, wie wir das machen können. Wir können das mit einer Surgery machen, einer Lumpektomie oder einer Mastektomie. Lumpektomien sind meistens mit Radiation kombiniert. Aber eine Lumpektomie plus Radiation versus a mastectomy.

I know we're getting biological here, but people can play it back. Lumpectomy plus radiation or a mastectomy are equivalent in terms of survival from breast cancer.

Okay. Why is that? Because what makes breast cancer potentially deadly has nothing to do with what's in your breasts. If I had both my breasts filled with breast cancer and it was rock hard and it looked weird and I touched it and it was terrible, but those cells never traveled outside my breast, Es wäre nie eine Bedrohung für mein Leben gewesen.

Wenn Frauen sagen, dass sie eine Bilaterale Total Mastektomie bekommen wollen, dass sie mit Breastcancer behandelt wurden, und dass sie niemals davon sterben wollen, dann ergibt das keinen Sinn. Es ergibt keinen Sinn, weil der Risiko ist, ob irgendein schmutziger Zellkörper fliegt.

Lymphatischer oder Blut, das wissen wir nicht. Der zweite Grund für Breastcancer-Besuch ist systematische Kontrolle. Und es gibt verschiedene Arten, wie wir das tun, mit Hormontherapie, mit Chemotherapie, abhängig davon, welchen Art von Brustkrankheit eine Frau diagnostiziert wird.

Wenn also eine Frau sagt, mit Stage-0 oder Stage-1 Brustkrankheit möchte ich niemals von dem sterben, dass ich eine Bilaterale Mastektomie bekomme, gibt es da keine Logik. It's about what we're doing to find or decrease the risk of what we call metastatic disease. What local control does if you get a bilateral mastectomy is decrease your risk of a new breast cancer. I see.

Or recurrence from the one that you had. So if you are diagnosed with an early stage breast cancer and you say I want a bilateral mastectomy. Maybe you're saying it because you don't want radiation. Maybe you're saying it because the stress of going for a mammogram is so damn high. I never want to go through this again. I don't want to worry about a new diagnosis of breast cancer.

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