Gina Kaye (Host): Welcome to the Live Greater podcast series, information for a healthier you from the University of Maryland Medical System. With me is Dr. Wen Liang, breast cancer surgeon at UM Capital Region Health in Largo. Our topic today is Beyond Mammograms: Taking Charge of Your Breast Health. Welcome, Dr. Liang. It's a pleasure to have you with us today.

Wen Liang, DO: Thanks for having me, Gina.

Host: Absolutely. We are excited to dive in and get more information about this very important topic. When we talk about breast health, what should women be thinking beyond mammograms?

Wen Liang, DO: I always say the first thing is know your body, know what's normal for you. I think that is so important because that's what's gonna help the doctors know what we should be cautious of and what we should look for and personalize your screening.

Host: Let's talk about factors that may put someone at higher risk for breast cancer, and how can a woman understand her own personal risk?

Wen Liang, DO: Yes, great question. You want to really know your risk. You don't want to underestimate, but you don't want to overestimate your risk. People don't realize the number one risk factor is being a female and living in North America. The average US woman is 13% risk over their lifetime of developing breast cancer.

You can certainly be at higher risk with certain family history, but even more so if you've had a prior history of radiation to your chest, for example. There's some unmodifiable risks like your family history and your personal previous medical history. But there's some modifiable risks such as your lifestyle, what you can do, what you can avoid, the healthy diet you can have, the exercise you can do.

Host: So, you already touched a little bit on family history. So, let's talk about how important is it to actually know your family history, and what should you know about your family's cancer history?

Wen Liang, DO: So for a woman who has no other risk factors, you would be considered at average risk. But if you knew your first-degree relatives, that would be the most important, specifically for breast cancer. Breast and ovarian cancer can sometimes run together with genetic mutations. So if you've had a first-degree relative, your mother or your sister, who have had breast cancer or even ovarian cancer at a young age, less than 50, those would be concerning factors you would want to certainly share with your doctor to see if you warrant genetic testing. I should have said also in case your father or your brother had breast cancer. Obviously, that's another red flag.

Host: Thank you. What breast changes should women pay attention to and bring to their healthcare provider's attention?

Wen Liang, DO: First is the appearance. So, sometimes we just forget that. And so once in a while when you get out of the shower, look in the shower, see what they look like. I will teach women to raise their arms and look for a dimple or retraction under or around the edges of the breast. So, any kind of retraction where it looks like a dimple sucking in the skin of your breast, that's a concerning factor.

The appearance of the skin in general, and I'm not talking about maybe a little red dot or a rash here and there, but something that's pretty significant where the skin is very thickened, sores that shouldn't be there or bleeding from the nipple or a visible lump even. Sometimes the lump is so large that it's bulging out the contour of your breast. So obviously the visible appearance. And then, that would lead to the feel. So, that's why you need to know what your normal lumpiness feels like.

Host: Okay, great information. Are there everyday things women can do to help lower their breast cancer risk?

Wen Liang, DO: Yeah. Recent studies have really looked at this, and not only does it lower your cancer risk in general, but the research has specifically looked at breast cancer risk. And you're able to lower that by avoiding toxins such as cigarette smoking, such as avoiding alcohol in excess, or even you're able to exercise daily. If you're able to modify your diet so you're eating less processed foods, less sugars, and more of a Mediterranean diet or what we call a prudent diet with healthy grains, healthy olive oils, for example, lean meats, but lots of vegetables, fish, fresh fruits. Those are all things you can do to lower your own individual .Risk

Host: Our final question: What is the most important thing you want women to do today to take charge of their breast health?

Wen Liang, DO: To know your own risk such that if you are of average risk and you're over 40, get a mammogram, grab your friends, have that conversation with your girlfriends, and make sure you're all doing what you can to stay healthy and around for a long time. So, taking care of each other.

Host: That's great advice. Thank you. Dr. Liang, thank you so much for sharing your knowledge and your time. It is very much appreciated.

Wen Liang, DO: Thank you.

Host: Thank you for listening to Live Greater, a health and wellness podcast brought to you by the University of Maryland Medical System. I'm Gina Kaye, and we look forward to you joining us again. Please feel free to share this on your own social media. For more podcasts, articles, and to sign up for emails, visit our health hub at health.umms.org. Thanks for listening.