Joey Wahler (Host): It's important for women and men alike. So, we're discussing breast health. Our guest is Dr. Tanja Gunsberger. She's a general surgeon board-certified by the American Osteopathic Board of Surgery. This is WickCare Talks, the podcast from Wickenburg Community Hospital and clinics dedicated to helping our community live healthier, more active lives. In each episode, we connect you with trusted health experts, sharing valuable insights on a wide range of topics, from managing chronic conditions to simple tips for everyday wellness. We're here to provide practical information to support you on your health journey. So, be sure to follow us so you never miss an episode. Thanks so much for being with us. I am Joey Wahler. Hi there, Dr. Gunsberger. Welcome.

Tanja Lea Gunsberger, DO, FACOS: Good morning. Happy day!

Host: Yes! We are ready to roll with a chat about breast health. And so, first, give us a brief overview please, Doc, on what do we mean by breast health these days. And why is it so crucial for both women and, as we pointed out at the top, men as well, to be informed about?

Tanja Lea Gunsberger, DO, FACOS: we know that breast cancer affects many women. One out of eight women at some point of their life will have a diagnosis of breast cancer. But it affects even more, because many women get that scare of, "I've got a breast mass. I've got to go get a biopsy," or something additional imaging. And that happens to more like one out of three or one out of four women. And it's something that's on our minds on a regular basis. With this kind of frequency, we all know family members, a sister, a mother, a a friend—and a lot of times, it's often a friend that has been given this diagnosis of breast cancer. And it's really a wise idea to have a little bit of information so you can support them.

Host: No question. As you point out, Doctor, it's not so much a question of if you'll have to encounter this as a woman, but when. And I mentioned men, while relatively rare, men too can get breast cancer, correct?

Tanja Lea Gunsberger, DO, FACOS: Yes

Yeah. The rate is rare. It's one out of a thousand, but that's still 2,500 cases every year. And honestly, breast cancer that affects women also affect men. It's your friends, it's your spouse. And men can play an active part in helping support that.

Host: Absolutely. So, how would you say the approach to breast cancer health has changed most in recent years and why is now a particularly important time to discuss this?

Tanja Lea Gunsberger, DO, FACOS: Well, we have great ability to do screenings. And since the 1980s, we have had a 40% decrease in our death rate from breast cancer, and that is really significant.

Host: So, what are some of the early signs and symptoms of breast issues that those joining us should be most aware of, would you say?

Tanja Lea Gunsberger, DO, FACOS: One of the things that we always encourage is the self-breast exam. And that is monthly exams where you just get to know what your breast feels like. All breasts have some lumps and bumps. They're not perfectly smooth. And by doing a monthly breast exam on yourself, you can then notice if a change happens and a change can then prompt you to go and have further evaluation done. Ten percent of breast cancer is found by the patient. So, that's a big number when you think of it in the grand scheme of things. Additionally, doing breast cancer screenings with mammograms, mammogram is recommended starting at age 40 by multiple institutions that look at preventative care. And mammogram is really the big bang for the buck, getting those mammograms done.

Host: Speaking of mammograms, you mentioned starting at age 40 typically, but how about risk factors that may involve getting it done earlier and possibly more often?

Tanja Lea Gunsberger, DO, FACOS: Correct. If there is a family history of breast cancer and sometimes there's genetic knowledge of what your family type has, getting those mammograms are often individualized and requested at an earlier age.

Host: When we talk about genetics and breast cancer, Doctor, am I right that, unfortunately, this is something that's often hereditary?

Tanja Lea Gunsberger, DO, FACOS: It can be. It really can be. But it can also be sporadic. So just because you don't have any blood relatives with breast cancer doesn't mean you want to skip the screening. But yes, in the last 10 years with our genetic knowledge base, we have found that there are specific links to certain genotypes. The ones that we talk about a lot are what we call BRCA, which is BRCA. There's a BRCA1 and a BRCA2. And that's one that's very talked about nowadays.

Host: When we talk about risk factors as well, anything besides genetics that could increase the likelihood of developing breast-related problems?

Tanja Lea Gunsberger, DO, FACOS: Yes. One of the most common one is alcohol ingestion. There's a lot of data support that if you exceed four ounces of alcohol on a daily basis, and sometimes it can be as low as two drinks per week, that your cancer rate of breast cancer, but not just breast cancer, most cancers actually increase. Additionally, your amount of your body habitus and how much adipose tissue, which is what we call fat tissue. And then lastly, there is the use of postmenopausal hormone therapy, hormone replacement therapy. That has a questionable link that needs to be looked at.

Host: And you mentioned a little bit earlier that, in recent years breast cancer is being treated more effectively. What advancements have been made in the early detection and diagnosis areas that account for that.

Tanja Lea Gunsberger, DO, FACOS: The mammogram screenings have gotten much more resolution. And then also getting sequential mammograms, having a mammogram from age 40. And then, going and marching along the years, you can see changes much easier. And today's technology, we're definitely using AI to supplement—not to replace, but to supplement—the radiologists so that we have like a backup check and the radiologist can go, "Does that look suspicious or not?" And AI has been helping with that.

Host: And so, another example where AI is being used in the medical world to not necessarily do the work of doctors like yourself, but to support it, right?

Tanja Lea Gunsberger, DO, FACOS: Correct, and increase the accuracy. Let the doctor get to those lesions faster so that the report can get to the patient faster, and actions can happen quicker.

Host: Absolutely. So, we're talking here about the importance of screening and prevention and early detection. But in the event that there is a breast cancer diagnosis, what are the most common treatment options available these days?

Tanja Lea Gunsberger, DO, FACOS: Well, first we start with we have a suspicious lesion in the breast. And what's nice about that is then you can have minimally invasive techniques to get a tissue, a little piece so that they can test that it actually is cancer, where 30 years ago, every lump came out and that was all we had. Now, we can go in there with ultrasound, CAT scan, or MRI-guided, put a needle in and get some tissue and send it off and have that knowledge of what are we dealing with before we have to go to surgery. And so, that's a significant improvement in care.

It also then changes sometimes how aggressive the surgery is or is not and if the surgery even has to happen. And then, it can also lead to what we call breast conservative surgery or the standard of the past was the mastectomy, removing the entire breast.

Host: How about the fear factor here? I would imagine when you deal with patients that are facing not just breast cancer, but even something short of that, as you pointed out earlier, a scare. It's a very stressful situation to say the least for anyone that even has the thought that there could be something wrong, right?

Tanja Lea Gunsberger, DO, FACOS: It really is. And I've personally gone through this. I had a cyst, and the cyst was a little atypical and it was, "What do we do with this now?" And even as I shared that with my medical assistant, she was in tears. She was so scared for me. The main thing to keep in mind is not every breast lesion is going to be cancer. And cancer, in today's world, when you're doing the right steps and getting the prevention and looking at it, catching it, when it's small, very often is survivable. It's a journey down an unpleasant road, but it's entirely survivable.

Host: Yeah especially nowadays, as we've pointed out. A couple of other things for you here, Doctor. How can those joining us stay best informed about their overall breast health and keep up with the latest guidelines, because it's kind of a moving target, right? Things are changing and advancing and improving all the time.

Tanja Lea Gunsberger, DO, FACOS: That's correct. And it's wonderful that we have so much research going on. And it is changing the knowledge, because usually those changes are good changes, meaning we can tailor and customize the care.

So, the first thing is always discuss this with your primary care doctor or if you have a gynecologist that you see for that and being on top of it. That's really the emphasis there. Other places that are good to look for is some of our associations that provide the screening recommendations, is another great place to go for.

Host: And in summary here, what's the top takeaway you would suggest for those joining us based on this discussion? Is it as simple but yet as crucial as just remembering one of the big things we've talked about here, which is stay on top of this? Because the last thing you want to find out if you do have any kind of a diagnosis of something is that you contributed to it by being lax, right?

Tanja Lea Gunsberger, DO, FACOS: Right. You really want to do those preventative measures that you can, and minimize the aggressiveness of surgery that you need. Maybe minimize what other steps would potentially be needed. So, the screening is critical. And advocate for your health, if you need that mammogram, get it. If you have a lesion that you feel a bump, go talk to your primary care doctor as soon as you possibly can.

Host: Doctors like yourself always stressing the importance of patients advocating. If you think there may be something wrong, in other words, perhaps there's not, but check it out just in case, right?

Tanja Lea Gunsberger, DO, FACOS: Right. Absolutely.

Host: It can be as simple as that, making a huge difference here. Well, folks, we trust you are now more familiar with overall breast health. Dr. Gunsberger, keep up all your great work, and thanks so much again.

Tanja Lea Gunsberger, DO, FACOS: Thank you.

Host: And for more information, please visit wickhosp, W-I-C-K-H-O-S-P.com/wickcaretalks. And we hope today's discussion is provided you with valuable insights to support your wellbeing.

Remember, every step you take is a step toward a healthier life. To ensure you don't miss future episodes, please follow us on your favorite podcast platform. And if you found this episode helpful, please do share it on your social media as well. We appreciate you being part of our community. Until next time. Thanks for being part of WickCare Talks, and stay well.