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March 21, 2024
Ep -
5

Dr. Armando Giuliano on the Science of Surviving Breast Cancer: Part Two

In this episode of SHE MD, we're back with the legendary Dr. Armando Giuliano for another deep dive into beating breast cancer. In this interview, we get into the details of breast cancer screening, diagnostic tools like mammograms, ultrasounds, and MRIs, and why knowing your risk is a life-changer. Dr. Giuliano unfolds the story behind the sentinel lymph node biopsy—an innovation in surgery that's been a blessing for so many women, cutting down on invasive procedures and their side effects. You'll get a clear understanding on everything from the different types of breast cancer, surgical options, immunotherapy, who should and should not be taking HRT, and the impact of chemotherapy. Wrapping up, Dr. Giuliano shares his top five takeaways on breast cancer awareness, detection, diagnosis, and treatment, aiming to empower women with knowledge and control over their health. Join SHE MD in the fight against breast cancer.

About the Guest

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Armando E. Giuliano, MD, has been a clinician-researcher for over 40 years. The main focus of his clinical research continues to be management of early breast cancer and quality of life of breast cancer patients. He served for five years as chairman of the Breast Organ Site Committee of the American College of Surgeons Oncology Group and was study chair for the sentinel node Z0010 and Z0011 studies which led to significant changes to the standard of care for patients with early breast cancer.

Dr. Giuliano was previously a principal investigator for the NSABP and contributed to the first lumpectomy study and to Alliance studies. He was a pioneer in sentinel node biopsy. This procedure has enabled early-stage breast cancer patients to avoid having more extensive surgery and reduces the incidence of complications such as lymphedema and shoulder problems. Giuliano also participates in translational research, merging what is learned in the clinic with knowledge gained in the laboratory.

Dr. A’s Breast Cancer Takeaways

  1. Know your lifetime risk of breast cancer. Use our lifetime risk calculator to assess your risk.  Coming soon!
  2. If your lifetime for breast cancer risk is average (around 12.5%) start yearly breast imaging with mammograms at age 40.  Dense breast tissue can make abnormal findings hard to see on a mammogram. If you have dense breasts, ask your doctor to order a bilateral breast screening ultrasound.
  3. If you fall into the intermediate category (15-20%), start imaging at age 40 with a mammogram. Add a breast ultrasound if you have dense breasts, and add a bilateral breast MRI every few years just to be safe.
  4. If you fall into the high-risk category (20% or more), start breast imaging as early as 30. You can alternate mammograms and ultrasounds every six months with a breast MRI.
  5. If you have a family history of breast cancer, get a genetic cancer test. Women with certain gene mutations like the  gene change have a greatly increased risk of breast cancer, as well as an increased risk of ovarian cancer, pancreatic cancer, and possibly some other cancers. These tests are almost always covered by insurance.