Breast cancer awareness, early detection, mammograms, and modern treatment options—learn what women 40+ need to know now. In this Breast Cancer Awareness Month special, we talk breast cancer signs, risk factors, and how early detection saves lives. Dr. Elizabeth O’Leary—breast surgeon and head of Lady Slipper Breast Center—shares practical guidance on breast cancer screening, genetics, lifestyle, and survivorship. If you’ve delayed your mammogram, this conversation is your nudge. We cover what’s changed in breast cancer care, what to ask your providers, and how to advocate for yourself with confidence.

Timestamps

(00:00) Introduction to Breast Cancer Awareness Month & why this episode matters

(02:05) Meet Dr. Elizabeth O’Leary: training, Johns Hopkins, and founding Lady Slipper Breast Center

(06:18) Patient-first care: time, personalization, and thriving after treatment

(10:40) Lisa’s breast cancer story: fear, surgery decisions, and believing for a cure

(15:22) Early detection essentials: mammograms, dense breasts, and screening timelines

(19:30) High-risk assessment at 25: who needs early imaging and why it matters

(24:05) Genetics 101: family history, moving-target panels, and what results mean

(28:48) Lifestyle factors: diet, exercise, stress, alcohol—what the research supports

(34:12) Advocacy & self-trust: how to speak up and choose your care team

(37:20) Hope & next steps: practical actions to take this week

(39:15) Where to find Dr. O’Leary & Lady Slipper Breast Center

Key Takeaways

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• Early detection saves lives. Annual mammograms (and MRI for select high-risk women) dramatically improve outcomes.
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• High-risk assessment should start at 25. A formal risk review can identify women who need earlier or additional screening.
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• Genetics is evolving. “Negative before” doesn’t always mean negative now—panels and insights continue to expand.
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• Lifestyle matters. Consistent movement, strength training, weight management, stress reduction, and limiting alcohol are linked to lower risk.
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• You can be both calm and proactive. Ask questions, understand your options, and choose a team that treats the whole person.
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Guest Bio

Dr. Elizabeth O’Leary, MD is a breast surgeon and founder of Lady Slipper Breast Center in Minnesota (St. Paul, St. Louis Park, Edina). Trained at the University of Minnesota and Johns Hopkins, she specializes in personalized, comprehensive breast care—from screening and diagnosis through treatment and survivorship—with a focus on early detection, minimally invasive approaches, and patient-centered outcomes.

Resource Links

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• Lady Slipper Breast Center (Dr. Elizabeth O’Leary): https://www.elizabetholearymd.com
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• Find a high-risk breast clinic near you (search “breast cancer high risk clinic” + your city)
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• Breast density info & screening options (ask your imaging center about tomosynthesis and MRI for high-risk patients)
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• Lifestyle tools: activity trackers, strength programs for women 40+, and stress-reduction practices (breathwork, prayer, therapy)
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Tags/Keywords

breast cancer awareness, breast cancer, early detection, mammogram, dense breasts, breast MRI, breast cancer screening, HER2, BRCA, genetics and cancer, women’s health over 40, breast surgeon, Lady Slipper Breast Center, Elizabeth O’Leary MD, breast cancer prevention, survivorship, cancer risk factors, alcohol and breast cancer, diet and cancer, exercise and cancer, midlife women health, doing life different podcast

I'm thrilled to have you here today.

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It is for Breast Cancer Awareness Month,

and you know, this is near and dear to

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my heart because you all know I've been

through this and I have such a treat.

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I have little butterflies

dancing in my tummy.

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I have Dr.

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Elizabeth O'Leary.

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She was my surgeon.

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She's amazing.

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You're gonna hear about her.

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She, um, studied at the U of M.

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She worked at Johns Hopkins before

she started her own, uh, private

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breast center called Lady Slipper.

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She's got three locations in Minnesota,

so we'll have a connecting, uh.

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Email address and website in my

show notes, but she's so amazing

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and we are talking all things

breast cancer today, and this is

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what I always want you to know.

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I am cured and they are

curing this all the time.

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They have made leaps and bounds

and we know the most important

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thing is early detection.

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So get that mammogram.

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Let this be your reminder.

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If this is all you hear.

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I want you to know that I'm really

excited because we're talking,

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we're gonna get to know Dr.

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Eli Elizabeth A.

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Little bit more.

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We're gonna talk about my cancer journey.

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We're gonna talk about some of the

advances in treatment, and we're gonna

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talk about ways to detect breast cancer.

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And you know, I just know with

her there's a lot that I'm gonna

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learn that I didn't know before.

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So, uh, and then on Thursday

I will wrap it up with.

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More information that

maybe we've sent hit on.

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Um, so I'll talk about that in

Thursday's saddle up segment.

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So thanks so much for being here.

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You're gonna love this angel of a surgeon.

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Speaker: Listeners, I am.

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I have like happy

butterflies in my stomach.

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I'm so excited.

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I know.

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When you're like excited

about breast cancer.

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No, I'm excited to talk about it,

to get the word out and I have

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such a special guest with me today.

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I have, I mean, I'm probably

gonna get teary through this.

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I have Dr.

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Elizabeth O'Leary.

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She was my.

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Breast cancer surgeon and my husband

calls you the angel and we'll get

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more into, you know, how you kind

of help me through my journey.

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But what I am so excited about today, Dr.

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O'Leary, is this is such

a great opportunity.

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I get to know you a little bit better,

and I have goosebumps because you

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are such an amazing physician to me.

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You.

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You were part of changing my life,

which is such a blessing, you

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know, how blessings come out of

these hard things we go through.

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So I'm so excited to learn.

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What led you to do this work?

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Speaker 2: Thank you so much, and

thank you for your kind words.

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It was actually my honor

to take care of you.

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So I'm, I'm very, very happy to be here.

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So happy to be able to share my story and,

and of course, my hopes in all of this

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is that it's gonna inspire somebody to

go out and get a mammogram and, uh, put,

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you know, just do it just to, and, and

potentially find an early breast cancer.

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So, um, so, yep.

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Hi, I am Dr.

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Elizabeth O'Leary.

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Um, yeah, so I, you know, I have kind

of a circuitous story, but I, um, have

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had a lot of cancer in my life and my

family, um, including breast cancer.

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And so I, um, really, cancer has

always been a, something that has been

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incredibly important from a child onwards

because of my so many family members.

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Who have, um, suffered from different

cancers, all sorts of different cancers.

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Um, and I, uh, essentially, uh, at one

point in my life, went off to school,

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uh, on the East Coast to Johns Hopkins.

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And, um, my mother said to

me on my way out, don't go to

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school outside of the state.

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You're nev you're gonna meet somebody.

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Fall in love and you're never.

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And, you know, as mothers tend

to be right, uh, she was right.

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And I did, I, I met somebody, fell in

love, and, uh, had my wonderful husband.

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Um, and we actually did, we ended

up staying for many years out on the

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East coast, in the Washington DC area.

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But the big blessing from

that was that I ended up.

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Um, being able to have the

pleasure, um, and the honor to

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work at a wonderful private breast

center in the Washington DC area.

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And it was just a phenomenal setup.

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We were able to really take

time with patients and spend

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as much time as they needed.

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Um, every single breast cancer

patient has their own story.

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They have their own.

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Disease.

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'cause ev no two breast cancers are the

same, and no two people are the same.

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So being able to spend that extra

time really makes a big difference.

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It helps the patient to

understand their disease.

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It helps us to understand like how, how

is the best way to help this patient.

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Um, and so, and then, you know,

there was this element too

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of, um, we don't wanna just.

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You know, operate and disappear.

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We wanna be there before,

during, and after.

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We wanna help them to not only

get through all this and get

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cured, but we want them to do it.

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Um, you know, powerfully we want

them to have a great quality of life.

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We want them to really

thrive, not just survive.

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Right.

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And so, um, we really.

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Embrace the whole survivorship,

um, journey as well.

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So this was just such a phenomenal

place that I was working at.

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Mm-hmm.

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So even though I told my husband when

we got married that we were gonna

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move back to Minnesota because I am

a Minnesotan, through and through.

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I love Minnesota, I love

Minnesotans, I love our culture.

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Um, so, uh, but it was just such a

great work environment and I, you

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know, I, I miss everybody back there.

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It was incredibly difficult to leave.

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I miss.

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My wonderful partners and my patients.

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So they got to take care of generations

of patients with, uh, breast cancer.

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So they became part of my family too.

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So it was a really, really special place.

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And finally COVID hit.

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And actually it was kind of a good

big kick that I needed to say, oh,

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we have kids and we have no family.

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We really, we really, we

really need to get back home.

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So, um, so we came back to

the Twin Cities and, um.

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Really, I looked around because I

wanted to find something as special

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as what I had out in the East

coast, and there really wasn't.

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We had lots of big corporations and I, my

really, my heart and my training and my

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experience was all about trying to have.

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Something where we could just, not

trying to get as many patients through

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as fast as possible, but really

trying to connect with patients, help

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them on their journey, and really

have that personalized approach.

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So that is what inspired me to, um, start

the Lady Suppler Breast Center here.

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Um, I really wanted to have a place

that patients could go, um, to get

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that personalized, comprehensive care.

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To be able to have time with their

providers and, um, have people

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who really cared about them.

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Um, and we're also kind of, we're

not beholden to a system, so I get

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to send people to the best place,

the best medical oncologist, the best

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radiation oncologist, not somebody who

I'm happen to be in the system with.

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So, so, so many, so many

elements to all of that.

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Um, and then of course, the all

other thing that people always ask

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about is about the lady slipper.

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Express the name.

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Yes.

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How in the world did we

come up with this name?

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Well, well, I wanted something that was

purely Minnesotan and I thought, what

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more Minnesotan than that beautiful lady

slipper orchid, which is our state flower.

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And so, you know, I thought, um, it just.

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Embodied our Minnesotans, and I thought

that would kind of be all inclusive.

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Um, and actually it was really neat

because, um, after I had opened the,

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I had a patient, a Native American

patient who came through and she was, had

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chosen lady slipper because of its name.

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Because it turns out there's a story of

a brave little girl from an Ojibwe tribe,

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and the legend is about this little girl.

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She was seeking medicine for her

family and tribe in the cold winter.

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And in her journey, um, she does

end up retrieving the medicine from

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another, another area far away.

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Um, but, uh, she encounters of

course, our wonderful Minnesotan harsh

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winter snows and loses her moccasins.

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So her feet ended up.

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Bleeding in the snow.

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And as she finally reached, as she

finally came back to the village

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and saved everybody, um, but when

the snow melted, they looked for her

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moccasins, but instead in those bloody

footprints, they found the lady slippers.

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Oh.

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So that's their story and their

interpretation of the lady slipper.

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And I think it's wonderful and,

uh, really allegorical to the story

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of our breast cancer patients.

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I mean, I think they, they travel a

very difficult road, um, to seek out

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medicine and a cure for their cancer.

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Um, and then they succeed despite

that difficult journey and their,

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um, you know, bravery and courage.

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Courage leaves beautiful flowers

of hope growing in their path.

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So I think it's, um, it's just such

a beautiful name for that reason.

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Yeah, I thought it was really kind

of brought together the whole idea.

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Speaker: That's beautiful and I'm, I

am tearing up as I listen to you, Dr.

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O'Leary, because I can't

help it make it personal.

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You did every, I'm so thankful that

you came back to Minnesota because,

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uh, I would not be the same if

it would not have been for you.

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And I mean that from

the, but, and that is.

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From so many different, there's so many

different things that you help me with,

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but I think, and we, and I told Dr.

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O'Leary that I would, you know,

tell my story because my listeners

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know I've been through this.

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And, um, when you, when I first contacted

you, you didn't even work with my

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insurance and you were just so sweet.

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And you said, just come in and

we'll, we'll, we'll talk through it.

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Now this is what was so weird about me.

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I was always someone

really into health stuff.

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'cause I was so terrified of ever

getting sick and I would like research

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everything and wanna know everything.

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And then this hit me and I was like, blah.

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And I think I came in and I think

I started out not being that nice

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to you, I think I was like, well

I can't work with you anyway.

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And you were so sweet.

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And I remember you just said, let's just

sit down and you taught me and listeners.

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You sat with me for over two hours when

your clinic had closed and you sat with

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my husband and I, and you went through

absolutely everything so I would know

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what the possibilities were, but this

was the thing that was amazing was.

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It didn't have to be so scary.

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You were like 98% positive

outcome, just like even, yep.

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It's gonna be hard, you know, like

this, this type, you have to have chemo

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and that's gonna be hard, but you're

still gonna have a great outcome.

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And so that's what I held onto

and I, I didn't have like.

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I wouldn't have had that

belief except for you.

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And then you connected me to

a beautiful oncologist who was

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amazing and you set that up.

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You helped me go to the

places that would work.

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The way you knew would be best for me.

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That would be gentle.

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I was a wreck.

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I mean, so I had so much anxiety

over health and interestingly

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enough, that's healed.

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I mean, it's truly a gift from God.

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It's been such a journey, but

sitting down with you that day

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was a game changer in my journey.

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I still didn't wanna do it.

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I still was scared.

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But let's, let's talk about that and

I'll throw some other things in as we

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go to about my story and the things.

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I mean, I sent a friend to you who

needed you shortly after me, and.

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Dr.

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O'Leary, I, I remember I told you a story

about a friend who said she wouldn't

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have done the double mastectomy again,

because she said every day I look

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and I told you that and you said you

were, you know, I listened to what you

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said and you just did the lumpectomy.

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And then I remember I went to

the bra store and they said,

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are you gonna keep your nipple?

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And I was like, what?

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And they started bawling.

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I'm like, well, I dunno.

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So then I talked to you and then

these things that you don't think.

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Would bother you.

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Mm-hmm.

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For women, it's like a piece of

you, you know, I just, my heart

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goes out and so we didn't know.

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We didn't know if you were gonna

have to, but you, you were so careful

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and you check the margins and you

did such an amazing job and you,

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it's honest to God, this is gonna be

kinda weird, but you can't even tell.

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Like you, I stand up and it's

like, well, it doesn't even,

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so thank you for that gift.

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I don't even know if I ever told

you that, but I don't remember it

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every time I look in the mirror

and, and so that's a blessing.

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Speaker 2: Aw.

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Well, thank you so much.

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I mean, that is really my goal.

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Um, I always say this is the most,

you know, hard enough as it is without

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adding in, you know, a visible incision.

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You know, that's, that's how

we used to do all of this.

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We used to just kind of.

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Go right over the top of the cancer and

it would just be this big ugly incision.

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And then we wouldn't bother trying

to put, you know, put patients back

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together so they'd have a huge defect.

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And so there's just some small things

you can do sometimes that make a huge

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difference because we, again, it's

kind of this bigger picture, right?

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We wanna think about this.

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Whole person.

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And we know that you're gonna get

cured and you're gonna go on and

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you're gonna live this wonderful life,

but we also don't want you to suffer

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the consequences for the rest of the

life of all of this treatment, right?

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So how do we improve your quality?

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And I think the number ones.

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Starting place is just being able to look

in the mirror, exactly what you said, look

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in the mirror and not have to say, I have,

I had breast cancer every single day.

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Right?

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You wanna just be able to look at

yourself in the mirror and say, oh,

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well this is great, and then kind

of scoot on with your day, right?

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So, so this is this whole very intentional

part of medicine that we can be incredibly

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intentional about how we do things.

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And how we personalize care so that

a patient doesn't have to suffer

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the con unnecessary consequences.

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Right.

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And it's, it's hard enough.

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It's hard enough without all that.

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So It is absolutely,

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Speaker: and Dr.

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O'Leary, I, you don't need to

comment on this, but I will tell

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you that I, I feel pretty confident

that had I had a different surgeon,

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it would've been different.

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Because, I don't know.

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And oh, and here's another story about Dr.

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O'Leary.

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I remember I was so terrified

going into the surgery 'cause

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that was just how I was.

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And I will never forget being

wheeled down and my surgeon is

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holding my hand and rubbing my hand.

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And you did that until I fell

asleep and I had you comforting me.

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And so in addition to

being an excellent surgeon.

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And doing an amazing job and getting it

all, having, you know, all the margins.

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You kept me in one piece, you know,

and I'm so thankful, and I know not

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everybody can have that outcome, you know?

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Speaker 2: Thank you.

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Thank you.

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You're, you're making me tear up here too.

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I'm just, well, I'm glad I could make a,

a positive difference for you and your.

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In your story and, um, I think it's

just, again, I think these small things

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make such a big difference to patients.

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Yeah.

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And it's, it's huge though.

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It's big for them because, you know,

it's so much stress and it's so much

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anxiety and it, and, and it doesn't

necessarily have to be that way.

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And especially from a

provider's standpoint.

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I mean, I, I've seen so many

people go through this, so

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I know you're gonna be okay.

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Speaker 4: Yep.

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Speaker 2: How do I convey that to you?

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Or how do I give that to a patient

who's just got gotten those words?

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You have breast cancer, right?

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Right.

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How do you start with that and pull

them back from that ledge and have

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them realize it's gonna be okay?

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And I think that is the biggest

gift you can give to a patient if

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you can just spend that extra time.

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Talk to them and hear them,

listen to them, because your

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story is just as important.

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And it's, it's part of the bigger picture.

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It's, it is the whole picture, right?

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Mm-hmm.

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So it's, it's, it's the

most important part.

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So I'm so glad.

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Thank you so much for, for sharing that.

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Oh my

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Speaker: gosh, yes.

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And you know, I have to say one

other thing that is amazing about you

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and my oncologist is you say cured.

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You're cured.

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You know, like go live your, you're cured.

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And that like hits you when, you

know, and I can believe that.

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Like I believe that.

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And it's true.

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And that's the thing.

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And we can kinda start talking a little

bit more about breast cancer today

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in early detection because I, you

know, this podcast is about helping

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women feel better and live better.

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And this is what I want you to know.

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Breast cancer, I made it a

lot harder by being so afraid.

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It kinda isn't really that scary.

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Like all the things that I went through,

I thought were gonna just be horrendous.

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And I had to go through the heart.

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I had to do the chemo thing.

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I tolerated that very well.

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I mean, I, you know, and I kept,

I lost some hair on the top of

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my head, which was hard, but.

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I cold capped and, um, my

oncologist was so positive.

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So, and, and this is, I mean,

early detection is so key.

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That is why don't be afraid.

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Now.

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I like go in, go check

every mole on my body.

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Go like, just check everything because

I know Yeah, when you catch it early.

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It's amazing.

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You like, you catch it and you're

done with it and you move on.

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So I think early detection, and I remember

in my case too, we were heading off to

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Arizona and I was like, gonna go get a, A

heart test, like a calcium scan and then

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I'm like, I'll just go get my mammogram.

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'cause I was a little late and

getting it maybe a couple months.

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Praise God that I did.

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Speaker 2: Yeah.

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Yeah, it's a huge deal.

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I mean, I think, I think there's so many,

so many reasons and so many barriers

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to patients for, you know, going out

and getting that annual mammogram.

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Um, I think that it's,

it's a lot of things.

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Um, you know, we have one in

eight women that are diagnosed

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and actually 80% of women have no

family history of breast cancer.

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So.

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That was me.

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Case in point.

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Case in point.

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So oftentimes patients are in my

office saying, you know, how in

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the world, you know, why in the

world is this happening to me?

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Um, but we know, um, so many

things about, um, you know.

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How, who is at risk for developing breast

cancer and who needs to worry about it?

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Sorry, I'm getting all sorts of calls

here at the, well, you're a busy woman.

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We just appreciate you being here.

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It's okay.

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No, no, it's okay.

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It's okay.

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Um, so I, but I apologize about

getting distracted there for a second.

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Um, so, um, yeah, so, you

know, it's so important to go

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out and get that mammogram.

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Um, and it's so a lot of patients

feel, they say, well, I don't

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have a family history, so I

don't have to worry about it.

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Well.

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Like we just stated, that's not the case.

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Right.

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Um, a lot of women are just such amazing

people and we take care of everybody

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else, and we always kind of forget

about ourselves at the end of the day.

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And that, you know, to be able to continue

to take care of our children and our

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husbands and our loved ones, um, we

need to take care of ourselves first.

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Right.

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And so, and just like you're saying,

if you find these things early,

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it's, it's really anno, I mean.

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For most people really an a

straightforward thing that

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we can, we can cure, right?

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Yeah.

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We can take it out, we can remove it,

we can move forward with your life.

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I think cancer, a lump on

somebody's breast is very scary.

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Um, and, um, I think sometimes that

delays people coming in too, is they're

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nervous about what if is the big C word.

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Right?

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And what does that mean?

401

I just feel like breast

cancer in and of itself is.

402

So unique and so different from

so many other types of cancer.

403

Um, things are always

changing for the better.

404

For breast cancer patients.

405

Every aspect is all about trying

to be more and more minimally

406

invasive and what do we absolutely

need to do to cure the patient?

407

Um, and there's so many new,

you know, drugs and new ideas

408

and how to do this all the time.

409

So that's one thing I always warn people.

410

Once they've had a cancer diagnosis

is, I say, you know, just because,

411

you know, people start to come out

of the woodwork and tell them their

412

story's well intentioned, but you

know, it doesn't matter if you've

413

got a, you know, triple negative

or an ER positive or two positive.

414

Each person's story is completely

unique, and when they're

415

getting treated is unique.

416

So everything is changing all the time.

417

So what we did even a year ago

for some types of cancers may be

418

something completely different now.

419

Right?

420

So it's a really, really wonderful

fast-paced field, and it's.

421

It's all about trying to do this

in a better way and to try to

422

really eliminate these cancers.

423

So, you know, don't be afraid

because of what you're seeing online

424

or what your friends are saying.

425

Um, I think going out and getting

that mammogram, um, to the point

426

of the mammogram, you know, if we

say start at 40 years of age and

427

do it every year, however, there

are some women who are higher risk.

428

So,

429

Speaker: okay.

430

I wanted to talk about that, Dr.

431

O'Leary because.

432

I, interestingly enough, I have

an accountant whose daughter

433

had breast cancer and she did

pass away, which was very sad.

434

She fought it for 12 years

or so, but she was 30, so she

435

wasn't getting her mammogram.

436

And I, I'm like, daughters, go get

your mammograms when you're 30.

437

I feel like why wouldn't everyone,

because we don't really know.

438

But can you get that covered by insurance?

439

Speaker 2: Well, this is a great, I love

that you brought this up because this

440

is actually a really important point.

441

Um, as of 2019, our American Society

of Breast Surgeons really wants all

442

women, is millions of women at the age

of 25 years of age to go in and have.

443

Something called high risk assessment.

444

Okay.

445

Okay.

446

And what that is, is it means sitting

down with somebody like me, um, or you can

447

Google away at any state that you live,

live in, and look for high risk clinics.

448

They exist everywhere.

449

Um, and, and sit down with

somebody and say, okay, these

450

are my, they'll go through

everything, all these risk factors.

451

Things like when did you

start your first period?

452

When did you go through menopause?

453

When did you start having babies?

454

Did you have babies?

455

It goes on and on and on.

456

There are many, many different.

457

Estrogen exposures throughout

our course of our lifetime, which

458

can really influence this risk.

459

But the idea is starting at around

25 because if we can have all

460

25 year olds doing this, then we

know, boy, this, this 25-year-old.

461

Or this 30-year-old,

let's say, needs to start.

462

We need to start doing

imaging at 30, right?

463

We can't wait until 40.

464

And that's essential.

465

Really, really important because

we've actually had a rise in the,

466

um, in our incidence of breast cancer

development in our younger population.

467

So our 40 plus year old has

just kind of increased over.

468

Um, and just in the recent

time, which has actually, um,

469

changed some of our guidelines.

470

And for the better, uh, yeah.

471

To try to capture more of this,

but you're absolutely right.

472

Those patients who are in their

thirties, in their twenties, who

473

can have breast cancers and they're

not even looking for it yet.

474

Oh wow.

475

Those are the ladies we

really wanna be able to reach.

476

Um, and, and, and also, you know,

things like breast density, right?

477

So you get a mammogram back and

it says you have dense breasts.

478

So we, it's not very sensitive

for your breast type, right.

479

Might miss something.

480

Right.

481

Um, and so people who have dense

breast tissue but who are also high

482

risk for developing breast cancer by

determined by one of these risk scores,

483

they are eligible to have a mammogram

alternating with an MRI every year.

484

And really Wow.

485

For breast density.

486

There's nothing better

than that breast, MRI.

487

So it's really, um, so important,

so important to be asking these

488

questions and saying, gosh, you know,

listening to this, um, conversation,

489

or, boy, my, you know, I had breast

cancer, should my daughter do this?

490

Right?

491

So it's all of those things, right?

492

So.

493

Just being able to go and start

at 25 knowing if you need to do

494

breast exams every year or what you

should be doing is so important.

495

This is

496

Speaker 3: really, you're have the

same issue too, as I was really

497

bizarre is I'm, here's the old pro.

498

I'm on Do Not disturb.

499

I am.

500

Oh, that's so funny.

501

Well, I don't feel so

bad now that mine went

502

Speaker: the host.

503

You know what it is?

504

Darn it.

505

It was a kid.

506

I forgot to tell my daughter in Arizona

at school that I was doing this.

507

'cause when you know how for those

kids, you let anything come through.

508

So sorry about that.

509

No, it's, we're talking about kids

now, and as I'm talking to you.

510

I'm sending, my daughter is 30 and she's

a medical doctor and she's in Edina now.

511

She's coming to see you.

512

Sounds good.

513

And so is my daughter-in-law, who is 27.

514

Perfect.

515

She's coming to see you.

516

Her dad was just diagnosed

with, but here's the thing.

517

This is what gives me

chills is it's curable.

518

Mm-hmm.

519

Early detection.

520

It's so curable.

521

You can just, you know, you

can get it, you can catch it.

522

So, um, I just, that's what I want.

523

I want everyone listening to make sure

they get their mammogram and I think

524

me having breast cancer and kind of

alerting friends, friends that didn't get

525

mammograms because they were like, oh,

I don't really know if I wanna do that.

526

Started going and so

that's a huge blessing.

527

Speaker 4: Mm-hmm.

528

Speaker: Um, so yeah, if you're

listening, get your mammogram, send your

529

daughters in for early detection at 25.

530

Start there because I bet a lot of 'em

are gonna be able to get a mammogram.

531

Speaker 2: Yeah, and it's

just, again, you're so right.

532

It's all about catching this

early and, and the other component

533

of this is genetics, right?

534

Mm-hmm.

535

The question about genetics, right?

536

I mean, that's the whole nother

part of the risk conversation that

537

we have when we talk to patients

to determine if they're high risk.

538

For developing breast cancer or not.

539

Um, oftentimes, even though 80% of

these ladies have no family history

540

of breast cancer, oftentimes they

have other cancers in their family.

541

They have prostate cancer or

ovarian cancer, or skin cancer even.

542

Right.

543

And they're just the first person to

develop breast cancer in their family.

544

And oftentimes all of these

mutations on one side of the family

545

can be explained by one mutation,

which is pretty, pretty amazing.

546

And I think that's what everybody

wants to know is the why, right?

547

Why me?

548

And, and does my, do my kids

have to worry about this?

549

Does my sister have to worry about this?

550

Does my brother have to worry about this?

551

Right.

552

Right.

553

So genetics is a moving target.

554

I think that's also the other big

message I'd love to get out there.

555

Right.

556

Which is um, 'cause I have patients

who come in all the time and they

557

say, I was tested and I'm negative.

558

And I'm always say to them,

well you're negative for what

559

we were testing for then.

560

Right, right.

561

A moving target.

562

We're learning more and more and more

about genetics all of the time, and

563

it's, it's just gonna change everything.

564

I think it's gonna save so many lives.

565

I see it.

566

I see that all the time with patients

who come in with a breast cancer and they

567

find out they have a BRCA mutation that.

568

Predisposes them to an ovarian cancer.

569

Mm-hmm.

570

So they decide to get out their

ovaries as a result, um, when they're

571

done childbearing and everything, and

oftentimes, not often, but it happens that

572

we will find, um, that the patient already

has a really early stage ovarian cancer.

573

So it's a really big deal.

574

This is a, something that, um,

you know, and you ovarian cancer,

575

unlike breast cancer, is not

something that you can detect early.

576

And so it's just so, it's

so, you know, you get.

577

Beg symptoms of bloating

and things like that.

578

Right.

579

Speaker 4: So

580

Speaker 2: it's just, I just see the

foresee genetics and our, um, especially

581

once it's out there and it's more on

the family practice level and the p so

582

everybody's getting a full genetic panel.

583

Um, I think that's

really gonna save lives.

584

So

585

Speaker: when they come in for

that high risk appointment, do

586

they get that genetic testing done?

587

Is that part Yeah.

588

And I think what you told me

is it's only going to help.

589

When you do that genetic testing, you're

helping the scientists more, aren't you?

590

By giving them your.

591

Yes.

592

Speaker 2: Yeah, so that's a

really interesting point actually.

593

And that's a great point.

594

Um, you know, these, depending on

which company you're using, they all

595

have different algorithms and how

they share or don't share, they don't

596

share your, uh, name or any of, they

can't do that because HIPAA laws pro.

597

Protect people from sharing

your personal information.

598

But when you do get genetically tested

though, that you're absolutely right,

599

there's all sorts of these big databases.

600

Sometimes they're within a huge company,

sometimes there's ClinVar, there's a

601

bunch of these, uh, big online sources.

602

So every time we're having

a patient with a cancer.

603

Plus a, a genetic mutation.

604

A pathogenic genetic mutation

that's oftentimes being registered

605

at these big registries.

606

So now, again, not the patient's name

'cause I know everybody's nervous

607

about that, but just the mutation with

what type of cancer they're having.

608

So you're absolutely right.

609

This is a big collaboration.

610

And the more we're doing this, the more

genes we're looking at the, the more

611

we get to that answer of why, why me?

612

What's going on?

613

Who needs to be worried about this?

614

Should I be worried about another cancer?

615

Right.

616

Right.

617

Stuff because it leads to that,

again, that early detection, right?

618

If you knew you were at risk

for something, then you would

619

just go ahead and, um, you know,

you go get screened or, or.

620

Speaker: Exactly.

621

Okay.

622

That's so helpful.

623

And I'm trying to be very, um, cognizant

of the time because it's almost up,

624

but I think, um, and everyone who's

listening knows, I have my little saddle

625

up segment on Thursday and I'll try to,

uh, put in anything that we've missed.

626

But everyone wants to know how

can I keep this from happening?

627

And I know I feel like I live my

life trying to be metabolically fit.

628

I have learned some things, you know,

that I maybe wasn't doing right and

629

I, I think one big thing was stress.

630

Mm-hmm.

631

And Dr.

632

O'Leary, I think trying to follow

the rules of health and white

633

knuckling it through fasting and

everything in my life mm-hmm.

634

Probably was a big reason why.

635

Mm-hmm.

636

I developed it.

637

And I don't really have alcohol anymore.

638

You know, I always said, oh,

I just have a glass of wine.

639

That was so back in the day,

not so much now it was so,

640

have a glass of wine at night.

641

It's good for you.

642

Yeah, I don't, I

643

Speaker 2: don't know if it really is.

644

Yeah.

645

No, I don't think so.

646

At least not from the

breast cancer perspective.

647

Right.

648

No, it's a great question.

649

Stress.

650

I, you know, a hundred percent believe

that stress contributes to the depression

651

of our immune system and our inability to

fight infections and then also cancers.

652

Right?

653

And so, and it's not.

654

Uncommon, it'll have somebody in there and

they've just gone through a big divorce.

655

They've had a death in their family,

they have job has just been horrible.

656

They have a bad boss, et cetera,

where they're up all night

657

and they're just not sleeping.

658

Um, and then they've now found this

breast cancer on top of it all.

659

Mm-hmm.

660

So I just can't imagine what type of

stress is in their system and, and what's,

661

you know, that suppression of their immune

system and their immune system ability to

662

work the as well as it should be able to.

663

Right.

664

The difficulty with stress

is how do we quantify stress?

665

We can't.

666

Right.

667

Really, we can't say, we can definitely

look at somebody from a subjective

668

say and say, gosh, this person, this

poor person has gone through so much.

669

Right.

670

Um, but it's really difficult to study

because of that, so it's hard to study.

671

How, you know, we know, we know these

things make sense, but you know, how

672

do we really look at this in a person's

life and how, but I think there are

673

some ways just you mentioned a few

of them in terms of decreasing your

674

risk of developing breast cancer.

675

I always say you can Google and find a

thousand ways to decrease your risk for

676

breast cancer, but I tend not to believe

them unless we've really had excellent.

677

Studies that have kind of shown the

same results over and over again.

678

Um, and the first and the second

are, of course, diet and exercise.

679

Those things are so key.

680

Um, I wish I could tell you

that there was a perfect diet.

681

Um, nutritional studies are really,

really challenging to do and to do well.

682

So, um, it takes, you know, enormous.

683

Population, uh, level data and just

a lot of resources to do them well.

684

So we have a lot of contradictory

data that's out there.

685

I think the main message is just to

maintain a healthy weight for you.

686

Mm-hmm.

687

And I think everybody has a

kind of an idea of what that is.

688

Everybody's different, they have

different bone structures and

689

muscle mass and all sorts of stuff.

690

So we can't just give you a weight

that's not gonna work for everybody.

691

Everybody has a good idea.

692

So just maintaining a healthy weight.

693

Now there's obviously a lot of different

ways to do that, um, in terms of how

694

you're eating and what you're eating.

695

Um, we, we were focused very heavily

on low fat diets for a really

696

long time in the breast world.

697

Um, but there's been a lot of

pushback about that lately.

698

Kind of saying, well, is it really the

low fat or did they just, you know, lose

699

weight or what, what would what right.

700

Exactly is it, is it really was that

really it, um, processed sugars in our

701

diet has been another big question,

and I won't be surprised as the data

702

matures if that doesn't play a bigger

and bigger role in cancer development.

703

Um, but we don't have, again, it's,

we don't have these really great huge

704

cohort studies where we're intentionally

really trying to answer this question.

705

It would probably take a sample

size of something like 130,000 to

706

really answer that question, right?

707

So it's, it's a big deal.

708

Um, and then the other

thing is exercise, right?

709

So exercise we recommend, um, somewhere

between 150 to 300 minutes a week.

710

I really.

711

I try to push towards the 300

minutes a week of exercise.

712

It includes both aerobics as well

as weight resistance training.

713

Um, and there's again, if you're labeled

high risk or you're a breast cancer

714

survivor, there's actually programs out

there that help you to achieve that.

715

Um, and so, and, and some of it

doesn't have to be intentional.

716

Some of it's just.

717

Right.

718

You know, you're walking up the

stairs instead of taking the elevator.

719

Right.

720

Exactly.

721

Or you're just doing

something that might help you.

722

Um, you're gonna do it anyway, but you're

just gonna do it, or you're walking a

723

little faster to get that heart rate up.

724

Right, right.

725

So the diet and exercise super important.

726

Um, alcohol is definitely

number three on my list.

727

Speaker: Oh, good.

728

Speaker 2: Yeah, it's a,

it's an interesting one.

729

Um, you know, um.

730

It is, uh, so well studied in relationship

to breast cancer and, um, there's a

731

lot of hypotheses as to why that is.

732

Um, because we can definitely see

after a drink of alcohol that a

733

person's estrogen level increases.

734

Right.

735

So that's an objective measurement.

736

Mm-hmm.

737

Um.

738

So the question is why, right?

739

And I think there's been a lot of

hypotheses out there that potentially,

740

you know, your liver is just trying to

clear that alcohol out of your system.

741

Speaker 4: Mm-hmm.

742

It's a

743

Speaker 2: box into your system and so

it's not doing some of the other stuff

744

as well as it should, like clearing

estrogens from your system so that, uh,

745

over time of course, you get that big.

746

Boost of estrogen.

747

So you can imagine after two drinks

of alcohol, right, three drinks

748

of alcohol, how much that estrogen

level is just sitting up there.

749

So it's a really important correlation.

750

And I, I do know that the previous, uh,

surgeon General was actually interested

751

in putting breast cancer on the outside

of alcohol bottles, just like we have,

752

uh, lung cancer on the outside of.

753

Speaker: So, Dr.

754

O'Leary, do you know, I

was not aware of that.

755

I wish I had been.

756

And so let's get that word out there

because Yeah, let's get it going.

757

Isn, is that important?

758

That's so, but it, and that was

just something that I kind of

759

concluded on my own because I'm

like, I exercise, I eat really well.

760

I had the stress and I then to

try to get out of the stress.

761

I'd have that glass of wine at night

and think about that, just over and over

762

every night could not have been good

for me for years and years and years.

763

And so now that's out of my life.

764

Mm-hmm.

765

And I'm just, another thing

that I'm learning is just to.

766

Joy, like to have fun with like this

right now here, this, this isn't work.

767

To me, this is so joyful.

768

Mm-hmm.

769

To have fun and, um, enjoy your

life and that's gonna kinda reduce

770

your stress a little bit too.

771

And I think I was missing

that, like how do you have fun?

772

Speaker 2: We women,

773

Speaker: we can forget

about that, can't we?

774

Sometimes?

775

Speaker 2: Yes.

776

Yes, indeed.

777

Yep.

778

Absolutely.

779

No, I, I, I think that's

such an important point.

780

Um, I, I always try to emphasize to

patients, especially as they're going

781

through everything, take stop, pause.

782

Go do something fun.

783

Go.

784

Yes.

785

On that vacation you've

been wanting to go on.

786

You

787

Speaker: did tell me that.

788

You did tell me that.

789

You said before and I didn't because I

was just like, I just gotta get this done.

790

They just hustled me

right through everything.

791

Mm-hmm.

792

But it was amazing.

793

And Dr.

794

O'Leary, I, from the bottom of my

heart, I am so thankful for you,

795

for my journey, for my story, for

that friend of mine that you helped

796

through her journey and through my.

797

Children, my daughters, my daughter-in-law

who you're gonna be helping in the future.

798

So I'm just so thankful for you, and I'm

thankful that you took this time because

799

I don't know a lot of other, you know,

highfalutin surgeons who would sit down

800

with little old me and talk about this.

801

So I, my heart, I just appreciate

you so much and I, I recommend

802

you, I mean, if anybody.

803

Wants to send, their daughter wants

to go check and see if they're high

804

risk, wants to just check things

out or is scared about something.

805

Go to Dr.

806

Elizabeth O'Leary.

807

We're gonna have your information

in our show notes, but I think

808

it's just, um, is it just, uh, Dr.

809

Elizabeth O'Leary?

810

Speaker 2: Yep.

811

Yep.

812

If you go to, uh, the website, I

believe it's, uh, the www elizabeth

813

O'Leary md com and then you'll find,

uh, you know, lady Slipper, you'll

814

find everything there about us.

815

Um, but, uh, we have three

locations at this point.

816

We're in St.

817

Paul's, St.

818

Louis Park and Edina.

819

And so please come on over.

820

You're welcome.

821

And it's, again, you know, it's

been my honor today, I really

822

have enjoyed talking with you and

educating your, your public and.

823

Thank you so much.

824

I really appreciate the opportunity.

825

Speaker: Thank you so much, honey.

826

You take good care.

827

Okay.

828

Speaker 2: Take

829

Speaker: care.