Do NOT Rely on Mammograms Alone — A Breast Cancer Survivor Doctor Explains What to Do Instead

In this episode, I'm joined by Dr. Boham, Medical Director of the UltraWellness Center, to explore why breast cancer develops, the hidden factors that may influence your risk, and what you can do to be proactive about prevention—not just early detection. Here's what we discuss in today's episode: Why breast cancer is increasingly being diagnosed in younger women The overlooked factors that may influence breast cancer risk beyond genetics and family history How your gut health, hormones, and environmental exposures may be connected to breast cancer What women should know about hormone replacement therapy and breast cancer risk The screenings, tests, and everyday habits that can help you take a more proactive approach to breast health While we can't prevent every case of breast cancer, there are meaningful steps we can take to influence our health. Understanding your individual risk and addressing the factors within your control can help you make more informed decisions about prevention and long-term wellness. Resources Mentioned Breast Cancer Risk Assessment Tool (National Cancer Institute) Dr. Boham's book, Breast Wellness: Tools to Prevent and Heal from Breast Cancer Visit Dr. Boham's website and access her free guide, 15 Tips to Decrease Your Risk of Breast Cancer: DrBoham.com Upcoming Free Webinar: A Functional Medicine Approach to Cancer Join the UltraWellness Center's upcoming UltraLearning Series webinar on Friday, October 23, at 12:00 PM ET. Dr. Elizabeth Boham, MD, FMCP-M, MS, RD, and licensed nutritionist Carly Leusner, MS, CNS, LDN, will explore how inflammation, insulin resistance, gut and immune health, environmental exposures, and other factors may influence cancer risk. They'll also share personalized nutrition and lifestyle strategies to support prevention, treatment, and recovery. This complimentary event includes a free guide to lowering cancer risk for every attendee. Register for the Free Webinar. Work with the UltraWellness Center Interested in exploring a Functional Medicine approach to your health? Submit a New Patient Inquiry to learn more about becoming a patient. Schedule a Discovery Call directly with a New Patient Engagement Coordinator to book your Functional Medicine consultation.

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

• 0:00Speaker 00

  And I think the reason we're seeing all of these increases in cancer in younger people is twofold. One is our microbiome and toxins.

• 0:08Dr. Mark Hyman?

  Every October, you're going to hear the same message everywhere you look. Get your mammogram, know your risk, early detection saves lives when it comes to breast cancer. And all that's true, but it's not complete because it treats the breast cancer like something that just happens to you, like weather. It doesn't work like that. Something you can only catch early, never actually prevent. So I want to challenge that whole idea today. And my guest has a very different way of thinking about this, not just because she spent her career studying it, but because she's lived it. At 30 years old, in the middle of her medical training, she was diagnosed with triple negative breast cancer. No family history, none of the boxes checked that were supposed to put her at risk. She was young, she was healthy, she was fit, she ate well, she studied nutrition, she got the diagnosis anyway. So the bad experience didn't just change her life, it

• 0:53Dr. Mark Hyman?

  changed how she practiced medicine. So today, she's a medical director at my center, the Ultra Wellness Center in Lenox, Massachusetts. You're all welcome to come. And she spent the last two decades asking a question most oncology docs don't ask. Not just how do we find the cancer and how do we cut it out and basically poison it with chemo or burn it with radiation, but why did this body become a place where cancer could grow in the first place? Why is the underlying biological terrain susceptible to cancer? That's a completely different question. And it opens up a completely different set of answers about estrogen, about your immune system, about your microbiome, about toxins, about your everyday exposures that you probably never thought twice about. Liz, welcome to the show.

• 1:34Speaker 00

  Thanks, Mark. It's great to be with you again. Thank you for having me.

• 1:39Dr. Mark Hyman?

  My pleasure. All right. Before we get into the science, I want to start with your story because you were diagnosed with triple negative breast cancer at 30. I want you to take me back to that moment when you got the diagnosis. What did that diagnosis change about how you practiced medicine and what happened to you in that moment?

• 1:53Speaker 00

  Well, in that moment, I was really in denial. I mean, I definitely was like, this is not real. I, I never thought I was going to get breast cancer. You know, in medical school, you sometimes think you're going to have all sorts of different diseases and you worry about them, but breast cancer was not one of them. And, um, and so that really took me, it really took, you know, took me off my rocker, you know, I was like, okay, what is this?

• 2:18Dr. Mark Hyman?

  30 years old.

• 2:18Speaker 00

  I was 30, no family history. And as you mentioned, Mark, I was all about wellness and prevention. I was exercising every day. I was eating healthy. I thought I was doing everything right. And so, you know, I, I definitely went through those stages of grief and denial was the first one. And then of course, there's anger and then you kind of work through it. At some point you're like, okay, this did happen to me. And I was like, I need to figure out why, just so I could prevent this from coming back for myself. I mean, that was 27 years ago now. So just crazy. I just had my 27th cancer-iversary.

• 2:56Dr. Mark Hyman?

  This episode is brought to you by Function Health, empowering you to live a hundred healthy years with over 160 lab tests for just $365 a year. And use the code MARK2026 to get $50 off your membership. I, I remember when you still had your short hair from the chemo when I met you.

• 3:14Speaker 00

  Right?

• 3:15Dr. Mark Hyman?

  You had like a little red, like short hair. And I was like, wow.

• 3:18Speaker 00

  It was kind of cute.

• 3:20Dr. Mark Hyman?

  It was cute. But yeah, I remember that. That was a long time. For everybody listening, we've worked together for, I don't know, close to 30 years now. And I think you were, you were just coming out of that period and you got very interested in functional medicine. So it really changed how you practice everything.

• 3:35Speaker 00

  Absolutely. Right? So when I was, started working with you at Canyon Ranch in 2004, and I was like, thinking, why did this happen to me? And you, you know Canyon Ranch, you guys sent us to, to IFM's training, the initial course called AFMCP. And it just, it just, it just blew my mind open. I was like, this is exactly what I'm interested in doing because, because in functional medicine, you ask that question, why? And I was trying to figure out for me, what got out of balance? Where did I need to focus? And so as we learn in functional medicine, we need to personalize our treatment approach. We treat everybody

• 4:18Speaker 00

  as an individual. We're not just focused on the disease, but for that person, what got out of balance and what do we need to do to restore that balance so that they can prevent it from coming back from, for themselves. But then also, you know, I wanted to learn what I could do to help all my patients prevent this if possible. We can't unfortunately prevent all cancer, but there's so much we can do every day that influences whether cancer grows or doesn't grow.

• 4:45Dr. Mark Hyman?

  Yeah, it's so important you say that. I think, you know, you, you kind of touched on it. I always say functional medicine is the medicine of why? Why do you have this problem? Not what? Conventional medicine is the medicine of what? What disease do you have? What drug do you take? Or what surgery do you need? Not why? And so, you know, we're good at diagnosing in traditional medicine. We're good at applying medications to problems. We're not so good about thinking about the origins of disease or about understanding how to change the biological terrain in which the disease occurred. Cause disease doesn't just happen like that. It comes from a set of conditions that are disturbed and there's often things we can do about it. So talk about this whole idea of the terrain theory of health and the body as, as, you know, this sort of soil where cancer seeds. And

• 5:30Dr. Mark Hyman?

  if you have a unhealthy soil, cancer can grow. And if it's healthy soil, it's, it's much, much different.

• 5:37Speaker 00

  It's so right, Mark. I mean, in, you know, in conventional medicine, we focus so much on the cancer cell, which is very important to do. But we know that the terrain, that soil around the cells in our body, um, really influence whether cancer will grow or not grow. We know that cancer likes to grow when there's a lot of inflammation around, whether it's local inflammation or systemic inflammation, inflammation in the whole body. So that's something we really pay attention to when we're evaluating somebody's terrain, right? We know that high levels of insulin in the body really create growth of cancer cells.

• 6:19Speaker 00

  So we're always evaluating, does this person have high levels of insulin? Do they have insulin resistance? We know like the microbiome, all of those amazing, healthful cells throughout our whole body, in our digestive tract, in our, in, on our skin, in our vaginal area, in our, in our uterus, in our, in our kidneys, right? And our breast tissue, our microbiome throughout our whole body influences so many aspects of our health and it can influence whether, whether cancer grows or doesn't grow. Uh, we know that, um, our lifestyle really influences our terrain and influences whether cancer grows or doesn't grow. Of

• 7:02Speaker 00

  course, there's our immune system, right? Is our immune system able to find those unhealthy cells, gobble them up and get rid of them? So, you know, we want to really look at, for each individual person, what is out of balance in their body? Where do they need to focus to create that terrain where cancer is less likely to grow?

• 7:23Dr. Mark Hyman?

  Yeah, so important. You hit on a lot of different topics there. I think the overall inflammation that we have in our society is something that helps promote cancer growth. And that can come from all sorts of things. Our microbiome is a huge factor. And the microbiome, as you mentioned, plays a big role in estrogen metabolism, which plays a big role in cancer. Also, you mentioned insulin resistance, another big one. We know that many cancers, including breast cancer, are fueled by excess sugar and starch and ultra-processed food. And that drives growth of cancer. We know that the role of environmental toxins is so huge, particularly because there are foreign estrogens. And all these things create an unhealthy soil. And so a lot of these things you can do something about. In

• 8:04Dr. Mark Hyman?

  fact, also stress, lack of sleep, lack of exercise, alcohol, these are all things that actually end up causing problems. So let's talk about the idea of this sort of immune function and how our immune system is working or not working, because there's the whole process where we're all getting cancer all the time. Like every one of us right now in this moment has cancer cells. And we have an immune system that goes out like, uh, kind of the Navy SEALs and goes and kind of gets rid of them. But that breaks down. So can you talk about that whole system and why, why it's not working the way it really should be working for many of us?

• 8:36Speaker 00

  Yeah. So we've got these things called natural killer cells that will go around and find abnormal cells, gobble them up and get rid of them. And that is an appropriate response that's happening, as you mentioned, all the time. But we know that there's certain situations where those, where those, uh, cells don't work as well. And somebody's immune system isn't able to, or doesn't find those abnormal cells as they should. And one of the biggest areas that influence how our natural killer, killer cells work is our nutritional status. You know, we know we need to be getting all of the nutrients our body needs for all the cells to work well. So getting, really focusing on nutrient

• 9:19Speaker 00

  dense foods really has a big impact on how well those natural killer cells work. We also know that when there's a lot of toxins that we're being exposed to, that that actually shifts the way that our immune system functions. There's been studies to show that certain toxins can cause the immune system to not, not work when it should. And so, you know, we're always in, in functional medicine, we're always looking for, you know, are there signs that this person has had exposure to a lot of toxins? We'll measure certain toxins. We'll think about what we can do to lower that person's toxic load and what we can do to help the body get rid of toxins that, that they, that we've all had exposure to,

• 10:04Speaker 00

  right? With, you know, getting a lot of fiber, having regular bowel movements, sweating, drinking sufficient water, eating all your phytonutrients, right? All of those colorful plant foods can help the body with removal of toxins from our exposure.

• 10:21Dr. Mark Hyman?

  So it's easy to say your immune system is influenced by everything. And we can improve the function of our immune system by eating better, by exercising, by sleeping enough, by removing toxins, by optimizing our microbiome, the whole thing, regulating insulin resistance, all that helps. So. You know, that's a very empowering message. Now you have to wait around and just cross your fingers and hope you don't get cancer. There's a lot of things you can do, particularly if you're at risk. And I think the next topic I want to jump into is this whole idea that isn't well accepted in traditional medicine of estrogen dominance, or estrogen excess, or estrogen toxicity. It's kind of like, it's kind of this weird, weird idea that is in functional medicine, but clinically, it's very real. And we know that this is a phenomenon

• 11:01Dr. Mark Hyman?

  where we have sort of an excess exposure to estrogen because of so many reasons. So why don't you kind of cover at a high level, what are the reasons that women experience an imbalance of estrogen and progesterone, an absolute excess of estrogen, or a relative excess of estrogen, and how that impacts the risk of breast cancer?

• 11:20Speaker 00

  You know, one major reason that you can have an imbalance in your hormones, or have high levels of estrogen, is what is your percentage of body fat? So, we know that when our percentage of body fat is higher, we actually produce more estrogen. And that's true for men and women. And so, and it's not all about, I'm always saying this to people, it's not all about pounds on the scale. It's really, what is your percentage of body fat? So getting an understanding of how much body fat you have is really important. Because if you don't have enough lean muscle mass, and you have too much body fat, then you're going to make more estrogen. And that hormone balance will get out of balance. Your hormones

• 12:02Speaker 00

  will get out of balance, and you'll have excess estrogen. The second thing is, is those xenoestrogens. So these are toxins from our environment that can act like estrogen in the body. And they can attach to the estrogen receptor, and they can influence our hormone balance. So, you know, there's been a lot of research in this area. It's fascinating. I mean, everything from BPA, right, that hard plastic that was discovered in like 1990 at Tufts University, when they were doing research on breast cancer, and they recognized that the plastic test tube was influencing their research. And that's when they started

• 12:45Speaker 00

  to say, oh, this hard plastic is acting on estrogen receptors in the body. It's a xenoestrogen. So, you know, these xenoestrogens from our environment, which include things like the BPA, the parabens, the phthalates, pesticides, herbicides, tricklison, right? These toxins from our environment are influencing our hormone balance. And some of us have more exposure to these toxins, and some of us also don't mobilize them as well.

• 13:16Dr. Mark Hyman?

  And also, some of us have genetics that make it hard to detoxify them, like me.

• 13:20Speaker 00

  And then, and then the microbiome has a huge impact on how you get rid of your hormones, and especially estrogen. There is, there is a substance in our gut called beta glucuronidase, which if you have an imbalance in your bugs in your digestive tract, if you have a dysbiosis, or an imbalance in there, that you can make more of this enzyme, which allows that estrogen to get reabsorbed into your body, and create this estrogen excess as well. There's also research on alcohol, right? There's a lot of reasons that alcohol is associated with increased risk of many different cancers, but it can also shift hormone levels in your body, and be involved in that way, too. So, those are

• 14:05Speaker 00

  just a few of the reasons why you can have this imbalance or estrogen excess.

• 14:10Dr. Mark Hyman?

  Every birthday tells you how many years you've been alive, but it doesn't necessarily tell you how your body's aging. And that's the part I'm really interested in. Because your body isn't standing still. Your hormones change, your metabolism changes, inflammation changes. What was true for your body five years ago may not be true today. And two people can be exactly the same age, and look very different beneath the surface. That's why with Function, I wanted us to think about testing differently. You get access to over 160 lab tests each year, covering your heart, your hormones, metabolism, nutrients, inflammation, toxins, and lots more. And what I truly care about is what happens next. You come back and you measure again. Now you're not just looking at a number, you're asking, is it moving? In which direction? What's changed? Because getting older is guaranteed. Living

• 14:54Dr. Mark Hyman?

  well, well, that's the part worth paying attention to. Check your health at functionhealth.com/mark. And if you're one of the first 1,000 people this week, use the code MARK2026 for a $50 credit toward your $365 a year annual membership. I mean, it sounds like a perfect storm. We've got, you know, obesity, which is an epidemic. And I remember in medical school learning that if women were overweight, you know, were in their 40s, and were fertile, they'd have higher risk of uterine cancer, and fibroids. And it's like, these are all estrogen-related problems. We know that alcohol increases estrogen levels in the blood. We know that your microbiome, if it's unhealthy, will cause a recirculation, like you said, and uptake of extra estrogen, even if you try to detoxify it. We know there's all these foreign molecules that act like estrogen

• 15:39Dr. Mark Hyman?

  in the body. So we have so many reasons why we're seeing this. And also, women are having more issues around anovatory cycles, where they don't ovulate every month, when they're getting their late 30s and 40s, they have PCOS. And all, this just leads to, basically, what we call unopposed estrogen, where estrogen is just there, and your body is just exposed to it. And that will increase your risk. So, these are things you can do something about. These are all modifiable risk factors. And exercise improves it, managing stress improves it, sleep improves it, eating a healthy whole foods diet improves it, eating more broccoli improves it. There's so many ways to handle it. Let's talk about, you know, the flip side a little bit while we're on the hormone topic. At the same time that we're talking about this phenomenon of, kind of, estrogen-related cancers, we're also

• 16:23Dr. Mark Hyman?

  seeing this sort of flip in our older thinking about hormone replacement therapy. It used to be, and we were, I remember when I was in Canyon Ranch, early on, I remember a woman came up to one of my lectures, and she said, Dr. Hyman, my doctor said it was malpractice if I didn't get Premarin and Probirin, which is the hormone replacement therapy. And then in 2002, the Women's Health Initiative came out and showed that there may be increased risk of breast cancer, blood clots, heart attacks, and so forth. And overnight, like 15 million women were taken off of hormone replacement therapy, which probably was a bad idea. And now we're kind of swinging back and going, well, maybe there were problems in that study. It wasn't bio-identical hormones, it was horse estrogen, and a synthetic progesterone, and these have other problems. Can you speak to that, sort of threading that needle of

• 17:08Dr. Mark Hyman?

  women who are going through perimenopause, who don't want to get breast cancer, but also want the relief from menopausal symptoms, and also with the protections around bone health, and brain health, and so forth?

• 17:20Speaker 00

  Yeah, you know, I think that there's so much that we can do to provide women with relief during perimenopause and menopause, that doesn't increase risk. So we're learning so much now. But it does require some really, you know, working with a good provider, having good conversation, and some nuance when you're deciding what you want to do with a woman. So if I'm working with somebody, and we know that hormone therapy is really, can really help with those symptoms around perimenopause, and menopause, that, you know, you really want to gather a history and really understand, what are you using it for? And you want, of

• 18:01Speaker 00

  course, go bio-identical, right? Not that Premarin, and not the Progestins. You want to go with a bio-identical estrogen and progesterone. Typically, I'm using estrogen that's transdermal through the skin, and progesterone, either oral or transdermal. And we're often using vaginal estrogen. That's a local estrogen that's, that's just working for vaginal dryness in the vaginal tissue. And then, we're looking at, okay, how is that working for the person? What are their levels like? How are they metabolizing their estrogen? Because we can measure that. You know, we can look at, how are they handling it? Because it's, what's fascinating to me, is that, you know, for some women, the lowest

• 18:44Speaker 00

  dose patch, for example, works really well, and is more than enough. And then for other women, they need a much higher dose. So it's, so really, we're all different. We're all different for all those reasons we've been talking about. So it's very important that you have those conversations to find the right, the right treatment for you. We don't necessarily think that bio-identical hormone therapy is causing cancer, right? But we do know that it can cause cancer to grow, if there is cancer cells there. So, you do have to be, you know, paying attention to what's going on, you know, doing breast exams, or screening, screening for, to be on top of that. But there is definitely a safe way

• 19:29Speaker 00

  that you can, you can use some hormone therapy to help with symptoms, and feel better, as well as not increase risk.

• 19:38Dr. Mark Hyman?

  Yeah, I think this is so important to remember. And I think, you know, a lot of things we just talked about are things we can evaluate. Like, we talked about the biological terrain, and the health of your soil, per se.

• 19:50Dr. Mark Hyman?

  And the good news is there's ways we can actually look at it and, and actually do a soil sample. And I think it's important to understand, what are those diagnostics that are not in traditional medicine? Some of them are like insulin resistance, you can kind of tell the doctor's home measure insulin. But what are the sort of go to things that you want to look at to make sure you're evaluating a woman's biological terrain to make sure they don't have a problem with nutrient deficiencies, or toxins, or the microbiome, or insulin resistance, or all these things that, that we've been talking about. But how do we, how do we find out if we have these problems?

• 20:21Speaker 00

  Absolutely. So, you know, I always am looking at, you know, fasting insulin levels, like you, you mentioned, and is there a sign of metabolic syndrome insulin resistance by looking at things like hemoglobin A1C, your cholesterol pattern. But then I will look for signs of inflammation, right? So we can do a C reactive protein, or sometimes even a sed rate, or, you know, signs of inflammation in the body. We can do things that look at serum zinc levels, serum copper levels, because if that is out of balance, that can influence the functioning of the immune system, as well as it can be a sign that there's inflammation. I will look at things like B vitamin status, because we need to be able to methylate with

• 21:06Speaker 00

  sufficient B vitamins to get rid of used up estrogen or other toxins, right? So you can look at methylation status with things like homocysteine levels in the body.

• 21:18Dr. Mark Hyman?

  And methylation, by the way, people listening, methylation is essentially a process where you chemically process things in your body using this step called methylation. It requires B vitamins like B12, B6, and folate. It's involved in everything from detoxification or hormone metabolism. So I just want to make sure people knew what that was.

• 21:32Speaker 00

  Absolutely, absolutely. And you know, you get a lot of your folate from your foliage. So all of your green leafy vegetables, when you're eating all of your, you know, eight to 12 servings of, of plant foods a day, your fruits and vegetables, all the different colorful plant foods and eating from the rainbow, you'll get all that folate. Some people need a little bit extra with a supplement, but you can assess that with using something like a homocysteine blood test. And then you can look at, you were mentioning, we were, we were talking about estrogen metabolism. We can, we can measure that. We can measure the microbiome. We can look at different patterns within our, our, our bugs in our

• 22:13Speaker 00

  gut that can influence whether we, how we metabolize toxins, and if we reabsorb them. We can look genetically to look at risk of, of how somebody is going to metabolize toxins or metabolize their hormones. So we can look genetically as well. So there's a lot of things we can, we can do to evaluate somebody's terrain.

• 22:35Dr. Mark Hyman?

  Yeah, even looking at toxin load, and you can look at urinary environmental chemicals, pesticides, herbicides, glyphosate, also heavy metals. You can, you can get a really good idea what's happening with the other nutrient levels, like, you know, vitamin A, and like you mentioned, you know, zinc, but also vitamin D plays a role in immune function. So you can kind of really get a deep sense of what's happening. You're going to get into resistance and all these things that play a huge role, we can actually measure. And we do that at the Ultra Wellness Center. When people come to see us, we do that through Function Health, through our basic membership. And I think you can get a really good idea of what's happening with your biological terrain. And it's important to do that as a, just for, for all health conditions, but particularly for preventing breast cancer. The thing that's really interesting to me, Liz, is, as I start to look at the literature, and you were a little ahead of the game on this one, with your cancer, but, you know,

• 23:20Dr. Mark Hyman?

  in the last decade or so, we've just seen an increase in breast cancers in women under 40. And what's even more troubling is that these are estrogen, you know, receptor positive breast cancers, meaning they are influenced by estrogen. And, you know, we're seeing rising rates, and not only that, we're seeing higher mortality in these women, not just that they get it, but they die from it. And there are a lot of reasons. It could be the estrogen dominance thing. There's a few other things we didn't talk about, like the age at menarche, the, if you have longer exposure to your period, if you have a period starting at eight years old, which is now happening, versus 14, it's a, it's a difference. Or whether you breastfeed or not makes a difference, or whether you have kids early or not has a difference, or how many kids you has, makes a difference. So all these things play, play

• 24:05Dr. Mark Hyman?

  a role in your overall estrogen exposure. That's why you see, you know, women with like 14 kids, they're probably never get breast cancer because they start early, they keep going. But, but now we're seeing, you know, women who wait till their 40s to have kids, they breastfeed, but it's like, it's, it's tough. You know, why do you think we're seeing this increase in, in younger women? And you were, you were one of the early ones, but now it's much more.

• 24:25Speaker 00

  Yeah, I led the way. Oh, no. You know, it's so true. When I was diagnosed at 30, I was the very rare person. I mean, there was a few other women that were going through treatment with me around that same age, but it was very strange to be 30 with breast cancer. And unfortunately, it's, it's not that strange anymore. It's unfortunately, we're seeing, as you mentioned, more breast cancer at a younger age. We're seeing a lot of other cancers as well. You know, think about the colorectal cancer, really high increase with younger people as well. And I think the reason we're seeing all of these increases in cancer in younger people is twofold. One is our microbiome and toxins.

• 25:08Speaker 00

  I think that's really where we, we need to focus, is the microbiome and toxins. So toxins is tricky. You know, some, of, of course, we want to lower our toxic load now, and we want to support our body's ability to detoxify. But we also know, unfortunately, that the toxin exposure may have happened when we were a fetus, or it may have been an exposure that our mother had, that does change our, our breast tissue in a way that increases our risk at a later stage in life. So it's, so these xenoestrogens are kind of tricky. They're not as, it's not always, oh, you have exposure now, and now you get

• 25:48Speaker 00

  cancer. It may have been you had exposure at a very young age, or, or even, you know, it's intergenerational shifts that are occurring. So we do want to be paying attention to lowering toxic load. And then I think the other thing is our microbiome. We've just, there's just too many, you know, we're treating too many people with antibiotics, but also all the antibiotics in our food supply is unfortunately shifting the microbiome in a way. And we know that that can change, you know, a few things that we know a lot about that influence risk of cancer. One is that beta glucuronidase enzyme that can increase reabsorption of toxins. But the other is butyrate. And we know that when we don't have enough butyrate,

• 26:30Speaker 00

  which is a postbiotic, that comes from having the right amount of probiotics or good bacteria in your gut, then you make the right amount of this postbiotic. So when women have a low level of butyrate, they actually have an increased risk of breast cancer. Just fascinating, right? So something going on in the gut is actually influencing your risk of breast cancer, you know? So it really is all connected.

• 26:55Dr. Mark Hyman?

  But butyrate influences oncogenes. Oncogenes are cancer promoting genes. So if you have butyrate, it turns off the cancer promoting genes. And butyrate comes from healthy gut bacteria digesting fiber, and you absorbing that and it entering your bloodstream. What's really amazing is that 25 to 50% of the metabolites in your bloodstream come from your gut bacteria's metabolites that you absorb, which is kind of crazy to think about it. You're, you're kind of basically just a carrier pigeon for the bacteria in your gut. Let's talk a little bit about screening, and then I want to talk about some practical tips about how we really can kind of take this home for women around prevention, because screening isn't prevention. It's just early detection. And yes, early detection is cancer's worst enemy, but prevention's

• 27:39Dr. Mark Hyman?

  better. So let's talk about mammograms and MRIs and ultrasounds, and what should women be doing?

• 27:46Speaker 00

  Yeah. So the general recommendation now is between the ages of 40 to 75, women should be getting mammograms every other year. There's some organizations that say between the ages of 40 and 45, have a conversation with your doctor, and, and, and that you may start then, or definitely between 45 and 75, every other year for a mammogram. Of course, that really is dependent on your individual risk. If you have dense breast tissue, you want to also be getting an ultrasound, and some high risk women get MRIs as well. But, you know, You know, I am really hopeful for, you know, the future in terms of better even screening

• 28:26Speaker 00

  methods, especially for our younger women. And there's some, you know, newer ultrasounds that are coming out that I would be hopeful that we could, that could be helpful for screening in, in the younger women where mammography just doesn't work as well. So the, you know, mammography is a, is a better screening test for that post-menopausal woman. And for our younger women, women with dense breast tissue is just not as good of a screening test. So I, I would hope that we can really develop some new, some new methods here.

• 28:58Dr. Mark Hyman?

  And the good news is there are also breast cancer risk calculators that you can find online that actually help you decide on whether you should do earlier screening. I mean, if you have a family history, if you have dense breasts, if you have this and that risk factor, it's going to push you towards earlier screening. So I think it's important to personalize screening as well, not just sort of go through a population level assessment.

• 29:19Speaker 00

  A hundred percent. And we all want to get to know our breast tissue. So at every age, you want to get to know your breast tissue. You know, you want to be able to, you know, if you see a change in the way your breasts look, if you notice a lump or a bump, you know, if, if there's a dimpling of your skin, you know, you want to go in and get that checked out.

• 29:37Dr. Mark Hyman?

  Absolutely. And I think, you know, we're going to put a link in the show notes about how to do a breast, breast calculator. It's important. So let's kind of just sort of close by talking about some of the really practical things that people can do to lower their risk from diet to supplements to lowering toxic load to their gut health. Talk about what are those sort of priority items that we should be focusing on that women can do tomorrow?

• 30:01Speaker 00

  Absolutely. So we all need to be paying attention to nutrition. I mean, that's our, that's like my favorite area to talk about. But, you know, from a, from a diet perspective, you really want to make sure you're balancing your blood sugar. You know, at every meal, you want to make sure you have a good source of protein, healthy fat and good fiber so that your blood sugar doesn't shoot up after a meal. Right? So really balancing blood sugar is important. From a, you know, some of the best things to include in a healthy diet include the cruciferous vegetables, right? Broccoli, cauliflower, cabbage, kale, Brussels sprouts, broccoli sprouts. These are rich in sulforaphane. Sulforaphane is amazing

• 30:40Speaker 00

  at helping the body detoxify in general, helps the body make glutathione, which is this amazing nutrient that helps the body get rid of toxins. But it also helps with estrogen metabolism that we were talking about. And of course, it's rich in, rich in other phytonutrients and fiber. So other things in diet that I think are so critically important, ground flaxseed, wonderful, wonderful fiber that helps with binding toxins, is rich in omega three fats. And then daily exercise, really that's important. We know that women who exercise daily have less risk of getting breast cancer, but if they do get breast cancer, they have, there's less cancer growth for those women or less recurrence. So, you

• 31:25Speaker 00

  know, getting in some daily exercise and, and a combination of both the, the cardiovascular exercise, but also that strength training. Cause as we, as we were talking about before, having sufficient lean muscle mass is critical for all, all, all over health as well as breast cancer risk. You know, for some women, and this is what it was for me, or one of the things that I needed to focus on was that stress management piece. Right? So, you know, maybe you're doing everything right from the diet perspective and the exercise perspective, but you know, you're just going, going, going, you're not resting enough, you're not adding in that breath work, the relaxation exercises. That's really important to focus

• 32:06Speaker 00

  on as well and getting adequate sleep. Really being careful with alcohol, you know, for, for women, you know, the general recommendation is less is better. Right? And we do know, you know, one or two drinks a week or even less is probably where we want to focus from a, from decreasing risk of breast cancer.

• 32:26Dr. Mark Hyman?

  Less than one drink a week is zero. And I, you know, if you look at the data, it was shocking to me. I thought, I remember this paper in JAMA when I was working at Canyon Ranch with you, that came out that said, if women have one glass of wine a week, their risk of breast cancer goes up by 40%. That's staggering.

• 32:42Speaker 00

  Yeah. You know, there is, it's, there isn't a linear association. Yep.

• 32:46Dr. Mark Hyman?

  Now be careful with that. And then also I think that the other thing that's important is reducing your overall toxic exposure to anti-grin disrupting chemicals. And the Environmental Working Group is great on how to reduce your exposure through skincare products, through household cleaning products, through food, through filtering your water, filtering your air. It's really important. You can't eliminate all this stuff, but like, don't be heating your food in microwaves with plastic. Okay. It's just, that's bad. And, and there's a lot of things like that that are super important. So this is really incredible conversation. I think it's very empowering. A lot of women go like, oh my God, I'm just like sitting duck. I don't know if I'm going to get breast cancer. I'm scared about it. I, the good news is there's a lot you can do to be proactive, to change your biological terrain, to reduce your toxic exposures, to improve your gut microbiome, to improve your insulin resistance,

• 33:30Dr. Mark Hyman?

  to reduce alcohol intake, to increase fiber intake, to manage stress, to get sleep. These are all things that are within your control. The change of fundamental, basically soil in which the cancer grows or doesn't. And so I think, you know, you're a testament to that. You're now, I'm about your age, you look much younger than you are, but it's been a while, it was 30 years since you had cancer and you're doing great. And I think that's a really helpful, helpful message for women to realize that they can, they can change the biology that's, that's setting the stage for them to be at risk and, and really make a difference for themselves. So Liz, you've spent a lot of time thinking about breast cancer. You've written a lot about it. You have a guide on it. Can you tell us where people can find out more information that you've created around how to navigate these very treacherous waters around breast cancer?

• 34:14Speaker 00

  Yeah. So I put together a book called Breast Wellness Tools to Prevent and Heal from Breast Cancer, that I actually wrote with my daughter, which was so much fun. And in there, we really is a guide for the average person to get a sense of where do they need to focus for themselves. So for some of us, it's, it's on the diet and some of us, it's on the stress and some of us, it's on the microbiome. So in this book, we go through, how can you figure out where to focus to create that healthy terrain and decrease your risk of cancer?

• 34:46Dr. Mark Hyman?

  And where can they find that?

• 34:47Speaker 00

  You can go to Amazon and put in breast wellness, Elizabeth Boham. You'll find it.

• 34:52Dr. Mark Hyman?

  And you have a website?

• 34:53Speaker 00

  I do. DrBoham.com is my website. And on there you can download my 15 tips for free on how to decrease risk of breast cancer.

• 35:03Dr. Mark Hyman?

  Amazing. Thanks Liz. Thanks for all you've done for the world, for this field, for supporting me for the last, I don't know, three decades, the better part of three decades and working together. And, and anybody listening, if you really want to dive deep on this, I welcome you to come to the Ultra Wellness Center. We take care of people with all sorts of chronic diseases and, and help people navigate all these, these issues together and, and hand in hand with you. Hey everybody, it's Dr. Mark here. I'm so excited to share that my new book is officially available for preorder today. After more than 30 years of practicing medicine and caring for tens of thousands of patients, I've written the book that brings everything together that I've learned about helping people get healthy and stay healthy as they age. It's called A Hundred, What to Do Today to Live 100 Healthy Years. It's a whole body guide

• 35:46Dr. Mark Hyman?

  to living 100 healthy years. It's grounded in a new understanding of how our bodies work. It's the new map of the body. And inside, I walk you through the seven core systems that drive your health from your gut and hormones to how your cells make energy to help you understand the signals your body's been sending you all along. Now, a lot of what's in the book, I learned the hard way through my own body. When I got sick, the medicine that I trained in did not have any of the answers I needed. So I had to go look for them myself. And that search became my life's work. This book brings together decades of my learning from my patients, from the scientific research and scouring that, from the things I got wrong and the things I had to rethink along the way. I don't want you to have to struggle the way I did to find those answers. So much of our health is shaped

• 36:30Dr. Mark Hyman?

  by what happens outside your doctor's office. And I want you to feel confident knowing how to care for yourself every day. I put so much of myself into this book and I'm really excited to finally share it with you. It's really my life's work. It's my capstone of my career. I put everything I know. It's finally available for order today, preorder, everywhere books are sold. Go get a copy. Please support me. And this is my life's work. So I think you're going to love it. If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Dr. Mark Hyman. Please reach out. I'd love to hear your comments and questions. Don't forget to rate, review and subscribe to the Dr. Hyman Show wherever you get your podcasts. And don't forget to check out my YouTube channel at Dr. Mark Hyman for video versions of this podcast and more. Thank you so much again for tuning in. We'll see you next time on the Dr. Hyman Show.

• 37:15Dr. Mark Hyman?

  This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at UltraWellnessCenter.com and request to become a patient. It's important to have someone in your corner who is a trained,

• 37:58Dr. Mark Hyman?

  licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening. When it comes to supplements, you only want the best for your body, the kind with the highest quality, cleanest and most potent ingredients you can get. That's exactly what you'll find at my supplement store, where I've hand selected each and every product to meet the most rigorous standards for safety, purity and effectiveness. These are the only supplements I recommend to my patients and they're also what I use myself. Whether you want to optimize longevity or reduce your disease risk, or you're looking to improve your sleep, blood sugar, metabolism, gut health, you name it, DrHyman.com has the

• 38:42Dr. Mark Hyman?

  world's best selection of top quality, premium supplements, all backed by science and expertly vetted by me, Dr. Mark Hyman. So check out DrHyman.com because when it comes to your health, nothing less than the very best will do. That's DrHyman.com, D R H Y M A N dot com.