October is going to be over soon, but we wanted to acknowledge that it is Breast Cancer Awareness Month — and this one is really close to home for me. I lost my mother to breast cancer in the year 2007, and I miss her every day. It’s really important for me to get this information out for women and men, especially when it comes to making sure that we're getting in to see our doctors and getting screened.

Dr. Todd Tuttle is a surgical oncologist at the University of Minnesota Medical School and M Health Fairview, with a focus on breast cancer and surgical outcomes of breast cancer treatments. Last year, he was named in the top doctors in Mpls.St.Paul and Minnesota Monthly.

Every Wednesday morning at 8:30 CST, Jill Riley connects with experts and local personalities for some real talk about keeping our minds and bodies healthy — from staying safe in the music scene, to exercising during a pandemic, to voting and civic engagement. Looking for more resources and support? Visit our friends at Call to Mind, MPR's initiative to foster new conversations about mental health. Subscribe to Wellness Wednesday as a podcast on Spotify, Apple, RSS, Radio Public, Stitcher, or Amazon Music.

Jill Riley: I read recently that approximately one in eight women will be diagnosed with invasive breast cancer in their lifetime. That's just so shocking to me.

Todd Tuttle: Yeah, that's really high, isn't it? It's a very common disease, kills more women globally than any other type of cancer. So it's very important that you're focusing on breast cancer this month.

So when should women start screening themselves for breast cancer?

There's some controversy about when to start. I tend to use the most conservative estimate: around 40. About age 40, maybe earlier if you have significant risk factors — like your family members have had breast cancer — but around 40 is a good time to start considering getting screening, mammography.

And there are things that people can do to kind of keep their eye on things, even at home.

Sure. Probably the most important thing that a woman can do regarding breast cancer, first off, is just have be aware of her breasts. The best way to do this is to shower on a regular basis and note any changes. The best way to examine your breasts is really just feeling the skin over the breast and noticing any changes.

I remember going through being there with [my mother] and and that question came up: what caused this? What happened here? Why did this happen? What is the cause? Is there more than one cause? That that was always the question that I didn't feel like we ever got the answer for.

Yeah, it's frustrating that we generally do not know what causes breast cancer. There's a couple of things that probably cause it. One is having an inherited mutation, the BRCA gene — that's what Angelina Jolie had — and the other is getting high-dose radiation to your chest, particularly as a teenager.

Other factors are more risk factors and not causation. So we know that if you're overweight, you have a higher risk of breast cancer. If you drink alcohol, you have a higher risk of breast cancer. If you delay pregnancy, you have a higher risk of breast cancer. Now these are these are very small increases, but they're associated with a higher risk of breast cancer, but not really to the point where we'd say, “This is what caused it.” We really don't know, for the vast majority of breast cancer patients today. What caused their breast cancer?

You mentioned that BRCA gene. How easy is it for people to get tested for that gene? What does that process look like?

It's really pretty easy if you meet criteria. It's a blood test. It's relatively inexpensive. It is covered by most insurance carriers, and it's a really pretty easy exam to do. There are some kits, like the 23andme, which can provide you with some screening for for BRCA. I would I would prefer that people went through their physicians and got a more medical type of test.

I think back to the year 2002, when my mother was diagnosed. I've had some other family members and friends who've been diagnosed with breast cancer since, and it seems to me that breast cancer diagnosis, there's something that seems more specific about it - like I hear people talk about “triple negative” or “negative positive.” I'm not quite sure what that all means.

We are learning so much more about breast cancer than we did in 2002, when your mother was diagnosed. We know that it's not just one disease. You mentioned a triple negative breast cancer, there's estrogen receptor positive breast cancer, there's HER2 positive breast cancer, lots of different types that have different prognoses and different treatments. [We] really have been able to characterize breast cancer much better. And probably more importantly, we can tailor treatments, according to the type of breast cancer that you have.

Are there any new treatments that are showing promise?

Every day, we are finding new treatments. They're small steps, but they're steps forward. We're also finding that treatments that we used to use 15-20 years ago may not be necessary today. And we're learning more about specific types of breast cancer and what helps treat them or what does not. One of the big advances is identifying more women who do not need chemotherapy, for example.

What else should we know for Breast Cancer Awareness Month?

I think this is the most important thing is that we're still in a pandemic. We know that over the last year and a half, many women put off screening mammograms, and as a result, we're seeing more advanced breast cancers. Additionally, women who had breast symptoms, they notice the lump, they had pain, they had some redness in their breasts but delayed coming in because of the pandemic.

So if I do nothing else today, [I want] to emphasize to women out there: it's safe to go to the doctor, it's safe to get a mammogram. Everybody is vaccinated, everybody wears masks. And if you're due for screening, come in and get your screening. If you've got a concern with your breast, come in and see your doctor. We can do this safely enough, so you don't end up with a late-stage diagnosis of breast cancer, which is much more difficult to treat.

Wellness Wednesday is hosted by Jill Riley, and produced by Christy Taylor and Jay Gabler. Our theme music is a portion of the song "F.B. One Number 2" by Christian Bjoerklund under the Non Commercial Share Alike 3.0 International License. This week's photo is by Fort Belvoir Community Hospital (CC BY-NC 2.0). The image was altered: it was cropped, filtered to greyscale, and supplemented with a logo.