Her Silent Risk: All Things Breast Cancer
October 7, 2025 | Episode 48
Producer’s Note: The following is an AI-generated transcript of The Wellness Conversation, an OhioHealth Podcast
SPEAKERS: Lindsey Gordon, Marcus Thorpe, Dr Natalie Jones
Marcus Thorpe 0:00
Facing breast cancer is a journey no one wants to take, but one doesn't have to take it alone. From the moment of diagnosis to finding hope after treatment, compassion, expertise and fight come together in that fight against breast cancer. Thanks for joining us for this episode of The Wellness Conversation and OhioHealthPodcast. I'm Marcus Thorpe
Lindsay Gordon 0:33
and I'm Lindsay Gordon. We want to thank you for being with us today, before we introduce our amazing guest, we encourage you to like, rate, subscribe to this podcast, leave us questions, drop us a comment. We'd love to hear from you. We are so pleased to be joined by Dr Natalie Jones, surgical oncology with a focus on breast cancer and melanoma. At OhioHealthis your title. We are so happy to have you here because this is something that breast cancer I've seen so many headlines about new research. Research shows this. New research shows that we got so many questions from our followers on Ohio Health's Instagram account. So I think we're going to have a really helpful conversation today. Thanks for being here.
Dr. Natalie Jones 1:12
Thank you for having me.
Marcus Thorpe 1:14
Let's start with detection. I think it is so critically important. That's an understatement. But how about screenings when it comes to what's available, when they should be used, and really how important that early detection can be for ultimate success.
Dr. Natalie Jones 1:28
So for average risk women, we suggest getting a baseline screening mammogram sometime between age 35 and 40 in yearly starting at age 40 and beyond. But then we also take into consideration is a woman at higher risk for breast cancer based on family history. We look at, have they had biopsies before that showed atypia? Do they have strong family history of breast or ovarian cancer? Do they have other risk factors that make us like a genetic mutation that would make us more concerned that they could develop breast cancer at an early age. And so in those women, sometimes we start the screening process even earlier. We usually say start 10 years before the youngest affected family member. So if someone in the family developed breast cancer at age 35 we potentially would recommend screening for that woman's children starting at 25 which isn't always mammograms, so it gets a little bit confusing, because mammograms are harder to interpret in young women with dense breast tissue. So we might do screening ultrasounds for the younger women who still are at higher risk, or we utilize breast MRI in other women who have those genetic mutations and strong family history.
Marcus Thorpe 2:40
You can tell that breast cancer has such a big impact on everybody in one way or another, because we've been doing this podcast for almost a couple of years now, and we've solicited questions before, and they'll trickle in here or there. When we talked about this topic, they really started to come. So there's a lot of folks that have questions that want answers, and I know that we want to get into some of that too.
Lindsay Gordon 3:01
Yeah. Speaking to the detection piece in the family history, Katie asks, does a family history of breast cancer make me more likely to develop it too?
Dr. Natalie Jones 3:11
It certainly can. We look for things like, is there two or more women affected with breast cancer on the same side of the family? Are there other cancers that sometimes can be linked with breast cancer that may make us want to recommend genetic testing, such as ovarian cancer, pancreatic cancer, prostate cancer in men. So sometimes it's looking beyond just the breast cancer history in a family, and kind of pulling out all of those cancers to know, Is this someone that should be recommended for genetic testing, or is this someone that we should start doing those screening tests earlier?
Marcus Thorpe 3:49
I know for a lot of people, there can be roadblocks as to why they don't go and get their procedures done. We had a question from Instagram about where can I go for screening if I don't have insurance.
Dr. Natalie Jones 3:59
So we have funding, even through Susan Coleman and other places where we never turn a woman away from a screening mammogram. So we would just encourage that to not be a reason for someone to not get their their mammogram. I know OhioHealthprovides resources for women who do not have insurance, who are who are under insured. And I believe all of the competing institutions do as well, because we don't want to turn anyone away who can't afford it. And once you're within the guidelines, honestly, of like 40 and beyond, some of that is should be paid for regardless, but we know there's always concern about finances.
Lindsay Gordon 4:41
When someone gets a breast cancer diagnosis, whether it be male or female, we know some men also get breast cancer. Is there always a lump that that's there?
Dr. Natalie Jones 4:52
Not always no men, yes, can get breast cancer. It only represents about 1% of all diagnosed cancers. But we certainly. See it usually. In men, it is a palpable mask, because they're not going for yearly mammograms, and it's not recommended either. But in women, it can be caught just from getting your screening mammogram, which could be micro calcifications, which end up oftentimes coming back as early stage zero breast cancer or ductal carcinoma in situ. It can be a variety of things, just a denser tissue, or we call it an asymmetry on a mammogram, that's not palpable, but enough to warrant doing a biopsy. So certainly, not all of them are palpable.
Marcus Thorpe 5:33
You mentioned calcification. So my sister in law, Lauren, who lives in Wisconsin, had a recent examination that turned up some abnormalities, and she wanted to take it to that next step. She had a lumpectomy, and there were some things that came back on her margins that weren't completely clear. I guess that's pretty common. It sounds like she said she thought it was in 20% or so of women. Is that pretty common?
Dr. Natalie Jones 5:59
It does. The statistic varies for so for women who are having a lumpectomy for an early stage breast cancer, our biggest concern is getting the cancer out with clear margins. So I just talked to patients about we want to get good, healthy, normal tissue around those abnormal cells and the margin re excision rate varies from surgeon to surgeon. Sometimes it can be as low as five or 10% some, sometimes it is up to 20% so that's that statistic is realistic. So there are women that do sometimes have to go back and have a second surgery to take more tissue, or they change their mind and or we advise them. As a surgeon, I don't think it's going to be a good idea to go back and just take more tissue. Maybe we need to rethink this and consider doing a mastectomy.
Marcus Thorpe 6:43
Yeah, she had a double mastectomy because she said, I don't really want to go through everything that comes with some of these treatments and those kind of things. And, you know, it's one of those things. When you first hear it from just somebody you care about, you worry about them, and what does that mean? And how's it going to be? And then you realize that each choice is an individual choice for a person, for a family, and that's what she went with, and we all supported her, and I think she's really happy with the choice that she made. Can you talk about that, how these choices are very individualized for people and for their families?
Dr. Natalie Jones 7:15
Yes, there's a lot of shared decision making, and there's there's no right or wrong. So as a as a breast cancer surgeon, when I talk to my patients, I'm always talking to them about these are, these are the options that you have available to you. And usually there's two main options, either lumpectomy, which is tends to be followed by radiation versus mastectomy, or even bilateral mastectomy. There's increasing incidence of women choosing to do both, not just to remove the cancer side, but to prophylactically remove the non cancer side. And so those are all very valid choices, and they're in the NCCN cancer guidelines, and it's our job to educate people and talk to them about differences in local recurrence rates and why radiation can be as effective as doing a mastectomy, but ultimately it's the patient's decision. So it's shared decision making. But ultimately it comes down to what is that individual, woman or man's what's their what's going to make them feel most at ease?
Marcus Thorpe 8:15
Yeah, and the last thing I'll say about Lauren is she's found some strength in this passion that she has with another cancer survivor, they've started this group called Hope chimes, where they're putting bells in centers to let people ring bells, not just at the end of treatment, but really through some of the highlights of what they're doing. So it's amazing to see when people go through tragedies and change in their own personal lives, to find that passion and to know where they need to be and what they need to be doing for other people.
Dr. Natalie Jones 8:42
So there's tons of wonderful support groups. I'm just so amazed with my patients, just the different groups within the community here in Columbus, as far as these women who band together for many institutions, many of which are patients that we've all taken care of at Ohio Health. But it's the sense of community and unity, and there's so much wanting and desire to give back.
Marcus Thorpe 9:03
I love that.
Lindsay Gordon 9:04
And of course, the month of October, we see so much for Breast Cancer Awareness Month, and so many events happening. Another great question we got from someone on social media, are breast ultrasounds more reliable than mammograms?
Dr. Natalie Jones 9:19
I would say no, but they can be better in certain situations. So I would never discount the importance of a mammogram. And there's people that come in all the time like, I don't want to get a mammogram. I want to get this test inset. And there's a lot of you know, education that goes into kind of explaining why certain things, like micro calcifications don't show up on an ultrasound. They only show up on a mammogram, so you don't want to do one without the other, but if it's a palpable finding, you want to add and do an ultrasound in addition to the mammogram, because sometimes together, it helps get you the best information.
Marcus Thorpe 9:57
What do those early days look like when. Somebody gets those words that you have breast cancer and you're going to need a surgical procedure, not only for the patient, but you as their surgeon. Can you talk about how those conversations start and then how the process goes as you start to work on a plan?
Dr. Natalie Jones 10:15
Yeah, those are really challenging, but some of the most rewarding parts of my job is, is, you know, giving patients and delivering the diagnosis of breast cancer. I think there's almost an art to how you do it. And as this my 13th year in practice. So after a while, it's not that it becomes easier. That's not the right word for it, but I think there's a way to kind of deliver the message, and I always try to paint it in the most positive light, because the treatments have come so far, and the prognosis is so excellent for the majority of women and men who are getting diagnosed with breast cancer. But the key is to kind of meet them where they are and explain that I understand this is a really difficult, challenging no one wants to hear the word cancer ever in a sentence. But once you can kind of get past that initial delivering, that first piece of news that, yes, you have breast cancer, then I try to really focus the rest of the conversation on how we can support her, how we look at we found it early. These are the things that we're going to do to help and guide you in your journey. And I think that's why it's such a rewarding field.
Lindsay Gordon 11:32
I can't imagine what that moment must be like, where I feel like when you hear cancer as a patient, it's just like echoing in your head, right? And you just are stuck on that one word, and you probably just gloss over and just You're not listening to everything else that's that's coming out. So do you do you see that with your patients, and how do you make sure that they are equipped to take the next step in their journey once they leave, leave your office?
Dr. Natalie Jones 11:59
First of all, it's many conversations. It's not just one. So the initial phone call is probably the hardest, when you tell them that, yes, you have breast cancer, and then usually I'll tell them, I'm going to call you back in a few days when the second part of your biopsy comes back with the hormone receptors, which will then allow me to assign your breast cancer a stage and really allow us to sit down and talk about treatment recommendations, and then that next meeting is an in person meeting where usually both myself and one of the nurses in my office will sit down and spend a long time. It's usually an hour visit with a patient, going over again, the imaging, the biopsy results, what their treatment options are, I like to give them, like a paper with like an algorithm, just so they can kind of visually see what their choices are. And then once I answer, or think I've answered, all their questions to the best of my ability, usually the nurse will stay in the room and spend extra time doing surgery, teaching, but also answering. Sometimes more questions come up in that and then patients utilize everything from my chart to calling back and pressing the option for the nurse line or asking to speak with us. We're all very readily available. And I think that's why by the time they get to surgery, they because it does is sometimes it takes asking the same question more than once, or you don't hear the answer the first time because you're so overwhelmed, but but by the time they get to surgery, I feel like the majority of our patients really understand which direction we're moving in.
Lindsay Gordon 13:29
Do you worry about the amount of information that's out there now on social media about breast cancer? And do you worry about like, I remember we had a family member get diagnosed with pancreatic cancer, and the doctor was like, Don't Google it. There's just so much information out there. And what's your message for someone who's maybe doing the research because they want to support a loved one with a new diagnosis, or they've just gotten the results back themselves, and they want to know more? What would you tell them? Because it's so tempting to just pick up the phone now and go down that rabbit hole.
Speaker 1 14:03
It is. And we've made it even more difficult for patients because of my chart and because the results get released to patients even before the physician has a chance to call them. So patients are often seeing their diagnosis and Googling it, and I'm quick to call even before I can get on the phone. It can be within sometimes 1020 minutes. But I always tell people, you got to go to the right places. If you're going to Google, you need to go to reliable sources like Susan gohman. Susan gohman, you know, MD Anderson, go to reliable the American Cancer Society, reputable websites. But also, I would tell them, try to stay off the internet if you can, because within that next week, we'll have, usually more imaging, more information back about their biopsy, and we're going to have that sit down meeting, and at that meeting, I give them a whole folder of resources that talk them through the whole part, not just the surgical part of their treatment, but the chemo potentially. The radiation, the hormonal therapies. So I try to just make sure they have good resources to reference. And then we just go from go from there. You can't keep people off the internet the way it works.
Lindsay Gordon 15:11
That's I would do.
Marcus Thorpe 15:12
I saw on my chart I had high cholesterol, and I was like, Oh my gosh, this is the worst. I started looking at different things. I was like, oh, it's really not that bad. You just you need to talk to your doctor about your plans and what you need to do next.
Lindsay Gordon 15:22
Less cheese burgers.
Marcus Thorpe 15:23
Good luck with that.
Marcus Thorpe 15:26
Let's talk about a positive attitude and kind of what it can do for families and patients. I know it's not medicine and it's not surgery and it's not treatment options, but do you see results from people who maybe have that right attitude of taking this on? Everybody's gonna handle it down? Handle it differently. But how much does a positive mindset go into outcomes?
Dr. Natalie Jones 15:47
I think it has a lot to do it. I really do both from the doctor perspective and the patient perspective. I think to try to focus on the positives that that's kind of my approach to how I deliver the news and all through the we follow patients for five years or more in our practice, so we don't just operate on people and send them away. But I feel like the ones who can really glean from this diagnosis and kind of take away the more positive they do. And not to say they do better, but they travel the journey, I think, more easily for sure.
Marcus Thorpe 16:23
Yeah, surgery is not always the option that people take true. There's there's other options besides surgery. Can you walk us through what a menu looks like for somebody who has a breast cancer diagnosis? What? What opportunities do people have? What possibilities do people have? And it's not always the surgical route.
Dr. Natalie Jones 16:40
Right. So the majority of patients will have surgery as part of their treatment algorithm. Unfortunately, for the small percentage that get diagnosed as stage four, where it's metastasized or spread to other parts of the body, those are the patients where usually there's not a role for surgery. But thankfully, that's a very small percentage of the patients that we see, but for other patients, it's then deciding is surgery the right first step for you, where we then start to have those conversations about lumpectomy versus mastectomy and then all the reconstructive options that go with it. Or there's patients where it's beneficial to do the chemotherapy first. So we call that neoadjuvant chemotherapy to try and down stage their tumor make the surgery easier, sometimes makes them eligible for additional treatments on clinical trials. So those are the patients we're always trying to identify and see, who we need to get in more urgently to see medical oncology, because surgery will be a part of their plan. It just will follow the chemo rather than coming before the chemotherapy.
Lindsay Gordon 17:46
I'm curious to know, in your 13 years that you've been practicing and doing this, have you seen anything evolve in that time? Are you seeing an increase in diagnoses, or is the age of your patients shifting younger? Are you seeing anything significant?
Dr. Natalie Jones 18:02
I do think we're seeing more young women. I don't think we know entirely why that is. I think there's lots of speculation. Maybe it's better detection, maybe it's something in the environmental exposures, maybe it's covid, maybe it's we don't know. But also, I think our treatment, our ability to treat breast cancer is so sub specialized now and so individualized. It's based on so much more than just the hormone receptors, but we have chemotherapy, we have immunotherapy, we have hormonal therapy, and the combined approach, I think, has made outcomes better, and it has really kind of changed the outlook. It used to be that 15, 10 15, years ago, if you had a her two positive breast cancer, it was like, huh, that prognosis was terrible. Now, when we see that we're like, we have targeted her two blocking therapies that we can put you on in combination with chemo. This is 100% curable, you know. So that's there's just been in that. There's so many examples of that about new hope. Yes, there's vaccines on the horizon for breast cancer. They're coming that aren't ready for real, like, you know, not ready to be talked about just yet, but there's so much research that it's exciting.
Lindsay Gordon 19:17
I mean, I even saw a headline on Instagram today, and I saved it. It said something about how, like GLP, one medications are showing promise in helping to reduce cancer diagnoses. And who knows if that's true or not.
Dr. Natalie Jones 19:30
It's just because healthy BMI equates to which is what those drugs are promoting. Got it weight loss, lowering diabetics risk, but also maybe overall lowering cancer risk, because we realize now that healthy weight is super important at lowering recurrence risk and hopefully lowering just no new diagnoses in general.
Marcus Thorpe 19:50
we've kind of covered, you know, what happens before during I kind of want to wrap up our conversation with what happens after. So after a procedure or. Medication, or everything that's been laid out. What does it look like when it comes to physically, emotionally, socially, kind of bouncing back from a surgery or a procedure or something like that?
Dr. Natalie Jones 20:12
We kind of talk to patients about kind of their new normal after going through all the active parts of their breast cancer treatment, whether that be surgery, chemo, radiation, a lot of patients are on some type of maintenance, hormonal therapy, but not all patients are. But then there's the psychological component of it, just supporting women through support groups, just the importance of talking about the mental health aspect of it. There's a lot of anxiety that comes with a breast cancer diagnosis, and I think it's just helping women navigate through that process, and knowing that we're going to be there to support them a year, five years, 10 years from now, is so important, because really the scariest time for these women is when they come back for their four month follow up, and they come Back for their one year and their two year follow up, because what they're most afraid of is their cancer coming back. So it's just gaining the confidence and the belief that they've done everything that they do, that they can do, to prevent it from returning, and just it just takes time to kind of believe that they've beat this cancer.
Marcus Thorpe 21:19
Yeah, I love what you said earlier and kind of reiterated it there, is that it's not just a one time conversation that you have with a patient and then she's on your with your team, but not with you. And once the procedures happened and the the recovery is there, it's not like, Okay, now you're recovered, see you later. This is a journey. It's a true journey, isn't it? Yeah, I love that. I love Absolutely.
Lindsay Gordon 21:42
I love that. And I hope, if there's anyone listening who was recently diagnosed, or they're trying to support a loved one, I hope they find this conversation helpful. Is there any last message you would have for that person listening? Or maybe someone who who's on that journey themselves?
Dr. Natalie Jones 21:56
I don't know. It makes me think of my my dad always used to put this little plaque on my on my bed, even when I return home from college or medical school. It said, Life is a journey, not a destination. And I feel like that's very true in the world of breast cancer, that we're going to help these women through this journey. And it's it doesn't it doesn't end a week from now, a month from now. It doesn't even end five years from now, but there's so much support out there, which is why I love doing what I do every day.
Marcus Thorpe 22:26
Yeah, Dr Natalie Jones, you've been great. Thank you so much for not only what you do for our patients, but spending a little bit of time with us and reaching people in a different way. It's been really awesome. And we appreciate you. Thank you. And again, if you or you have a loved one that's going through this, you're certainly not alone. You can check out OhioHealthResources support groups and find your own hope. We hope that you do that too. Of course, we thank you for joining us for this episode of the wellness conversation and OhioHealthpodcast. Before we wrap up, a note for the listeners. If there is a health and wellness topic that you'd like for us to cover, we would love to hear from you. You can drop us a comment. Of course, we would love any likes, subscriptions those kind of things. It helps us get the word to more listeners.
Lindsay Gordon 23:07
This episode transcript will also be available on the podcast page. If there's any information you'd like to go back and read about, you can find us at ohiohealth.com/the wellness conversation as always. Thanks for joining us.
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