AntiFool Transcript: Breast Cancer Screening w/ Leslie Ferris Yerger

Transcripts Sep 30, 2020

Please enjoy this transcript of my interview with Leslie Ferris Yerger!

Leslie is a TEDx speaker, author of Probably Benign and a women's advocate with a laser focused mission. Leslie was diagnosed with stage four breast cancer in November, 2017. After an all clear mammogram and ultrasound, experiencing firsthand, the failings of current breast cancer screening technologies. She is now determined to advance the next generation in breast cancer screening. So that her story does not become your story.

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Transcript

Norman Chella: [00:00:48] Hello there. Norman here. Welcome to Antifool hosted by your foolish friend. This episode, we're going to talk about something serious, and that is breast cancer.

If you don't know, cancer cells tend to duplicate out of control and they've passed certain stages. They become incurable in that cancer cells start to spread across the body. And this is why we have screenings to detect these cancer cells beforehand so that we can eradicate them over time. For women, breast cancer is definitely one form of cancer that is worrying in their minds. We tend to have the mammogram as the standard procedure for detecting cancer cells.

But what if it's not enough? What if that there are cancer cells that still exist within the body, despite you doing the standard procedures, even after you receive an all clear, it may not be necessarily true. And who better to talk about breast cancer screening than Leslie Ferris Yerger.

Leslie is a TEDx speaker, author of Probably Benign and a women's advocate with a laser focused mission. Leslie was diagnosed with stage four breast cancer in November, 2017. After an all clear mammogram and ultrasound, experiencing firsthand, the failings of current breast cancer screening technologies. She is now determined to advance the next generation in breast cancer screening. So that her story does not become your story.

This is a very difficult topic to talk about, especially as it concerns facing cancer. Especially cancer in women and Leslie's experiences as someone diagnosed with stage four breast cancer. So in this episode, we talk about Leslie's origin story, when and how that she received that call, that it was a lot worse than an all clear, the flaws and limitations of a mammogram and ultrasound, and what other procedures help find the cancer cells, the lack of accessibility for effective methods right now throughout the U S. And why are they not widespread? The fears in women who do not take an extra step beyond their standard mammogram every year to find more cancer cells and the notion of cancer-free and why Leslie thinks that that phrase is false or inaccurate rather.

We go through the full range of breast cancer screening, definitely a field that I have no knowledge about. It is great to hear Leslie sharing with us, all of her experiences, her knowledge and her energy as she advocates for proper breast cancer screening.

So without further ado let's play the fool and learn from the wise by diving into my chat with Leslie Ferris Yerger.

Norman Chella: [00:03:39] Miss Leslie Ferris Yerger with the full name, welcome to Antifool. How are you doing?

Leslie Yerger: [00:03:47] Fantastic. And thank you for having me. How are you doing?

Norman Chella: [00:03:50] I am doing great. And I am also very excited because this is going to be a topic, I know I'm going to be very honest. Absolutely nothing about this. And by this topic, I mean the practice of breast cancer screening and especially the practices around it. because I have a very surface level knowledge of the different kinds of screenings or different methods, but whether or not they are effective, whether or not they are available and whether or not we have a proper, shall we say public perception?

Uh, of maybe the signs or maybe whether or not we should believe this methods is a whole other story together. So I would love to, you know, learn all about this from you, Leslie. But before we dive into that, I would love to know your origin story. How did you start this journey to become a woman's advocate for proper screening of breast cancer?

Leslie Yerger: [00:04:45] Great. Great questions. So in November of 2017, I was diagnosed with. Stage four breast cancer, which is the last stage, um, which is incurable. Also, and that was two months after an all clear mammogram and ultrasound. So I got that phone call, that we all want to get, you know, after we've been screened that says yes, all clear, all clear see you next year.

Um, and so I thought, well, at least I know I don't have breast cancer. Um, and then I was, I was doing, um, some other just preliminary things that my doctor suggested that I do given the age that I am at that point, I was 55. And that is to get a baseline bone density scan. So we were just doing that because as women get older, our bones thin, and that's why we shrank and start hunching over and all that kind of thing.

So he said, let's, let's find out where the situation with your bones now and get a baseline so that as the years go on, we'll know if you're losing bone or not. If we don't do that and when we will have anything to compare it to perfectly logical, perfectly innocent, there was no reason other than that to do it.

So I did that. And then the radiologist said, Oh, we see something strange in your bones. Um, we'd like to get an x-ray. So then I went to get an x-ray. Um, and then the whole thing started with there's really something not right going on in the bones, you know? So we went through four to six weeks of the x-ray then a CT scan and then a bone biopsy, and then a bunch of other tests for bone issues, like multiple plant myeloma, which is bone cancer.

Um, those were all negative. Um, and then the biopsy told detail, um, it came back with breast cancer cells in it. So what that means is that you have breast cancer that has then gone to somewhere else in your body. In my case, the bones and that's stage four breast cancer. So when you find cancer in your bones, um, it's either bone cancer or it's some other kind of cancer that has taken up in your bones.

And they're two very different things. To be treated very differently. So that is how I came around to knowing what I now know and what I want everyone to know now about breast cancer screening, um, went to the Mayo clinic for a second opinion because I'm sure that you can imagine how confusing that whole thing was.

Um, they quickly, you know, confirmed the diagnosis, but up there, I began to learn. Through reading and talking to people there that there's a gap, there's a hole in our breast cancer screening processes. that is missing a lot of cancers. So I thought to myself, okay, well this happened and I, I can't change it.

I can't, you know, I can't do anything about it, but what I can do is become an advocate for supplemental breast cancer screening for women who need it so that this happens to less people in the future. And so that is now what I'm about. That's what I do podcasts about. That's what I wrote my book about.

That's what I give my speeches about. I have a program called Be the Boss. Be the boss of your breast cancer screening, that I give to people for lunch and learns club meetings and stuff all on Zoom now, of course, Um, cause of COVID. But for me, that's what, that's what it's all about. I want to be a part of moving us from where we are to where we need to be with breast cancer screening.

Norman Chella: [00:08:42] This is very fascinating from a very confusing perspective, because like you've just mentioned. You've had your, your standard screening and now you had a screening for something supposedly is irrelevant or at least, you know, done in parallel a very standard procedure on bone density because that's very standard at that age.

And all of a sudden you see, you know, cells that should not be there, cells that are cancerous, that were supposedly meant to be detected prior in a previous screening. Why weren't they detected? Was there any explanation from the ones that are involved with the first screening?

My lack of medical knowledge is going to assume that it will detect at least all of the cancer cells or at least detect that there is less presence that it becomes harmless or at least, you know, too minimal to make an effect, but the fact that they have a screening of that doesn't really handle, or it doesn't actually isn't meant to be involved with cancer cells. Um, what are the different, dangerous effects of current screening technology today for breast...

Leslie Yerger: [00:09:54] so here, here is the whole reason why what we're doing is not a hundred percent effective. So if you back up 50 years ago, you know, they started to introduce the mammogram for breast cancer screening. And the mammogram is basically an X Ray of your breasts. I mean, there are a lot of other, you know, like software things around it, and now we're doing it digitally and all that kind of stuff, but is an xray of your breasts.

When a view is obstructed on any picture, you can't see through it or behind it. So many women, in fact, two thirds of all premenopausal women have what's called dense breast tissue. So our breasts are made up two things really. They're made up of fat and they're made up of other things like the ducts and the glands that are milk producing because that's what the breast is really for. Right. Um, and so depending upon your mix of those two things, if you have a lot of fat and not much of those other things, then your breast isn't very dense and a mammogram sees quite well in that kind of breasts. Okay. Um, so for women who don't have very dense breasts, a mammogram is actually quite effective.

You know, well into the 90%, you know, cancers, if they're there, but the murkier those pictures get with those other densities, the more likely it is that a mammogram will not be able to detect, will be able to tell the difference between the density and the cancer. Because both of those things show up white on a mammogram picture.

So a friend of mine in New York, she explains it like this, looking at a mammogram of a really dense breasted woman and trying to find cancer among all the density is like trying to find a white bunny in a snow storm. Very difficult. Very very difficult, so easy to miss you can't really see it a lot of times. You're going to miss it a lot of times.

And in fact, mammograms will find less than half of all cancers in women with dense breasts. And a lot of women have dense breasts. And here's the kicker about breast density. It increases your likelihood of getting breast cancer in the first place. So I kind of summed that up to say that mammography can fail the very women who might need it the most and those are the ones with high breast density. So it's kind of a double whammy, right?

Norman Chella: [00:12:32] Yeah. Okay.

Leslie Yerger: [00:12:32] It can't see the cancer in the women that are likely to have the most cancer.

Norman Chella: [00:12:39] So wait, so that means that this screening method just isn't effective for those who are most likely to get breast cancer, then what, what's a good alternative?

Leslie Yerger: [00:12:52] Right. So this is, this is the question, and this is why I say we need to go from where we are to where we need to be.  so 3D mammography now has come onto the scene and it was really build, really designed to take care of this problem. I call it a step and not a leap. So it finds maybe one more cancer per thousand women than standard mammography, but there are still a lot being left behind and there are studies proving this out.

Now, even with this new, you know, fabulous 3D mammography that we have, and the industry has spent a lot of money. Getting that one extra cancer per thousand of women and kindly telling us women that, Oh, here's your peace of mind now that you're using this 3D thing, when really it's a step and not a leap, and it's a leap that we need and it's a leap I'm going for.

Some people even get, they do screening ultrasound and they're not a bad thing at all. They find a couple more breast cancers per thousand women. that's a pretty verified number on average, two more. It takes an expert operator and there are a lot of false positives and it's two more again, I would call it a step and not a leap. So, um, there's their breast MRIs. There are some people and some organizations pushing for that to become more of a norm for screening. Cause it finds out a lot. Find a lot and their issues with that. Cost, capacity. Um, some people have an issue with the contrast that's used that sort of thing. Um, and then there's something that's being invented and tested out quite well at the Mayo clinic sites in the United States, Rochester Minnesota, um, that's called molecular breast image imaging.

And that's the thing that I found out. About when I was there couple years ago that got me thinking, well, wait a minute. If they're using something to screen their dense breast people with that finds three to 400% more breast cancers, then mammography and women with dense breasts, why don't we all have it?  I couldn't believe it. Um, there's, there are a ton of reasons for that. and I'm trying to help resolve all, those reasons in the way that I can. Right. Um, in order for that to become the norm, um, instead of where we're at,

Norman Chella: [00:15:40] So what are some of those reasons actually, because it sounds like you've discovered either to is discovered or at least you've uncovered a method that is much more effective, but it's just not mainstream as in

Leslie Yerger: [00:15:55] It's absolutely true. Um, I'll rattle off several reasons. One is the medical industry. Once these large scale, multi-year multi-site many thousands of women. Trials in order to accept things in to the norm that is going on now, but it's not complete. So one of the things that I did in the fall 2018, um, a whole year after I was diagnosed, as I walked the Camino de Santiago, don't know if you know about that.

Um, but it's a, it's a 500 mile journey across Spain. And walking. And, um, obviously I did that for personal reasons, but also I fundraised while I was doing that, as I was doing that, um, to provide money for that study that I'm talking about. needs to be completed.

So that's one reason, even without the completion of that study, Mayo clinic uses it as standard fare for their breast cancer screening for women with dense breasts. And the clinic is Mayo clinic. I mean, they're, they're kind of ahead on a lot of things. There may be four or five other places throughout the country that use molecular breast imaging.

As standard fare for screening, they've gone above and beyond. You know, what the national guidelines are and said, you know, the national guidelines are not good enough for us. We're going to do this in order to catch so many more cancers early, like we should be doing. And they've just gone ahead and done it with huge success.

So that study is one reason. another reason is insurance coverage. insurance in the United States is a, is a very complicated and, and really crazy thing. But some insurance companies say, Oh, that's not in the national guidelines for screening. So I won't cover it. So that prohibits the use of it.

And it prohibits breast imaging centers from even being interested in buying the equipment because they don't think they can recover their costs. So that leads me to the next thing is money. So that's all tied up about, you know, money, you know, the medical industry in our country is not completely 100% all about the patient and what's best for the patient.

Norman Chella: [00:18:27] so I've heard.

Leslie Yerger: [00:18:28] to do with money. enough said there, but there's a lot to do with money. And then I think the fourth thing that I'll say is the reason why we're not really adopting it is what I call the mammogram story. So to many, many, many people's credit for decades, they have worked long and hard to get women to go in and get their mammograms because some people still don't do it. It's uncomfortable. It takes time. You know, some people still don't do it. And so they've worked long and hard and hard, you know, just, just viciously, ferociously, trying to get everybody to do that because they want it to say, but they're good.

Noble. Very good. But by having that story so strongly out there, um, that if you get a mammogram, it'll save your life to have that be not a hundred percent true all the time. And it's actually not a hundred percent true all the time because mammography does miss quite a few cancers we're finding out and what I'm trying to expose is a tough pill to swallow. It's a tough one. You know, there are people that like, they don't want that to be true. So when women go to get their mammogram, when they do get that call, it says, all good. See you next year. They hear that. But what they also hear is I don't have breast cancer.

That's what I heard. That's what everybody hears. So, cause that's what you want to hear. And that's why you got one to begin with. So you want to believe that story? All the time to be a hundred percent true. And now we're saying let's back up a little bit. Maybe not be a hundred percent true. You might need something else.

In addition to a mammogram, it's disruptive, it's change. It's hard for people to accept. And that is, I think, as big a reason as any.

Is that is the only solution to it. Like having a mammogram, detecting it early. And then that's it, sir. Sure. The principal mean can mean the same. It doesn't matter what method it is. If you detect it early, maybe you can act on it. But now that you're telling me that the standard practice of detecting it early, detect all of it early, it does bring up like what you said.

It's a tough pill to swallow. It does bring up may potentially bring up fears or may bring up doubts to the women who believe that they do have breast cancer, especially when they, you know, just don't want to get cancer at all. That's why you want to go through all of these procedures.

Leslie Yerger: [00:21:36] Yeah. And I also think I'm in addition to that, I think people may be afraid that if we start talking about what I'm talking about, that people will say, I'm not going to get, I forget it. I'm not going to get a mammogram then. Okay. That's the wrong message.

Norman Chella: [00:21:49] Yeah.

Leslie Yerger: [00:21:50] That is the wrong message. How many times, how many ways can I say that's the wrong message?

So it's not, don't get a mammogram. It's get one.

Because getting a mammogram is the only way to find out your density. Anyway, there's no other way to find out your density because you have to look at a mammogram to find out, right. And then if you are dense, which many women are, then you might need something else.

So mammogram is kind of like, um, the beginning of the fork in the road. So you have to go through that fork to get to the fork that you need to get to or get down the road. Does that make sense? Yeah. So it's, it's mammogram plus maybe something important distinction, but I do think that maybe people are afraid to let people we're now going to disregard it and they should not do that.

Not what I'm saying.

Norman Chella: [00:22:44] Yeah, it's only the first step, especially in D

Leslie Yerger: [00:22:48] The first step.

In

Norman Chella: [00:22:49] the path to to detecting and ultimately eradicating breast cancer cells from the body. A lot of people stop at step one and where step one is only the mammogram.

There is, you know?

Leslie Yerger: [00:23:02] So yeah, if you look at it that way, a mammogram is the, is the first step and it's the first step that everyone should take. And it might be good enough for a lot of people, but it's not good enough for everyone. And so, I mean, we're not all the same aren't we. Well, not all the same. All of our bodies are constructed differently.

Some women have very dense breasts and women don't have very dense breasts at all. And they're all normal, but we're not all the same. So why should we expect all of our screening to be the same?

Norman Chella: [00:23:34] This is really difficult to. not, not talk about it. I'm sure we can talk about this at length. What I'm worried about is if you were to bring this up, even if it's like a diagram of step one, mammogram, step two, question Mark, whether it is MBI or any other method, which can prove to be effective in addition to mammogram, that extra step can lead to.

A lot of people dropping off and not taking that second step. And maybe it can range from cost to insurance, to the medical accessibility where not everyone has the equipment to, you know, or not everyone has the capability to fly to a clinic that has to equipment. That's another thing.

Leslie Yerger: [00:24:18] Yeah, no, that's true. I mean, I think that's a legit concern, but. Um, and I've thought a lot about, you know, thought a lot about that because, you know, I'm, I'm saying things I'm about something and that maybe somebody could misinterpret and then not do. Right. Right. So that's, that is concerned to me. I have one worried about that, but can we really be afraid not to take the next step because you know, because somebody might not take a step at all.

Like, so if we, if let's say we follow that fear. Then we don't make progress at all and, and big picture, that's not good. You know, like we need to make progress. We need to do better. We need to get from where we are, where we need to be. And you know, these fears that we have about doing that should not be the thing that stop us from making progress because.

If you want to talk about costs, this is just one element of what we're talking about here. If we're going to talk about costs, I'm here to tell you as a stage four cancer, thriver cancer is expensive.

Norman Chella: [00:25:32] I can guess I can, I can guess. But.

Leslie Yerger: [00:25:34] Wow. Right? I mean, I it's wildly wildly expensive. So a $400 screening once a year. For the rest of my life is minuscule compared to what it costs for my healthcare now. And if you multiply that, you know, over thousands, even millions of women catching their cancer early, zapping it, getting rid of it so that it's a blip in their life.

And so they're not having this wildly costly. Not to mention what it does to you emotionally and personally, that's a whole nother thing. Um, you know, there's no comparison. So, you know, if you look at it that way, it makes a lot more sense to catch it all early, um, and just nip it in the bud. So the person can then go on with their life and be a productive person too.

No. So, um, you're right. And I've thought about that question a lot and thanks for bringing it up because it is, it is something that, that I think about a lot in that people do bring up, so we need to discuss it, but we need to figure out a way to get people there, regardless of that fear and then, you know, get them their next thing.

Norman Chella: [00:26:51] So let's, let's dive into that last part. Then if we want to help people who, uh, those who are on the fence and taking the  next step, or those who haven't even taken their first mammogram or about to take their yearly schedule of, um, step one, being the mammogram and, you know, they, they may have dense breasts and therefore they may be recommended to take an MBI or, you know, fly to a different clinic to continue, but they're on the fence. How can we, and let's take this question from two perspectives, from your perspective, as someone who is a stage four cancer thriver, and as someone who may be a part of the circle, Of someone who is going through potentially screenings, potentially getting breast cancer, et cetera, how can we support or even encourage, um, these women to continue onto getting MBI or so on?

I love to hear your take on this as you know, someone who has experienced experiencing this firsthand and getting support from those around you. I'd love to

Leslie Yerger: [00:27:55] Yeah. So, um, I'm a believer in if people understand their risks. And they understand, really understand the choices that they're making in a rational way. That's not fear-based then a lot of times, or most of the time, you know, they'll, they'll make the right decision. And even if they don't, they're making the decision. Okay. So I think that. Our health, at least the United States. I can't speak to other countries as well. But the United States, you know, a lot of our care really up to us, we have to be, you know, where there's not a lot of requirements there, vaccination requirements and things like that, but there aren't a ton of requirements, so no, we have to be in charge of it.

And if we're in charge, but then we need the information to know exactly what it is we're doing. No. So I'm a believer in, let's get this information out there, present each person with the data, you know, here are your options. Here's on average, what it's going to find, or what's not going to find here's on average, how many false positives that you're going to have with each one that would mean getting a biopsy and then having it not be cancer.

Oh, this is what a false positive is. Um, which people call a harm and it happens quite a lot, especially with mammography and ultrasound, and let them make the decisions. That's my philosophy and my way of thinking, um, other places may feel differently. Um, but. Having information out there and having women not know it for whatever reason that I can't live with. And that's kind of why I do what I do.

Norman Chella: [00:29:53] Yeah. Bridging the gap between awareness and being the guide to getting them from point a to point B where point a is them. Maybe, you know, their worries, their doubt, their fears, um, going through their routines and point B, is that getting that amazing call at their cancer-free not on false positives, actually getting cancer free, like actually detecting cancer cells  the body.

It's going to be, I'm going to be very honest. It's a very difficult path. So I really respect that you are able to

Leslie Yerger: [00:30:30] It's gonna take a long time. I mean, there's been a little progress in the last maybe decade. Um, but the, we have a long way to go, but the quicker we get there, you know, the more women that will become survivors of breast cancer and that's what we need until such time. That we come up with a cure.

Now, if we can come up with a cure, you know what let's let's project ourselves into the future. That would be fantastic. Let's let's just play that game for a minute. So maybe we go to the doctor once a year, along with your cholesterol, glucose level, all this kind of stuff. There's another test that finds out there's any breast cancer in your body.

Hey, and if there is, then you get a shot and it's gone. Okay, so we can do that then. Fine. You know, but, but the whole thing with all this screening is because once it gets to stage four, it's not curable

and it just, it takes over your body eventually. And that's it. So it's all about all the screening is to prevent it ever exiting the breast and going somewhere else in your body at stage four where it's not curable.

Hey, if we can find a cure, no, a lot of things would change. But you know, we've been talking about a cure for breast cancer for, Oh, I don't know, 40 years. I'm not holding my breath. Because why would I? So until that time, we need to do better with screening because early detection is the key to survival.

It's always been the key to survival. That's why the mammogram was invented and it still is until we find the cure, mammograms have done a lot for the world and for women everywhere, but we can do better. And if we can do better, then we must.

Norman Chella: [00:32:33] Of course. So like the mammogram was made with the intention to help detect

Leslie Yerger: [00:32:39] And it has done. It has done. There is. There is no, um, there is no question about that. The data is there. It's not even disputable that a mammogram mammograms have had helped a lot. It's just kind of plateaued in what it can do, you know? So just because something was great and did a lot doesn't mean you can't make it better. You know,

Norman Chella: [00:33:05] There's also, it's also that.

Leslie Yerger: [00:33:08] can be true at the same time.

Norman Chella: [00:33:10] Yeah. Yeah. It's also not absolute, right? It's not like the end destination for, Oh, your cancer is just gone after you just do this one trick. It's not like that. We're looking for a lot of 'em that's, especially with something as sensitive as cancer, which is quite a life changing event.

I'm sure that you can attest to this, um, to be able to have a method to. You know, once it protects it to your mind, help cure it or detect it, or at least alleviate the pain or alleviate the struggles of these. Shall we say, desires that we have that really prime us to just go ahead and do the test and then be gone with it and move forward.

Leslie Yerger: [00:33:49] Yeah. And I think the breast cancer is so scary. This is, this is an odd thing that I think we do sometimes breast cancer is so scary. Everybody knows something, somebody who's had it everybody. Right. Um, and if we get a mammogram, we might find out that we have it, and that's a scary that we don't get the mammogram.

So we don't do the very thing that can help us the most.

Norman Chella: [00:34:16] I see. Okay.

Leslie Yerger: [00:34:18] Yeah, that sentiment is out there, you know, and this is the struggle that, that the people who have spent decades trying to get everybody in for their mammogram face still do face that same.

Leslie Yerger: [00:34:38] it.

I think it's subliminal. I think it's just in our minds, you know, like it's scary. And the time between when you've actually gone in for your mammogram and when you get the call can be days a day, you know, a few days to a week and all the time you're going. That's why, that's why when you get the all clear thing that we want to believe that it's a hundred percent absolute. If we get the all clear call, because we've just spent all that emotional energy, getting the test, waiting for the results, you know, all this kind of stuff. So there's a lot of that in this whole scenario as well.

Norman Chella: [00:35:19] This is so heavy to think about, is it really, really heavy to think about.

Leslie Yerger: [00:35:24] Yeah. And when you consider that one in eight, women will get breast cancer in her lifetime. That's like 13% of people, you know, and some people are more risks than others, you know? Um, but that's the average and you know, those, those really aren't great odds, you know, they're really not great odds. So people.

Have a reason to be a little bit scared. Complicated, complicated.

Norman Chella: [00:36:00] It is, it is. And it's, it's not exactly, there is no absolute in it because that is actually the nature of cancer. It's like, you know, tumors grow malignant growth and they, they multiply and they spread throughout the body and you have how many hundreds, different kinds of cancers. And we're only talking about just one specific kind.

Leslie Yerger: [00:36:23] Oh, there are many clients and I'm really just backing up from that for a minute. I struggle now that I have cancer with the phrase of cancer-free. Like, you know, this whole thing about, Oh, if you know, I had cancer of any kind and it hasn't come back in five years. So now I'm cancer free, you know, that's a little bit of a myth.

It might be true, but there's really nothing magical from what I understand about five years. I mean, statistically, maybe, but you know, I think that, especially with breast cancers, what I've heard of is sometimes it comes back. I heard one woman the other day, 32 years later came back 32 years later. Well, it was kind of lurking in there all the time, probably, you know, um, but never really took off and then something makes it take off.

This is true of other cancers too. So this is kind of why I'm a little bit beyond the phrase. Cancer-free I wonder if any of us are really cancer free, you know, so I'm leery of the phrase.

Norman Chella: [00:37:43] I can't say that I fully understand your take on it. I can probably say that I can. At least logically understand why you might think that way. Mainly because at the very least, if we change our, you know, our diet, our environment, our physical activity, and more to try to prevent the grow forward to minimize it, I would think it's more like cancer sustained or cancer controlled where you

Leslie Yerger: [00:38:11] I know. Yeah, that, that could be, I mean, that woman, that, where it came back, 32 years later, I mean for something, kept it at Bay for that long. I have no idea what that something was, but that's a long time, you know, that's a really long time to have cancer in your breast. Think you were cured. And then 32 years later, it comes back in your body somewhere.

That's a crazy idea almost, but it happened and it does happen. Um, sometimes it's many years later, so it's, you know, it's been lurking around in there for quite a long time and that, and then something happens that it. It starts to grow or be, or maybe it's slow, slow, slow growing that it just, by that long becomes a thing, you know, that's detectable, I don't know.

But, um, I'm always careful to use those two words together. Cancer-free you know, because you just never know, you never know.

Yeah.

Norman Chella: [00:39:14] I think after this conversation, I will never ever use that phrase because as much as as much as, as much as we're having a very rational conversation about this, there's some element of fear into, into the knowing that, um, like we're actually more like rational fear as in. The right procedures to ensure that this doesn't happen to at least my friends who may, you know, go through and mammograms or anything beyond, they may have to search for something on top of that, because that is already worrying even to me.

And I might not be able to risk. I do have something to ask though, actually. So on your website, it says, um, I would love to hear your take on this. It says you have a sentence that says in whose life is probably benign good enough. So could you tell me more about that?

Leslie Yerger: [00:40:12] I'm glad to hear that that peaked your curiosity. So probably benign is the name of my book. And probably benign is, um, something called BI-RADS three. So when you get a mammogram, you get six different ratings. This is the BI-RADS rating, and I'm not an expert on the BIRADS rating and I'm not professing that I am, but BI-RADS three is, um, that category that says we see something. That might be cancer, but it probably isn't, it's probably benign,

Norman Chella: [00:40:54] okay. Alright.

Leslie Yerger: [00:40:56] okay. So it's kind of like, Hmm, it looks suspicious, but it probably isn't cancer. So sometimes people are like, well, it's probably nothing. Nevermind. Sometimes it's. It's probably nothing, but let's do an ultrasound or let's follow up or let's do a biopsy or something like that. Sometimes it's, let's come back in six months or a year and look at it again to see if it's changed.

Okay. So this is the nature of what happens with mammography and breast cancer screening. Now there's a lot, you need to come back for more minute more images or, Hm, Mmm. Probably okay. I mean, that would be, that would be what you would kind of get with, you know, a, a mammogram and somebody who's got really dense breasts, you know, like it's really not no cancer it's we don't see any cancer.

Right. So there's a lot of. Not sure. Maybe can't really tell playing the odds, that sort of thing. And they are doing the best they can. I'm not arguing with any of that. But my point is why, why are we messing around in probably land so much? Like why do we have to be where we are with not really sure need to take more pictures.

Oh, it was probably okay. You know, like what is all of that? So whose life is that good enough is really my point there. It's not pointing the finger at the system or anyone or what anybody does or doesn't do, or the BI-RADS three, none of that. It's just sort of pointing out the state current state of affairs, which is a lot of probably, maybe not sure.

Can't really see. Hmm.

Norman Chella: [00:42:55] Yeah, the vague observations will only serve to make me more anxious. If I were to get readings back on getting any form of cancer to say, Oh, there's something growing there, but don't worry about it. It's okay. It's

Leslie Yerger: [00:43:11] Yeah, or it's probably benign, you know, and, and wins really statistically when you get a probable benign by BRADS-3 writing. Yeah, it probably is. Problems like, is that, you know, like, you know, w we can get closer to definitely, we may never a hundred percent get there because nothing is perfect. Even MRIs, which supposedly find the most cancer, they mess up. because of the, where it is.

right. So nothing is perfect. So we're never going to get totally, definitely, you know, in any imaging, but we can get closer.

Norman Chella: [00:43:55] Yeah. And also from I'm assuming from the perspective of the medical professional, it will be very difficult to give a guaranteed observation

Leslie Yerger: [00:44:04] Never going to be here.

Norman Chella: [00:44:05] Yeah. So rather, you know, us safety net observation, just to let you know, this is what this means. It can mean this. It can be that, but it's okay. We

Leslie Yerger: [00:44:15] And that's where they are. I mean, that's what I mean. So that's a difficult decision for them.

Norman Chella: [00:44:21] Yeah. Yeah, it is.

Leslie Yerger: [00:44:22] You know, um, and I respect that and I'm not trying to disrespect any decision. As I said before, I'm just saying, why, why are we in such an arena where we're not a hundred percent sure when, when we could do better?

Norman Chella: [00:44:41] Yeah. I think it will be at the point where. You can normalize MBI on top of that so that you, you can just render that observation redundant, because you just mentioned that, Oh, we've noticed this let's move on to step two where we will just look at it more at a micro level and then figure it out for real, if there's anything cancerous,

Leslie Yerger: [00:45:04] right. Or anything else that, that, that can do that too. I don't want to preclude other things that could also, you know, find cancer. So that's kind of why I'm like, let's talk about all things that are FDA approved. That's the United States, you know, saying, um, that could help. Not any one particular thing, because things could change new things could come in line, you know, all of that.

So, um,

Norman Chella: [00:45:31] Yeah, really accessibility for all of these options.

Leslie Yerger: [00:45:34] yeah. yeah. And the standardized use of them when it's really a good idea to do that.

It's the equipment, it's the processes, but it's also the institutionalization of actually doing it, having a different screening process that isn't just one size fits all. When we now know that it really doesn't fit all very well.

Norman Chella: [00:46:04] Yeah, but having all this options there in the first place would be great. I also would think the implementation throughout all the States in the U S is also pretty, highly, highly important, but I, I can't really comment on that. Cause I mean, I'm not from there. I can't really see how has

Leslie Yerger: [00:46:23] Still a lot of breast cancer screenings all work differently with different institutions. They have different processes, they have different people. They have different equipment. I mean, you know, like there's no other than the mammogram and now potentially three D mammography. I mean, that's kind of standard fare, but how they do it, you know, their, all their processes, what they do about density.

If they don't. No, there's not, not a huge amount of standardization around that, except you have these certain full runners, like the Mayo clinic and a few other places around the United States that are like, okay, I'm not seeing what I need to see in women with dense breast. I'm doing ultrasound, molecular breast imaging, some MRI, um, and they kind of triage around all of those things.

Um, but they do something as standard fare.

Norman Chella: [00:47:14] And that will be great to see for all doin, to have it, all of them, all of the processes to ensure

Leslie Yerger: [00:47:23] for them, if they need it.

Norman Chella: [00:47:25] Yeah, that if they are not confident enough with one test, you have other tests and other methods available. Leslie, we are coming up on time, but I would love to wrap this up with a couple of segments that I would like to pass on to you.

I'm sure you might be very interested in answering them. So the first one is called mementos. Do you have a memento that represents who you are?

Leslie Yerger: [00:47:52] Oh, my goodness. Oh, um, can it be an image?

Norman Chella: [00:48:04] It can be your interpretation of the word memento. It doesn't have to be a physical object, so it can be anything you want.

Leslie Yerger: [00:48:12] from me? It's kind of that little icon in the top left of my website. That is this little picture with a pass.

Norman Chella: [00:48:23] Let me find it.

Leslie Yerger: [00:48:24] So it's, um, and I've actually got, that's actually a picture that I took on the Camino de Santiago. Um, but I think it's about my, for me, it's kind of like where I am, where we are with a lot of road ahead of us with no end in sight. That's kind of how I think about what I do. Is that, you know, we need to just keep walking, keep going. And ultimately we will get there.

Norman Chella: [00:48:58] It's very poetic and very beautiful. Thank you for that. And also the next segment is called walkaway wisdom. So say that we walk away from this conversation right now. And I meet a stranger. I become friends with them. And throughout the course of time, I, you know, become more vulnerable with them and I grew to become intimate and that is sharing my life with them.

I tell them about everything that happens in my life. And part of that is this conversation right now. Is there a piece of wisdom that I can share with them that represents who you are?

Leslie Yerger: [00:49:36] That represents who I am. Love today, but no, not the back and the can be better tomorrow.

Norman Chella: [00:49:56] Love today and there can be a better tomorrow. Go for it. All right. And last but bonus question. Since you have been on the Camino de Santiago, right? I would like to ask you, what is your interpretation of the scallop shell?

Leslie Yerger: [00:50:20] Oh, wow. It's kind of like a hand. Right. So the wrist would be one and, and then there's lines going out like that. So for me, there's a million interpretations, right. But for me, kind of what I was thinking about when I would see that is, you know, there's this central core, there's a central you, you know, there's like your soul. Um, and who you are, who I am. Um, so, um, how does solid one of those and then branch out into the world? fingers pointing all different directions fan out, but the central core is your, you know, who you are, who you really are, your beliefs, what you want to do, your mission, your purpose, and then fans out from there.

Norman Chella: [00:51:26] That is amazing. The scallop shell of Leslie Yerger. Thank you so much. If we want to reach out to you to contact you about. You know, anything that we've talked about in this conversation or about, you know, worries on breast cancer screening or methods to check out or much more, how do we contact you?

What's the best way to do that?

Leslie Yerger: [00:51:49] A central hub of me is my website. Leslieferrisyerger.com. You can find the book there. You can book me for speaking. You can contact me to start a conversation. Um, you can then go to a website that I've been working on called Be Breast Smart, was kind of gives you a rundown of what we've been talking about.

Um, and. Anything and everything from there. And my email, obviously, which is on that website, but it's Leslie@leslieferrisyerger.com. So I'm happy to hear from anybody and any time.

Norman Chella: [00:52:26] Fantastic. And of course, links to all of these websites will be in the show notes below and also your email. So you can directly email Leslie for any questions and really pretty much start a conversation because there's nothing more powerful than the awareness, uh, of. These screenings, there are flaws and the different solutions to help add on to the current standard so that, you know, all women who are going through these are playing it safe and really becoming more competent with their results, which is the biggest result right there.

And of course, Leslie can help you with finding out more about this. So thank you so much for being on the show and I'll talk to you soon.

Leslie Yerger: [00:53:08] Thank you for having me really, really enjoyed it.

Norman Chella: [00:53:12] And that is it. My chat with Leslie Ferris Yerger. Thriving despite her situation and advocating for proper breast cancer screening. Now, this is a very difficult topic to talk about, and I'm coming from an outsider without the awareness of the limitations of standard screening procedures. So it's nice to know that Leslie has brought us a lot of information to really share and educate us on breast cancer screening.

So if you have any loved ones who are going through their standard mammogram, are noticing specific signs that may lead to a malignant growth or anything unusual on their body. It's best that you go through as many tests as possible so that you can really have a healthy life.

You can also reach out to Leslie for more information on this. I am sure she'll be happy to have a chat with you about this. So if you are more aware of breast cancer, proper screening methods, and much more, all as well. Stay warm, stay lovely, take care of your loved ones. And I will see you in the next episode, your foolish friend, norm.

Tags

Norm

Norman Chella is the Podcast Rainmaker, Polymath in Progress and a very strange writer. His creative pen name is N.T. Cloever. You can find his words right here.

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