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#AskAMogulAnything:Hi,I'mDr.SusanHarvey.I'mthedirectorofbreastimagingatJohnsHopkinsandamtakingonbreastcancerinthedevelopingworld.Askmeanythingyou'dlike!YourquestionswillbeansweredLIVEon10/18at2pmET.

Dr. Susan Harvey
Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
almost 3 years Conversation

Your questions will be answered Tuesday, October 18th at 2 pm ET. To ask a question, click here to create a Mogul profile, then post a question in the comment section below!

Hi - I'm Dr. Susan Harvey. 

I'm the director of breast imaging at Johns Hopkins. I practice out of locations around Washington, D.C. and Maryland.

I have a wide range of expertise in the field of breast imaging, including breast biopsies, breast cancer, diagnostic radiology, mammography, stereotactic biopsy, tomosynthesis and ultrasound.

In addition to serving patients in the U.S., I serve patients around the world. I specifically have a clinical interest in breast imaging in the developing world. I have traveled to Haiti for this purpose and am working to have Johns Hopkins Breast Imaging play a role in breast cancer detection and treatment programs in Uganda through collaboration with Imaging the World.  In addition, I've received grant funding to conduct international work in South Africa. And I've contributed to numerous publications and presentations, as well as clinical trials.

Now's your chance to ask me anything! Please write your questions in the comments section below and I'll answer the questions live on Tuesday, October 18th at 2 pm ET. 

44 replies

As a guest user, you can still reply to conversations. Just press the "Reply" button below, which will prompt you to sign in or sign up on Mogul before your Reply posts.

  • 930Sun
    almost 3 years ago

    2.5 year survivor - menstrual cycle stopped about 1-1.5 months into chemo , took tamoxifen for 1 yr asked doctor to test hormones to confirm menopause which it did twice so I asked to switch to Arimidex and did and felt much better. 7 month later I bleed for 8-9 days, gyn considers abnormal, have ultrasound and hysteroscopy both unremarkable and no cancer detected. Bleeding skips a month, then following month 6-7 days of bleeding. Dr runs hormones again confirms menopausal any suggestions where to go from here?

    2.5 year survivor - menstrual cycle stopped about 1-1.5 months into chemo , took tamoxifen for 1 yr asked doctor to test hormones to confirm menopause which it did twice so I asked to switch to Arimidex and did and felt much better. 7 month later I bleed for 8-9 days, gyn considers abnormal, have ultrasound and hysteroscopy both unremarkable and no cancer detected. Bleeding skips a month, then following month 6-7 days of bleeding. Dr runs hormones again confirms menopausal any suggestions where to go from here?

  • 930Sun
    almost 3 years ago

    2.5 year survivor - menstrual cycle stopped about 1-1.5 months into chemo , took tamoxifen for 1 yr asked doctor to test hormones to confirm menopause which it did twice so I asked to switch to Arimidex and did and felt much better. 7 month later I bleed for 8-9 days, gyn considers abnormal, have ultrasound and hysteroscopy both unremarkable and no cancer detected. Bleeding skips a month, then following month 6-7 days of bleeding. Dr runs hormones again confirms menopausal any suggestions where to go from here?

    2.5 year survivor - menstrual cycle stopped about 1-1.5 months into chemo , took tamoxifen for 1 yr asked doctor to test hormones to confirm menopause which it did twice so I asked to switch to Arimidex and did and felt much better. 7 month later I bleed for 8-9 days, gyn considers abnormal, have ultrasound and hysteroscopy both unremarkable and no cancer detected. Bleeding skips a month, then following month 6-7 days of bleeding. Dr runs hormones again confirms menopausal any suggestions where to go from here?

  • tara@taraglenn.com
    [email protected] Freelance Writer & Legal Assistant
    almost 3 years ago Pensacola, FL, United States

    How do you feel about the pink ribbon campaigns? Are they effective in raising awareness or are companies taking advantage of us by putting pink labels on products that may help contribute to cancer?

    How do you feel about the pink ribbon campaigns? Are they effective in raising awareness or are companies taking advantage of us by putting pink labels on products that may help contribute to cancer?

  • kbeee
    almost 3 years ago

    Thank you for taking questions. The protocol to not do scans on women with breast cancer after treatment is based off of 2 studies from Italy in 1994; they followed patients for 6-10 years, which means that the treatments were 1984 and 1988 standards. Are there any plans to see if this holds true for current day treatments? Basing a protocol on treatments that are over 30 years old, without consideration for current treatments seems inconceivable. I know 3 people whose bone metastases were found very early and they're all alive 10 years later. Everyone I know whose metastases s were found once the symptoms were severe enough for their doctors to decide to scan them lived about 2-3 years, because by the time they were symptomatic, their metastases were widespread. I feel that once we're done with treatment, we're just written off because yearly scans for the first 2-3 years would be too expensive for all of the survivors in the world. Thoughts?

    Thank you for taking questions. The protocol to not do scans on women with breast cancer after treatment is based off of 2 studies from Italy in 1994; they followed patients for 6-10 years, which means that the treatments were 1984 and 1988 standards. Are there any plans to see if this holds true for current day treatments? Basing a protocol on treatments that are over 30 years old, without consideration for current treatments seems inconceivable. I know 3 people whose bone metastases were found very early and they're all alive 10 years later. Everyone I know whose metastases s were found once the symptoms were severe enough for their doctors to decide to scan them lived about 2-3 years, because by the time they were symptomatic, their metastases were widespread. I feel that once we're done with treatment, we're just written off because yearly scans for the first 2-3 years would be too expensive for all of the survivors in the world. Thoughts?

  • Dr. Susan Harvey
    Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
    almost 3 years ago

    Thank you all so much for all of your questions. It's been a pleasure to spend this hour with you and hopefully this was helpful. I'll be signing off now, thanks again!

    Thank you all so much for all of your questions. It's been a pleasure to spend this hour with you and hopefully this was helpful. I'll be signing off now, thanks again!

  • carrie
    almost 3 years ago

    I'm stage 3 A triple Neg with 4 nodes involved . I'm almost two years out and what are my chances of reoccurrence ?

    I'm stage 3 A triple Neg with 4 nodes involved . I'm almost two years out and what are my chances of reoccurrence ?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Hi Carrie - everyone's situation is different. We are happy to help you with a second opinion and provide you with an individual treatment plan. My best advice to you is to learn more about our breast cancer program at www.hopkinsmedicine.org/breastcenter and to make a consultation.

      Hi Carrie - everyone's situation is different. We are happy to help you with a second opinion and provide you with an individual treatment plan. My best advice to you is to learn more about our breast cancer program at www.hopkinsmedicine.org/breastcenter and to make a consultation.

  • Bethany Heinrich
    Bethany Heinrich Mogul Influencer
    almost 3 years ago New York, NY, United States

    What would you say are the biggest challenges in your job? What are the best parts about it?

    What would you say are the biggest challenges in your job? What are the best parts about it?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      The biggest challenge of my job is that as a breast imager, we begin women on their breast cancer treatment journeys. Following the biopsy, we notify women of their diagnosis which can be a pivotal moment in someone's life. The most satisfying part of my job is when we find an early cancer, we essentially saved someone's life and that's huge. It's an honor to have a skill set that can make this type of impact on women.

      The biggest challenge of my job is that as a breast imager, we begin women on their breast cancer treatment journeys. Following the biopsy, we notify women of their diagnosis which can be a pivotal moment in someone's life. The most satisfying part of my job is when we find an early cancer, we essentially saved someone's life and that's huge. It's an honor to have a skill set that can make this type of impact on women.

  • Dr. Susan Harvey
    [deleted]
    almost 3 years ago

    [deleted]

    [deleted]

  • Dr. Susan Harvey
    Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
    almost 3 years ago

    Hello everyone this is Dr. Susan Harvey, director of breast imaging at Johns Hopkins Medicine. I am delighted to be here for a live hour of questions and replies.

    Hello everyone this is Dr. Susan Harvey, director of breast imaging at Johns Hopkins Medicine. I am delighted to be here for a live hour of questions and replies.

  • Jan Greenberg
    almost 3 years ago

    I had mammograms yearly, last October had my yearly, and in May had a strange track mark on my left breast. Mammogram showed nothing, untrasound showed 2cm, biopsy showed cancer, 2 days later I saw a surgeon who sent me to have a MRI, which confirmed my tumor was 8cm. Can you please explain why some tumors do not show up on mammograms.

    I had mammograms yearly, last October had my yearly, and in May had a strange track mark on my left breast. Mammogram showed nothing, untrasound showed 2cm, biopsy showed cancer, 2 days later I saw a surgeon who sent me to have a MRI, which confirmed my tumor was 8cm. Can you please explain why some tumors do not show up on mammograms.

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Jan, unfortunately mammmography has limitations which are more prominent in women with more dense breast tissue and with certain cancers such as invasive lobular cancer. Supplemental tools such as ultrasound and MRI can be helpful but are typically used in high risk women or women with extremely dense tissue. While mammography may not be 100% accurate in every single case, it is an extremely important exam and detects the majority of cancers early and is a life-saving tool.

      Jan, unfortunately mammmography has limitations which are more prominent in women with more dense breast tissue and with certain cancers such as invasive lobular cancer. Supplemental tools such as ultrasound and MRI can be helpful but are typically used in high risk women or women with extremely dense tissue. While mammography may not be 100% accurate in every single case, it is an extremely important exam and detects the majority of cancers early and is a life-saving tool.

  • Sarah Otte 39
    almost 3 years ago

    Thanks for taking the time to answer questions! I've often heard it said that early detection of breast cancer does not have any impact in terms of outcomes. That the cancer which is going to metastasize will do so, whether detecting early (and treated aggressively) or not. What do you say to this? I am a 3 year survivor, and my Her2+++ cancer was found by mammogram at age 42. I'd had a clinical exam just 3 months prior, and the tumor wasn't detected then, nor by self-exam, although by the time of discovery it was 2cm (it was close to the breastbone, hard to feel). So, I feel like that mammogram saved my life, but I'm constantly hearing the message that early detection does nothing. What are your views?

    Thanks for taking the time to answer questions! I've often heard it said that early detection of breast cancer does not have any impact in terms of outcomes. That the cancer which is going to metastasize will do so, whether detecting early (and treated aggressively) or not. What do you say to this? I am a 3 year survivor, and my Her2+++ cancer was found by mammogram at age 42. I'd had a clinical exam just 3 months prior, and the tumor wasn't detected then, nor by self-exam, although by the time of discovery it was 2cm (it was close to the breastbone, hard to feel). So, I feel like that mammogram saved my life, but I'm constantly hearing the message that early detection does nothing. What are your views?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      I'm very aware of this conversation which includes overdiagnosis and overtreatment of breast cancer. From the information that we have today, we are not able to determine which cancers will cause harm and which cancers may not; therefore, we must treat each case as if it will eventually progress. As research continues and we build a greater understanding of individual cancers, the goal is to treat each cancer personally and as accurately as possible for that individual. For now, to keep women safe we need to continue our early diagnosis and treatment programs.

      I'm very aware of this conversation which includes overdiagnosis and overtreatment of breast cancer. From the information that we have today, we are not able to determine which cancers will cause harm and which cancers may not; therefore, we must treat each case as if it will eventually progress. As research continues and we build a greater understanding of individual cancers, the goal is to treat each cancer personally and as accurately as possible for that individual. For now, to keep women safe we need to continue our early diagnosis and treatment programs.

  • Default
    Guest
    almost 3 years ago

    What would your advice be for women to pursue your field? How many female doctors are specializing in your area?

    What would your advice be for women to pursue your field? How many female doctors are specializing in your area?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      This field requires a long educational commitment including medical school, followed by residency and sometimes fellowship training. My training took 10 years to complete. Having said that, it is an incredibly rewarding profession and I would encourage others to pursue it as well. More and more women are attending medical schools, in fact the ratio is about 50/50 male to female. More and more women are joining breast imaging each year. I feel that there's a growing level of support for women pursuing this path.

      This field requires a long educational commitment including medical school, followed by residency and sometimes fellowship training. My training took 10 years to complete. Having said that, it is an incredibly rewarding profession and I would encourage others to pursue it as well. More and more women are attending medical schools, in fact the ratio is about 50/50 male to female. More and more women are joining breast imaging each year. I feel that there's a growing level of support for women pursuing this path.

    • Default
      Guest
      almost 3 years ago

      Is it a job that's 24/7 or do you find time to have hobbies too?

      Is it a job that's 24/7 or do you find time to have hobbies too?

      • Dr. Susan Harvey
        Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
        almost 3 years ago

        Of course! We all have to balance life and work and make time for ourselves. In the end it makes us better care providers.

        Of course! We all have to balance life and work and make time for ourselves. In the end it makes us better care providers.

  • Jan Greenberg
    almost 3 years ago

    Thank you so much for ansewering our questions. I have a personnel question that I have not been able to get a clear ansewer on. After having Stage 2B, double masectomy, progesterone/estrogen positive, Hers2 neg, and now on Tamoxifen for 5 years, I am wondering because my cancer was hormone fed, should I avoid dairy products? I am a huge milk drinker, and even though I drink organic milk, im afraid I will need to give this, and other dairy products up. Can I please get your opinion on this. I so greatly appreciate your thoughts.

    Thank you so much for ansewering our questions. I have a personnel question that I have not been able to get a clear ansewer on. After having Stage 2B, double masectomy, progesterone/estrogen positive, Hers2 neg, and now on Tamoxifen for 5 years, I am wondering because my cancer was hormone fed, should I avoid dairy products? I am a huge milk drinker, and even though I drink organic milk, im afraid I will need to give this, and other dairy products up. Can I please get your opinion on this. I so greatly appreciate your thoughts.

  • Courtney Dercqu
    Courtney Dercqu Content Marketing Strategist & Writer
    almost 3 years ago

    Hi, Very excited to speak with you! My Mother has been battling stage four breast cancer since 2011. As her daughter, what would my risk factor be for also being diagnosed with breast cancer? What preventative measures, if any, should I be taking right now?

    Hi, Very excited to speak with you! My Mother has been battling stage four breast cancer since 2011. As her daughter, what would my risk factor be for also being diagnosed with breast cancer? What preventative measures, if any, should I be taking right now?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      You should be taking the same preventive measures as everyone else (not smoking, healthy weight, healthy diet, annual screenings) Because you have a family history of breast cancer, it may be helpful for you to be seen in a high-risk clinic with genetic counseling. Here's a link to our website: http://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_diagnosis/breast_ovarian_surveillance_service_genetic_testing. Most large medical centers would likely offer a similar service.

      You should be taking the same preventive measures as everyone else (not smoking, healthy weight, healthy diet, annual screenings) Because you have a family history of breast cancer, it may be helpful for you to be seen in a high-risk clinic with genetic counseling. Here's a link to our website: http://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_diagnosis/breast_ovarian_surveillance_service_genetic_testing. Most large medical centers would likely offer a similar service.

  • TinaGayle
    TinaGayle Author Tina Gayle
    almost 3 years ago Southern California, CA, United States

    Thank you, Dr. Susan Harvey for answering our questions. I believe the reason most women don't get screen is because the test can be painful. How close are we to have a breast cancer test that doesn't require you be squeezed like a balloon until you feel as if you are ready to pop? Thanks again for visiting with us.

    Thank you, Dr. Susan Harvey for answering our questions. I believe the reason most women don't get screen is because the test can be painful. How close are we to have a breast cancer test that doesn't require you be squeezed like a balloon until you feel as if you are ready to pop? Thanks again for visiting with us.

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      New technologies are coming along to detect breast cancer but there's nothing available to replace mammography at this time. While some may find getting a mammogram uncomfortable, the exam typically only lasts a few seconds. Most women feel the benefits of the exam outweigh the discomfort. I encourage you to continue to get screened, you could bring a friend or relative if that makes you feel more at ease.

      New technologies are coming along to detect breast cancer but there's nothing available to replace mammography at this time. While some may find getting a mammogram uncomfortable, the exam typically only lasts a few seconds. Most women feel the benefits of the exam outweigh the discomfort. I encourage you to continue to get screened, you could bring a friend or relative if that makes you feel more at ease.

  • glasshalffull100
    almost 3 years ago

    There's been a great deal of interest in elective mastectomies in the wake of Angelina Jolie. Is this kind of procedure something more women should consider? What should women consider when making this kind of decision?

    There's been a great deal of interest in elective mastectomies in the wake of Angelina Jolie. Is this kind of procedure something more women should consider? What should women consider when making this kind of decision?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      The decision for elective mastectomies is very personal and depends on your specific risk factors. Being seen in a high-risk clinic with genetic counseling would be critical for someone making this decision. Here's a link to our website: http://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_diagnosis/breast_ovarian_surveillance_service_genetic_testing. Most large medical centers would likely offer a similar service.

      The decision for elective mastectomies is very personal and depends on your specific risk factors. Being seen in a high-risk clinic with genetic counseling would be critical for someone making this decision. Here's a link to our website: http://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_diagnosis/breast_ovarian_surveillance_service_genetic_testing. Most large medical centers would likely offer a similar service.

  • misslacey
    almost 3 years ago

    Thanks for taking our questions, Dr. Harvey! I was wondering what initially sparked your interest in helping women access healthcare around the world? In what you’ve seen in your experiences, how is the need balanced in developing countries between the sometimes competing priorities of immediate life-saving care (ex. infectious disease treatment) and preventative care (ex. screening for breast cancer) when there are such limited resources?

    Thanks for taking our questions, Dr. Harvey! I was wondering what initially sparked your interest in helping women access healthcare around the world? In what you’ve seen in your experiences, how is the need balanced in developing countries between the sometimes competing priorities of immediate life-saving care (ex. infectious disease treatment) and preventative care (ex. screening for breast cancer) when there are such limited resources?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Thank you for this wonderful question! The majority of women who die of breast cancer live in low resourced areas of the world with no hope of treatment or care. Cancer is the leading cause of death in the developing world. While it may be more expensive to treat cancer than infectious disease, there are ways to implement breast cancer care low cost, our research is exploring ways to create the best outcomes at the lowest costs. I believe the time has come to address breast cancer care in the developing world and I'm optimistic the team I'm working with will accomplish this. The huge disparity between a breast cancer care in the United States versus an underdeveloped county is an inspiration to me to work towards a solution.

      Thank you for this wonderful question! The majority of women who die of breast cancer live in low resourced areas of the world with no hope of treatment or care. Cancer is the leading cause of death in the developing world. While it may be more expensive to treat cancer than infectious disease, there are ways to implement breast cancer care low cost, our research is exploring ways to create the best outcomes at the lowest costs. I believe the time has come to address breast cancer care in the developing world and I'm optimistic the team I'm working with will accomplish this. The huge disparity between a breast cancer care in the United States versus an underdeveloped county is an inspiration to me to work towards a solution.

  • jamij23
    almost 3 years ago

    Hello, Dr. Harvey! What an honor to be able to ask you questions! Thank you for caring! I was diagnosed with LCIS a few years ago. They wanted to jumpstart my menopause with chemicals and begin Tamoxifen. It scared me and I declined, I was afraid of a chemical menopause. Did I make the right decision? Now I have another lump and am scheduled for mammogram and ultrasound (have very dense breast tissue) and hoping for the best. I am 46 and still get my period like clockwork. Very regular to this day. Also, it's like a can feel a pressure in the affected breast, is that just my mind playing tricks on me? I read that cancer doesn't hurt but it's like that breast is telling me something is there. Thank you for your time, it is greatly appreciated!

    Hello, Dr. Harvey! What an honor to be able to ask you questions! Thank you for caring! I was diagnosed with LCIS a few years ago. They wanted to jumpstart my menopause with chemicals and begin Tamoxifen. It scared me and I declined, I was afraid of a chemical menopause. Did I make the right decision? Now I have another lump and am scheduled for mammogram and ultrasound (have very dense breast tissue) and hoping for the best. I am 46 and still get my period like clockwork. Very regular to this day. Also, it's like a can feel a pressure in the affected breast, is that just my mind playing tricks on me? I read that cancer doesn't hurt but it's like that breast is telling me something is there. Thank you for your time, it is greatly appreciated!

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Each breast cancer case is very different from one another. My best advice to you is to learn more about our breast cancer program at www.hopkinsmedicine.org/breastcenter and to make a consultation. We prefer to treat each case individually and as precisely as possible.

      Each breast cancer case is very different from one another. My best advice to you is to learn more about our breast cancer program at www.hopkinsmedicine.org/breastcenter and to make a consultation. We prefer to treat each case individually and as precisely as possible.

      • jamij23
        almost 3 years ago

        Thank you so much for your time and expertise!

        Thank you so much for your time and expertise!

  • Maddy Bernstein
    almost 3 years ago

    Do you think we are getting close to finding a cure?

    Do you think we are getting close to finding a cure?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Maddy, it is our hope everyday that we are getting closer to finding a cure. Currently, a large amount of my active research is changing the way breast cancer is treated, by doing this research, we hope to find more answers about cures, as well more effective treatments. To answer your question we are getting closer, we still have a long road ahead. Organizations and foundations that support breast cancer research are helping achieve this goal.

      Maddy, it is our hope everyday that we are getting closer to finding a cure. Currently, a large amount of my active research is changing the way breast cancer is treated, by doing this research, we hope to find more answers about cures, as well more effective treatments. To answer your question we are getting closer, we still have a long road ahead. Organizations and foundations that support breast cancer research are helping achieve this goal.

  • Bethany Heinrich
    Bethany Heinrich Mogul Influencer
    almost 3 years ago New York, NY, United States

    Thank you so much for being here, Dr. Harvey. The work you are doing is so important. What are the preventatives women should take to prevent breast cancer? What are the foods or drinks we should avoid?

    Thank you so much for being here, Dr. Harvey. The work you are doing is so important. What are the preventatives women should take to prevent breast cancer? What are the foods or drinks we should avoid?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Ways to reduce your risk include not smoking, maintaining a healthy weight, exercising, keeping a healthy diet and making informed decisions with your medical provider on using hormone replacement medications. Many times though, there isn't much we can do to prevent breast cancer which is why screening mammography and early detection are so important. The earlier a cancer is found, the better the survival rate will be. Women who have early stage cancers in the United States have a 5 year survival of 98.6%. Unfortunately, foods and drinks have little impact on breast cancer risk given the data we currently have. Maintaining a healthy and well balanced diet is important as is maintaining a healthy weight.

      Ways to reduce your risk include not smoking, maintaining a healthy weight, exercising, keeping a healthy diet and making informed decisions with your medical provider on using hormone replacement medications. Many times though, there isn't much we can do to prevent breast cancer which is why screening mammography and early detection are so important. The earlier a cancer is found, the better the survival rate will be. Women who have early stage cancers in the United States have a 5 year survival of 98.6%. Unfortunately, foods and drinks have little impact on breast cancer risk given the data we currently have. Maintaining a healthy and well balanced diet is important as is maintaining a healthy weight.

  • Ufi Tahir
    almost 3 years ago New York, NY, United States

    I'm a medical student based in India and currently preparing for USMLE Step 1. Its an honor to have you answering my question. The overall incidence of breast cancer in India is less as compared to the US but most patients are diagnosed late and this delay is mainly because of lack of awareness and the social stigma associated with the disease, especially amongst rural population of India. What advice would you give to medical students (like me) and health care workers in developing countries like India, so that we could help in early detection of Breast Cancer. Thank you so much!

    I'm a medical student based in India and currently preparing for USMLE Step 1. Its an honor to have you answering my question. The overall incidence of breast cancer in India is less as compared to the US but most patients are diagnosed late and this delay is mainly because of lack of awareness and the social stigma associated with the disease, especially amongst rural population of India. What advice would you give to medical students (like me) and health care workers in developing countries like India, so that we could help in early detection of Breast Cancer. Thank you so much!

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      I'm honored to be communicating with you about this important topic. Some of the date from low resourced regions do suggest lower incidence but the data can also be difficult to collect and analyze accurately. As we set-up programs in low resourced areas we initially assess readiness for screening by confirming if it's culturally acceptable, if the answer is yes, our next step is patient and healthcare provider education on the importance of screening for early detection. Once this is accomplished we think of screening as a spectrum from breast exam to ultrasound to mammography and advanced imaging depending upon the regional resources. As a medical student you could duplicate a similar program in the region where you are training which could have a huge impact. I encourage you to move this forward. https://www.rad-aid.org/ This link and book may assist you in your plans.

      I'm honored to be communicating with you about this important topic. Some of the date from low resourced regions do suggest lower incidence but the data can also be difficult to collect and analyze accurately. As we set-up programs in low resourced areas we initially assess readiness for screening by confirming if it's culturally acceptable, if the answer is yes, our next step is patient and healthcare provider education on the importance of screening for early detection. Once this is accomplished we think of screening as a spectrum from breast exam to ultrasound to mammography and advanced imaging depending upon the regional resources. As a medical student you could duplicate a similar program in the region where you are training which could have a huge impact. I encourage you to move this forward. https://www.rad-aid.org/ This link and book may assist you in your plans.

  • Sally22
    almost 3 years ago

    There has been some controversy in recent years concerning charities affiliated with breast cancer and breast cancer research. If we want to donate to funds that are most guaranteed to go towards eradicating breast cancer (or that will go most directly towards research aimed specifically at breast cancer research), what do you recommend?

    There has been some controversy in recent years concerning charities affiliated with breast cancer and breast cancer research. If we want to donate to funds that are most guaranteed to go towards eradicating breast cancer (or that will go most directly towards research aimed specifically at breast cancer research), what do you recommend?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Sally this is an excellent question. There are many organization to which one can donate. These all have overhead of some sort to cover costs but this can vary quite a lot. I would recommend that you ask what % of the $ go to over head and as for an accounting. One can also donate directly to an individual doing research, all academic institutions will have information on their websites as well and this can be an effective way to donate.

      Sally this is an excellent question. There are many organization to which one can donate. These all have overhead of some sort to cover costs but this can vary quite a lot. I would recommend that you ask what % of the $ go to over head and as for an accounting. One can also donate directly to an individual doing research, all academic institutions will have information on their websites as well and this can be an effective way to donate.

  • booklover423
    almost 3 years ago

    It seems as if so many young women are being diagnosed with breast cancer. I personally have five friends and colleagues ages 30 to 40 who have been diagnosed. What are the leading causes of breast cancer? What can women do to diminish their chances of contracting breast cancer?

    It seems as if so many young women are being diagnosed with breast cancer. I personally have five friends and colleagues ages 30 to 40 who have been diagnosed. What are the leading causes of breast cancer? What can women do to diminish their chances of contracting breast cancer?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      The majority of breast cancers are caused by a mutation in a cell within your breast tissue, this is different from a hereditary mutation passed from your family - only about 10% are related to your family genetics. Ways to reduce your risk include not smoking, maintaining a healthy weight, exercising, keeping a healthy diet and making informed decisions with your medical provider on using hormone replacement medications. Many times though, there isn't much we can do to prevent breast cancer which is why screening mammography and early detection are so important. The earlier a cancer is found, the better the survival rate will be. Women who have early stage cancers in the United States have a 5 year survival of 98.6%.

      The majority of breast cancers are caused by a mutation in a cell within your breast tissue, this is different from a hereditary mutation passed from your family - only about 10% are related to your family genetics. Ways to reduce your risk include not smoking, maintaining a healthy weight, exercising, keeping a healthy diet and making informed decisions with your medical provider on using hormone replacement medications. Many times though, there isn't much we can do to prevent breast cancer which is why screening mammography and early detection are so important. The earlier a cancer is found, the better the survival rate will be. Women who have early stage cancers in the United States have a 5 year survival of 98.6%.

  • MaryPflumPeterson
    almost 3 years ago

    Such an honor to have you answering our questions on Ask A Mogul Anything, Dr. Harvey! I am wondering what your advice is to young women. Advice has differed in recent years as to when women should have their first mammogram. What age do you recommend? And there is additionally conflicting information that's been circulating as to whether mammograms are as effective as other diagnostic tests, notably MRIs , when it comes to determining whether there are potential signs of breast cancer. What are your thoughts?

    Such an honor to have you answering our questions on Ask A Mogul Anything, Dr. Harvey! I am wondering what your advice is to young women. Advice has differed in recent years as to when women should have their first mammogram. What age do you recommend? And there is additionally conflicting information that's been circulating as to whether mammograms are as effective as other diagnostic tests, notably MRIs , when it comes to determining whether there are potential signs of breast cancer. What are your thoughts?

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Mary thank you for this wonderful question. There is a lot of complex information that is out right now. I believe that the difference in recommendations truly stems from a difference of perspective. If one is considering the society cost of mammography, as was done in the US Preventive Task Force recommendations, then less screening is less cost. If your perspective is to save as many lives as possible and diagnose early when treatment is less invasive and more effective then beginning mammography (for average risk women) at the age of 40 and having annual mammography is one step toward this goal. While mammography is limited especially in women with denser breast tissue, it is the ONLY screening exam currently proven to save lives. MRI and other studies can be used to supplement a mammogram especially in high risk women. There are studies reviewing the effectiveness and cost of screening with MRI alone, but the data is not in yet to be certain of the outcomes.

      Mary thank you for this wonderful question. There is a lot of complex information that is out right now. I believe that the difference in recommendations truly stems from a difference of perspective. If one is considering the society cost of mammography, as was done in the US Preventive Task Force recommendations, then less screening is less cost. If your perspective is to save as many lives as possible and diagnose early when treatment is less invasive and more effective then beginning mammography (for average risk women) at the age of 40 and having annual mammography is one step toward this goal. While mammography is limited especially in women with denser breast tissue, it is the ONLY screening exam currently proven to save lives. MRI and other studies can be used to supplement a mammogram especially in high risk women. There are studies reviewing the effectiveness and cost of screening with MRI alone, but the data is not in yet to be certain of the outcomes.

  • Tiffany Pham
    Tiffany Pham Founder & CEO, Mogul
    almost 3 years ago New York, NY, USA

    Such an honor to have you here, Dr. Susan Harvey. What has been one of your most rewarding moments? Also, what advice regarding breast cancer detection would you give to 18-year-olds, 22-year-olds, 30-year-olds, and then 40-year-olds (if at all different)? Thank you so much!

    Such an honor to have you here, Dr. Susan Harvey. What has been one of your most rewarding moments? Also, what advice regarding breast cancer detection would you give to 18-year-olds, 22-year-olds, 30-year-olds, and then 40-year-olds (if at all different)? Thank you so much!

    • Dr. Susan Harvey
      Dr. Susan Harvey Director, Breast Imaging, Johns Hopkins
      almost 3 years ago

      Tiffany thank you for this opportunity to answer questions. There are so many rewarding moments in the work that I do it is hard to choose one. As you know we begin women on the journey of breast health and knowing that the work I do may save lives is incredible and gives me a wonderful reason to wake up and go to work each day. Regarding breast cancer detection, self breast exam can be performed beginning at age 18 and for women too young to have a mammogram can be life saving. I recommend mammography begin at age 40 if women are not at high risk. Also understanding your personal risk is critical at any age and with can be done with on line risk models and discussions with your care providers.

      Tiffany thank you for this opportunity to answer questions. There are so many rewarding moments in the work that I do it is hard to choose one. As you know we begin women on the journey of breast health and knowing that the work I do may save lives is incredible and gives me a wonderful reason to wake up and go to work each day. Regarding breast cancer detection, self breast exam can be performed beginning at age 18 and for women too young to have a mammogram can be life saving. I recommend mammography begin at age 40 if women are not at high risk. Also understanding your personal risk is critical at any age and with can be done with on line risk models and discussions with your care providers.


Dr. Susan Harvey
Director, Breast Imaging, Johns Hopkins

Dr. Susan C. Harvey is the director of breast imaging at Johns Hopkins. She is board certified in diagnostic radiology and is affiliated with Sibley Memorial Hospital, Johns Hopkins Hospital and Johns Hopkins Bayview Medical Center. She practices out of locations around Washington, D.C. and [...]

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