Kristi Funk, M.D. - Breasts

A PIONEERING APPROACH TO BREAST HEALTH

Since I founded the Pink Lotus Breast Center in Los Angeles in 2007 alongside my husband, Andy Funk, our mission has been to fuse state-of-the-art breast cancer screening, diagnosis, and treatment with preventive strategies and holistic, compassionate care. We’re out to save lives in a way that eliminates fear, instills confidence, and provides hope in a moment of panic. Pink Lotus aims to transform the delivery of breast health care in America and to help as many women as possible, regardless of their income or status in life. We see thousands of patients every year, with a wide range of concerns, and do our best to accept most insurances, including Medicare. For low-income uninsured or underinsured women, the Pink Lotus Foundation provides 100 percent free breast cancer screenings, diagnoses, treatment, and support to those who otherwise might not be able to receive any care at all.

I am incredibly grateful that occasionally working with prominent celebrity voices affords me the unique opportunity to get my message about breast health and risk reduction into the world. Three days after I removed Sheryl’s breast cancer, she arrived in my office with a paper in hand and revealed, “I want to go public about this. Can you please fact-check this press release?” And Angelina Jolie’s New York Times op-ed, “My Medical Choice,” led to a permanent increase in BRCA testing documented around the world. 4I consider it an honor and duty to continue the conversations they started.

While I’m best known as a surgeon, my ultimate mission as a physician is to get to people before they need to go under the knife. I do everything I can to teach others about breast health—I appear on television, contribute to our Pink Lotus Power Up blog, give lectures, publish articles, perform research, and sponsor campaigns. I want to empower you with facts and arm you with strategies to help you understand your breasts, reduce your cancer risk, and open your eyes to life-changing interventions and treatments if you are diagnosed with the disease.

HOW TO USE THIS BOOK

Educating yourself on breast health simply requires a commitment to living your best life. We should never die from something we can largely control. Can we control breast cancer? Admittedly, a percentage of breast cancer occurs in women who seem to have mastered all the things that promise to maintain health and wellness throughout life. Until that elusive cure or prevention vaccine shows up, our best efforts will occasionally be thwarted by uncontrollable mutations and unrecognized causes. Nevertheless, you do have significant power over this disease—let’s use it. A solid 50 percent—and perhaps as much or more than 80 percent—of all breast cancer could be eliminated from planet Earth if women understood that daily choices like food, drink, exercise, weight, toxic exposures, and mind-set create the environment inside the very cells of our breasts, which either stay healthy or turn malignant. 5Every single day, we make countless choices that bring us closer to cancer or move us farther away. The easiest cancer to cure is the one you never get.

Here’s what you can expect as you move through all these pages. I suggest reading the entire book to best comprehend all the important information it contains, but I certainly understand if you want to jump directly to the sections that apply to you and your interests. To that end, let me give you a little direction so you can navigate straight to the topics that intrigue you most.

In the first half of the book, I focus on boosting your breast savvy and teaching about lifestyle choices that reduce your breast cancer risk. In part 1, you’ll learn how to care for your breasts and never again mind the myths surrounding breast cancer’s causes. I have spent much of the last two decades researching the connection between lifestyle and cancer, and many of the things you’ve heard cause breast cancer are false. In part 2, we’ll discuss what else you can do besides showing up for your yearly mammogram and hoping that you don’t find a lump in the following 364 days. I’ll help you reduce your cancer risk based on food and lifestyle changes, particularly those that keep estrogen in check, since estrogen fuels 80 percent of all breast cancers. The healthiest meals are plant-based, low fat, and high fiber: an abundance of fresh fruits and vegetables (preferably organic), 100 percent whole grains like brown rice and oats, nonanimal proteins such as lentils, beans, and soy, with a cup of green tea on the side. I will also talk about choices like supplements, exercise habits, weight control, and hormones that can impact risk.

In the second half of the book, I’ll explore uncontrollable risk factors for breast cancer, plus outline your medical choices if you’re at elevated risk for, newly diagnosed with, living with, or navigating life after breast cancer. In part 3specifically, I’ll detail the operations and medications that mitigate risk. I field a lot of questions from patients about genetics and BRCA mutations in particular, and will share the latest research on mutations and what they mean for you. The key with uncontrollable risks is to understand them and then to use them to inform controllable choices. And if you do have elevated risk, this doesn’t mean there is a one-size-fits-all protocol. Some patients choose prophylactic surgery. Others don’t want to go anywhere near the knife but take preventive medications. Still others decide to improve lifestyle factors combined with an aggressive screening regimen. If you’re struggling with medical choices, in part 4I’ll help you find a path that leaves you feeling confident and comfortable with your decisions. I will review surgical options, explain the differences between lumpectomy and mastectomy, endocrine and immunotherapy, radiation and chemotherapy, and address specific questions I repeatedly hear at my center.

It turns out acronyms abound in medicine, and in the interest of keeping you easily moving through our time together in this book, I use a number of them. To that end, please reference the appendix, a handy-dandy table that puts all those acronyms into a tidy little list. I’ve been sure to back up every claim I make with reference to a study, a paper, or a text. These endnotes are quite extensive, so I’ve placed them online for easy searching at pinklotus.com/drfunkendnotes. Long quotes from studies or articles, and the endnotes attached to data in tables, have been retained at the back of the book.

So let’s get started! I firmly believe that knowledge is power, and power replaces fear with confidence and joy, which motivates you to implement changes—changes that I know could save your life, and in turn, make the lives of all those whom you love, and who love you in return, all the more joyful too.

PART 1

BREAST HEALTH BASICS

CHAPTER 1

Breast Care ABCs

Take it from someone who’s around breasts all day, every day, and has been known to dream of them at night—women can have very emotional associations with their breasts. It takes a strong sense of self, which I hope we all strive to achieve, to say, “I am not my breasts,” because breasts connect in undeniable ways to femininity, sexuality, body image, and womanhood. Our feelings about our breasts run the gamut from pride in their shape and size, to awe over their milk-producing and life-affirming function, to trepidation and dread that someday they may give us cancer. To this last point, despite our fears, there have been few solid guidelines on how to improve your breast health, lower your risk of getting cancer, optimize your outcomes if you’re faced with a diagnosis, and make informed medical choices after treatment—until now.

I’d like to start off here with a few basics about breast health: the parts and functions of your breasts, surprising facts about the “girls,” and how to take good care of them so you live a long, vibrant life. Understanding the breasts you’re caring for will ultimately go a long way to reducing their cancer risk. While you can’t control all your risk factors—some, like being a woman and getting older, are nonnegotiable—you can influence and reduce more than you may know by recognizing the factors that are under your control and then adjusting your life choices accordingly.