Elisa Port: Discuss THE BREAST ADVICE Book

“I may be the expert in cancer, but you are the expert in you.”—Elisa Port, MDGround Truths is a reader-supported publication. To receive new posts and support my work, consider becoming a free or paid subscriber.Dr. Elisa Port is Professor of Surgery, Icahn School of Medicine at Mount Sinai; Chief of Breast Surgery for the Mount Sinai Health System; Director of the Dubin Breast Center; and Director of the Center of Excellence for Breast Cancer at the Mount Sinai Tisch Cancer Center, a NCI-Designated Comprehensive Cancer Center. She is remarkably well qualified to provide guidance for prevention and treatment of breast cancer, and runs a model program at Mount Sinai in New York (←we’ll get into why I say that).She has just published a terrific book that centers around the concept of informed optimism. Many of her patient stories are integrated.We tried to cover the waterfront during our conversation including:—4 Ws for reduction of risk: weight, walking, wine, and working out (especially in Nature, “green exercise”)—Only 10-12% of women will ever develop breast cancer during their lives —Role of adipocytes (fat cells), aka estrogen and inflammation factories—Misinformation (underlying the need for this book)—Pervasive myths of magic supplements, with safety issues of unregulated intravenous drips and others when analyzed turned out to be crushed up, dried house plants—Total body MRI: mixed results from her patients —Breast cancer on the rise in young women. Dr. Port relates about recent patients diagnosed in their 20s. Some without BRCA or other pathogenic mutation. Why?—Mammograms in non-dense breasts pick up 80-90% of breast cancer. It’s the 40-50% women with dense breasts, which the scan is trying to find a polar bear in a snowstorm, is a problem. The problem with false-positives.—Use of AI with mammography for increased initial detection, prevention, detect high-risk in women with a “normal” mammogram, and risk of heart disease (see my recent Ground Truths and piece in The Lancet on this important topic)—Mount Sinai provides Transpara AI (the one validated by the big Sweden trial of >100,000 women) to all women getting mammograms FOR FREE. That is the best validated AI tool in medicine today!—How a mammogram saved a patient’s life, not about breast cancer!—Hormone replacement and birth control pills. How to assess benefit and risk in women young and older? Differences in the hormone risks.—Tamoxifen for primary prevention in high-risk people. Reduction of breast cancer in 50% or more in these women. In some subgroups reduction as high as 80%!—GLP-1 drugs may reduce breast cancer risk and this may not just be related to weight loss—Lack of utilization of Genetic testing (it could be your father). I disagreed with respect to use of polygenic risk scores, as I wrote about in SUPER AGERS—“I just wanted to scream out on top of the mountain about genetic testing, family history, and early screening.” Tennis legend Chris Evert—The lack of our ability to assess the immune system in the clinic and how that could change the face of prevention and very early detection of breast cancerAn infographic summary I made on Dr. Port’s book with the help of NotebookLM****************************************Thank you YOUR DOCTOR KLOVER, Diane Romero, Bob Fleischman, Danielle, MagnaAnimus, and 450+ others for tuning into my live video with Elisa Port! Join me for my next live video in the app.A big thanks to all the Ground Truths subscribers from every US state and 212 countries. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. If you’re not a subscriber, please join!If you found this interesting PLEASE share it!Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don’t hesitate to post comments and give me feedback. Let me know topics that you would like to see covered.Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. It enabled us to accept and support a record number of 51 summer interns coming in 2026! These are high school, college and medical students selected from thousands of applicants. We couldn’t do this expanded program without the funds coming in through Ground Truths. Get full access to Ground Truths at erictopol.substack.com/subscribe