Breast cancer: how to catch, treat, and survive breast cancer | Harold Burstein, M.D., Ph.D.

**Peter Attia** (0:11)
Hey everyone, welcome to the Drive Podcast. I'm your host, Peter Attia. This podcast, my website and my weekly newsletter all focus on the goal of translating the science of longevity into something accessible for everyone.
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If you want to take your knowledge of this space to the next level, it's our goal to ensure members get back much more than the price of the subscription. If you want to learn more about the benefits of our premium membership, head over to peterattiamd.com forward slash subscribe. My guest this week is Dr. Harold Burstein, who goes by Hal. Hal is currently a professor of medicine at Harvard Medical School. He earned his MD and PhD in cellular immunology from Harvard Medical School, as well as a master's degree in history of science from Harvard University.
Hal trained in internal medicine at the Massachusetts General Hospital before his medical oncology fellowship at Dana-Farber Cancer Institute. He joined the staff of Dana-Farber, and he is also on staff at Brigham and Women's Hospital, where he is a clinician and the clinical investigator in the Breast Oncology Center.
His research interests include therapy for early-stage and advanced-age breast cancer, health care for breast cancer survivors, and quality of life and psychological issues among women with histories of breast cancer. This is an episode I have wanted to do for a very long time. As you know, I've already done an episode or two on prostate cancer, and while prostate cancer is the second leading cause of cancer death for men, it's no surprise that breast cancer is the second leading cause of cancer death for women. And therefore, this episode is long overdue. In this episode, we talk about all things related to breast cancer. Beginning with, of course, the anatomy of the breast and the endocrinology of the breast. We speak about the increasing rate of breast cancer over the past decades. We speak about the changes to a woman's breast throughout her life and how that relates to understanding the pathology of breast cancer. We talk about the different kinds of breast cancer, including the precancerous lesions of ductal carcinoma in situ and lobular carcinoma in situ, DCIS and LCIS, and all the way to invasive breast cancer in the various stages. We talk about the different ways that you would classify these things. And I think Hal does a masterful job of taking it into the three categories of breast cancer. This was an obvious thing that I hadn't really considered until the discussion. And I find it to be now a much more helpful framework for myself. We speak about the different types of breast cancer screening available, including the utility of self-exams, mammograms, ultrasounds, MRIs and more. And we talk about the importance of early screening and detection as it relates to breast cancer. This is interestingly still a very controversial topic.
We then talk about the available treatments for the different types of breast cancer. And again, we'll go into much greater detail about how someone listening to this with breast cancer can understand which bucket they're in of the three and what the implications are.
We end the discussion by speaking about the role of genetics in breast cancer. Of course, many people have heard of the Bracken mutations. We talk about the role that they play, but they're not the only genes involved in breast cancer. So we have a more thorough discussion about that. We also touch on male breast cancer. This is something that many people are surprised to learn exists, but I personally have a very close friend who was diagnosed with breast cancer. Fortunately, it was caught at an early enough stage and he's doing fine, but this is never something that should be too far off your radar. So without further delay, please enjoy my conversation with Dr. Harold Burstein.
Hey, Hal, thank you so much for joining me today. This is a topic I've been really wanting to do a deep dive on for quite some time. We've done a deep dive on prostate cancer a couple of times. I think we're long overdue to talk about the second leading cause of cancer death for women, which is of course breast cancer. But maybe just briefly give listeners a little bit of a sense of your background, the post you sit in and the work you do.