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For Wendie Berg, a little self-advocacy with her doctor paid off big time. A decade ago, she asked her doctor to schedule a breast MRI. A radiologist herself, Berg knew that her dense breasts put her at higher risk for developing cancer. "As luck would have it, that MRI showed a small, invasive cancer that was not visible on my mammogram," she says. Berg had the tumor removed and remains cancer-free.
Dense breasts contain more concentrated clusters of glands and tissue, as opposed to fat. About 40% of women have either dense or extremely dense breasts. And not only are they at higher risk for cancer, but cancer in dense breasts is also more difficult to detect with a mammogram, as NPR’s Yuki Noguchi reports.
And while newer 3D mammograms show benefits over traditional 2D imaging, evidence suggests that ultrasounds and MRIs detect more cancers.
However, MRI machines are in short supply in the United States, and most imaging beyond a mammogram is not covered by insurance. Out-of-pocket, an MRI scan can set a patient back about $1000. Fewer than a tenth of those eligible for the follow-up MRIs get them, says Dr. Berg.
Berg’s website densebreast-info.org and the Susan G. Komen foundation provide resources to help patients determine whether to pursue more imaging. Talking through the risks and benefits of additional screening with your doctor is also a good idea.
Learn more about dense breasts and cancer detection best practices.
Plus: 3D mammograms show benefits over 2D imaging, especially for dense breasts |
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If you’re familiar with the Charles Dickens’ story Oliver Twist, you’ll recall the scene early on when the hungry young protagonist works up the nerve to ask for a second helping of gruel. This request for “more” sparks an outrage, and gets him kicked out of the orphanage.
I may be overdramatizing here, but that’s kind of how I felt at mealtimes when I was on the weight-loss drug Zepbound. Whenever I thought about going back for seconds, a strange, tight feeling of fullness warned me that having “more” would not be accepted. And if I overrode that feeling and continued eating, I would get heartburn and indigestion.
The drug eventually affected my mental health too, and I stopped after the second dose.
In a new study, almost 65% of people taking GLP-1 drugs for overweight or obesity went off the medication during the first year. Many of those who stopped say they experienced significant side effects.
Mara Gordon, a primary care physician in Camden, N.J. and an NPR contributor, tried Ozempic to lose some baby weight back in 2022. She describes herself as an early adopter “and an early quitter.”
As a doctor, Gordon understood the science behind Ozempic, which works by slowing digestion and increasing feelings of fullness. But she says her experience with Ozempic made her realize she “had confused two distinct issues: Being healthy is not always the same thing as being thin,” Gordon writes. Symptoms like nausea and abdominal pain made it difficult to exercise and sleep.
Now off of the drug, Gordon's shifting her focus from weight loss to health, both for herself and her patients. While she does prescribe GLP-1 drugs, she focuses on objective measures of health like blood glucose and hypertension, rather than on weight or BMI.
Moreover, “My patients decide what it means to be well,” she writes, “with or without a GLP-1 drug.”
Read Dr. Gordon's essay.
Also: Eli Lilly sues companies selling alternative versions of its weight loss drug |
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ETIENNE LAURENT/AFP via Getty Images |
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Air pollution still plagues nearly half of Americans. That does a number on our health
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Salmon on benzos: How medications leaking into waterways may be changing fish behavior |
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We hope you enjoyed these stories. Find more of NPR's health journalism online.
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Andrea Muraskin and your NPR Health editors |
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