#396 ‒ Breast cancer screening: understanding risk, deciding when to start and how often to screen, and choosing the right imaging strategy

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. Our goal is to provide the best content in health and wellness, and we've established a great team of analysts to make this happen. It is extremely important to me to provide all of this content without relying on paid ads. To do this, our work is made entirely possible by our members. And in return, we offer exclusive member only content and benefits above and beyond what is available for free. 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 peteratiamd.com forward slash subscribe. Welcome to a new episode of The Drive. Today, we're diving into breast cancer screening. Why women are still dying from breast cancer despite effective screening tools, where current screening strategies fall short, and how to think about personalizing your own screening. This episode is really about one central question. How do you give yourself the best possible chance of not dying from breast cancer? As we consider this to be a really important public service announcement, the full episode and the detailed show notes for this discussion will be available to everyone regardless of whether or not you're a premium subscriber. So without further delay, please enjoy this episode of The Drive. Most of us have heard that terrible statistic. About one in eight women will develop invasive breast cancer over the course of their lifetime. In The United States, roughly forty two thousand women die every year from this disease. That makes it one of the leading causes of cancer death behind only lung, colorectal, and pancreatic. And yet despite how common and consequential this disease is, many women have questions about screening, including when it should start, how often to do it, and what factors actually matter. Even women who have looked at the guidelines often come away more confused than before because the guidance differs between organizations, and it's also shifted over time. And that confusion has real consequences because breast cancer screening works. Cancers found through screening are more likely to be caught early before they've spread when treatment is easier and outcomes are better. And that stage shift, as it's called, matters enormously. When breast cancer is caught at stage one, the ten year survival is over ninety six percent. By stage four, five year survival is only around thirty percent. It's no surprise then that women who screen regularly are up to forty percent less likely to die from the disease. Now, of course, screening is not without trade offs. For example, overdiagnosis of lesions that would never progress to cancer can increase health care …