>> I'm Dr.

Benjamin F. Chavis Jr., and this is "The Chavis Chronicles."

>> The rates of breast cancer deaths have definitely decreased, especially since the 1980s.

If we look at the statistics, the rates of breast cancer deaths were steadily climbing.

And now we've seen that it's actually starting to go down.

>> Major funding for "The Chavis Chronicles" is provided by the following.

At Wells Fargo, we continue to look for ways to empower our customers.

We seek broad impact in our communities, and we're proud of the role we play for our customers and the U.S.

economy.

As a company, we are focused on supporting our customers and communities through housing access, small-business growth, financial health, and other community needs.

Together, we want to make a tangible difference in people's lives.

Wells Fargo -- the bank of doing.

American Petroleum Institute -- our members are committed to accelerating safety, environmental, and sustainability progress throughout the natural gas and oil industry.

Learn more -- api.org/apienergyexcellence.

The Reynolds American organization -- on a mission to grow a better tomorrow by building a smokeless world.

Today, Reynolds American is investing in innovation, people, jobs, and manufacturing to grow tomorrow right here in America.

♪♪ >> We're very honored to have two of the nation's leading breast cancer surgeons.

Dr.

Allison Bruff and Dr.

Regina Hampton, welcome to "The Chavis Chronicles."

>> Thank you.

>> Happy to be here.

>> Dr.

Hampton, how did you come to focus as a breast cancer surgeon?

>> So, when I started in practice, I started in Prince George's County, which is just outside of Washington, DC.

I mean, at that time, there were only two other female surgeons.

And so a lot of -- >> Two other female surgeons in the whole county?

>> Yes.

>> Wow.

>> Yes.

And so a lot of the primary cares would start to send me women with breast issues.

And then I molded my practice into a breast-only practice, and that became the first breast surgery practice in Prince George's County and just grew from there.

>> Dr.

Bruff, tell us how you came to focus on being a breast cancer surgeon.

a little bit more of a circuitous route.

I thought I wanted to be a trauma surgeon and started my training that way, but realized that, you know, a lot of communities were being, you know, not addressed as much.

And loved working with women, loved working with underserved populations.

And I had a mentor in medical school and in my residency training who did breast surgery and kind of told me that I could address both of those with breast surgery in women's health.

And so that is how I transitioned into that field.

And honestly, I haven't looked back since, and I've enjoyed every moment.

>> I know both of you are busy because there's such a high percentage that have breast cancer.

What is the percentage?

>> Yeah, so, actually, African-American women get breast cancer less than our white counterparts.

However, we die at a higher rate.

The death rates are about 40% higher in African-American women when compared to white women.

>> Wait, can you say that again?

40% higher death rate?

>> Yes.

>> Why?

>> Well, there are several factors.

There's access to quality care.

There's the fact that African-American women tend to get breast cancer at younger ages.

We tend to get it under the age of 50, whereas white women more commonly get it over the age of 60.

And so when a young woman presents to a doctor, she may not even be at an age where she's required to get a mammogram, which starts at age 40.

So, if she's 30, 35 with a breast mass, they're often dismissed, as we see in other factors of health when it comes to African-Americans.

>> So, early diagnosis is an issue?

>> Yes.

>> Dr.

Bruff, tell us how you get people to being diagnosed early or having the right exams.

>> So, a lot of it starts with patients understanding themselves and knowing their bodies.

There has been some change where we don't necessarily recommend people do a breast exam on themselves.

However, I think it's still very important for women to kind of know who they are and what is there.

>> So, self-examination.

>> Self-examination.

And, really, being able to speak up to a provider if you should know something different or notice that something is different.

And a lot of times, like Dr.

Hampton mentioned, patients will notice something, but they might not have a primary care physician.

Or they tell them, you know, "You're fine.

You're too young."

Really advocating for yourself and seeking a second opinion, a third opinion if you need to, is really important for these women.

>> At what age should women consider getting mammogram?

>> So, the recommendation is to start at age 40 for a woman of what we say an average risk -- no family history and starting at age 40.

If there is a family history, then women should start 10 years earlier.

So, if Mom or Grandma were, say, 41, 42, the women in that family should start by age 30, starting to get screened and get -- followed by a high-risk program similar to the one that Dr.

Bruff and I run.

>> So, one's hereditary background is a factor in breast cancer.

>> Yes, that's correct.

>> Or raises the potential.

>> Yes, absolutely.

>> There have been a lot of discussions about breast cancer overall in the United States of America.

Dr.

Bruff, what do you think that the public needs to know about not just the diagnosis, but has medicine got to the breast cancer in check?

Or is it still a runaway train?

>> I believe it can put it in check, and the way I can say that confidently is that the rates of breast cancer deaths have definitely decreased, especially since the 1980s.

If we look at the statistics, the rates of breast cancer deaths were steadily climbing.

And now we've seen that it's actually starting to go down.

And that's mostly because of early detection and the advances in medicine with the treatment of breast cancer that we have.

>> What would you say to Black women and to all women today who have fears of getting early diagnosis, who have fears of mammograms and other things?

You know, there are a lot of women out there who only go to get medical treatment at the emergency room.

So, how do you overcome some of the social determinants of medicine in America, particularly from a breast cancer perspective?

>> Well, I would start by saying it's not your grandmother's breast cancer.

It's definitely very much not the same care that happened.

A lot more of this medicine is personalized to you, and it's not a one-size-fits-all.

So, that's first and foremost.

A lot of people think, if they have breast cancer, that means they have to have their breasts removed, they have to get additional serious treatments like chemotherapy or radiation therapy.

And there's a lot of nuance to this care, and we tailor it to each woman in their case.

I also feel that, as you say, you know, the social determinants of health -- you know, if we could figure that out, we would have a lot more equity in the care of medicine.

And I do agree that it can be difficult to get women to start on this screening journey.

And I feel, really, exposure, people talking about their experience and their diagnosis, can help women understand that it's not as scary as you think or, while it may be scary with the first diagnosis, we really have ways to bring you through this, and we will get you through it.

>> Why do we get all of these maladies at an early age?

>> I think that is the million-dollar question.

I think if we could answer that, I think we could really solve it.

But we know that a lot of cancers -- breast cancer, colon cancer, prostate cancer -- that we tend to get them at younger ages.

And so, you know, I think that takes us into looking at how we do screening for patients in general.

We have to move away from a one-size-fits-all.

You know, saying that everyone gets a mammogram at age 40, we're just missing a whole segment of the population.

And so I think that's where we the people can advocate and say, "Hey, we've got to do this different.

We've got to meet the needs of each unique community."

>> So, awareness is very important in terms of family histories.

Dr.

Bruff, what has been your call and response?

When you address not only young people, but all people, particularly Black women, is there a sense of responsiveness?

What's been your response?

>> I've had very young patients who you're telling them "You have breast cancer" and they're in their late 20s, early 30s.

But they are ready to do anything and everything and have no questions and just want to get it taken care of.

And then I've had, you know, older women who have had family history, no people with it, and they're very hesitant, very resistant.

And so, really, it's just meeting the patient wherever they are and giving them that support to get to, you know, making that change and going through the journey.

That's important.

>> I know the new national president of the National Medical Association is also the head of Howard University Hospital, a young brother.

And we had a discussion recently about overall healthcare to the African-American community and other communities of color.

And there appears to be growing challenges to the work that you do.

Some of it is the lack of public information, the lack of public education about the importance of breast cancer, but also I think that the mindset of taking care of one's health is under new challenges.

Dr.

Hampton, what should people in the communities do to make sure that in their particular community or their particular hospital or their particular general physician, that there's not a retreat, but a continuing advancement in the delivery of health care?

>> Yeah, I think it's important for us to just keep advocating for our own health.

We need to advocate for there to be good facilities in our communities.

We need to advocate for those providers to see us, to hear us, to take us seriously.

And then I think we need to seek out providers and facilities that, you know, will give us the care that we deserve.

But I think, again, it's we the people, and I think we need to really take that power into our hands and really allow, you know, those that lead the country to hear us because they work for us.

>> Very important point.

So, in terms of the context of today and the future, what is your vision?

Do you see that the work that you, both of you, do is gaining traction and that, as we move forward, that more and more women will be taking diagnosis early as something that is a necessity, not something that's an option?

>> I do.

I really do.

And a lot of it has to do with social media and how we just spread information a lot more freely.

I feel that fewer women have or know as much stigma about breast cancer, about mammograms.

Obviously, it still exists, but I am encouraged with, you know, the patients I see, the women I meet who come in already armed with a good knowledge base, a good, you know, foundation.

And I feel that, you know, we are engaged in our community and do outreach.

And we also work with the primary care physicians in our community, as well, to help them also be able to provide that outreach to patients we might not see.

And it's -- I'm encouraged.

>> Dr.

Regina Hampton, Doctor Allison Bruff, thank you for joining "The Chavis Chronicles."

>> Thank you.

>> Thank you very much.

>> We have a lot of smart minds in this country that are trying to solve some of the most challenging health care issues that are facing the world.

That's happening here in this country.

The issue is, as we know, that there's essentially an attack on science and medicine.

♪♪ >> We're very honored to have the national president of the National Medical Association, >> That's right.

>> Dr.

Mitchell, welcome.

>> It's great to be here.

It's great to see you, sir.

>> You're the 126th national president.

>> That's right -- 126.

We've been around since 1895, the oldest and largest group of Black physicians in the country.

>> What are the three top priorities for the National Medical Association today?

>> Well, one of the biggest things is environmental justice.

That's extremely important.

You know, where we live and our access to clean water and access to food as medicine is extremely, extremely important to us.

So, environmental justice is one.

The other is innovation, how our patients can engage with wearables and other AI modalities so that they can have better health care and making those things accessible to people that don't necessarily have the resources to have a watch that's gonna tell them their blood pressure or have a app on their phone that lets them know that they need to go get their blood sugar checked or a wearable that shows that their blood glucose or blood sugar is low and they need to eat -- or too high.

Those types of things and innovation is extremely important.

That's two.

The other is health justice.

I am a forensic pathologist, and I believe violence is a public-health issue.

The number-one killer of adolescents in our country is gun violence.

We need to be talking about gun violence as a public-health issue.

We need to be engaging in the activities of violence interruption and making sure that violence interruption and violence prevention is something that's happening in our community.

>> You say gun violence is at the top of the list?

>> That's right.

Gun violence is at the top of the list.

Gun violence is taking more of our young people than car accidents right now.

Gun violence is taking more of our young people than cancer right now.

Gun violence is the top priority, should be the top priority of any public-health institution in this country, particularly if they care about the lives of Black men -- Black men, boys, and Black women and girls.

Gun violence is -- And it's preventable.

Because it is linked to the social determinants of health -- where we live, love, work, play, and have our being -- because it's linked to our ability to change our climate and our culture, gun violence is a preventable disease, and we can decrease homicides and suicides in our community.

One of the things about gun violence is -- The thought is that there's more homicides in this country than there are anything.

The top killer in gun violence is suicide.

It's self-inflicted.

And that looks a little bit different.

Older white men kill themselves more than anyone else.

So, when we talk about gun violence in this country, it affects everyone.

And this is extremely important.

>> Healthcare is a major issue not only in the African-American community, but all communities across the United States.

As the president of the National Medical Association, what is your assessment on the state of health care in America today?

>> Well, I mean, there's a lot to be said about the state of health care in America today.

I mean, our people are sick.

We have some very sick people here in this country.

But our innovation is bright.

We have a lot of smart minds in this country that are trying to solve some of the most challenging health care issues that are facing the world.

That's happening here in this country.

The issue is, as we know, that there's essentially an attack on science and medicine.

There is this -- >> Overall?

>> Overall, overall, particularly with this administration, there's a lack of trust and there's a casting of doubt surrounding some of the tried and true approaches that we've been taking to healthcare and in medicine, and so -- >> Almost like a pseudoscience and pseudo health.

I mean, they're, like, taking traditions, throwing them out, and coming up with all kind of -- I would even say weird principles about science and healthcare.

>> One of the big things that we rely on as physicians -- I'm a physician.

I'm a forensic pathologist.

I've been practicing for over two decades forensic medicine.

I do autopsies for a living.

And one of the things that we base our medicine on is evidence, evidence-based approaches, evidence-based approaches in our practices.

When we see a patient and they present with that cough, what is the differential diagnosis in that cough?

These are the series of treatments that we can give.

Let's give those treatments.

Let's see what the outcomes are.

And that evidence extends not only into the clinical treatment, but also in the research that we do in order to find new treatments like precision medicine.

Well, today there's an assault on that.

Today there's defunding of certain research projects, particularly when it comes to those that focus on diversity and those that come up and show up differently than the mainstream.

>> I want to make sure I hear you right.

Are you saying that a lot of the public-health policies today are not based on evidence and not based on the scientific principles?

>> That's right.

You know, when you make a decision to decrease access to Medicaid and take people off of Medicaid in order to save money, that's not evidence-based policy to improve the health outcomes of your citizenry.

That is not evidence-based.

Matter of fact, evidence have been showing that if we want to improve cost on health care, then you move towards a value-based-care approach, meaning you value prevention.

You get as many people into preventative care -- screenings for your prostate, screenings for your breast exam and your mammography, screenings for your eyes, screenings for diabetes, screenings for HIV.

And then you develop a way of treating that patient before their disease progresses to the extent where they need a hospital, right?

That's a value-based approach, and that is rewarded by additional resources.

The more people you have in your value-based approach, the more people you have in prevention, the better your reimbursement, right?

That was the road we were going down.

The healthier the American people, the least sick individuals will be, and the lower the cost.

Well, what we've decided to do, what this policy is that we're facing today is, "Well, we're gonna decrease costs, and we're gonna to do it very lazy.

We're gonna be very lazy about it.

We're just gonna move a swath of people off of the cost of coverage, and that will decrease costs."

But what will happen is, is individuals will become sicker.

They won't go get the prevention that they need.

When they have a numbness of their foot, they won't say, "You know what?

I should go get this numbness checked out."

Or they have an injury the size of the tip of my pinky.

"That's not healing.

Let me go get that checked out."

They're not gonna do that if they don't have access to care or don't have insurance coverage 'cause that cost is gonna come out of their pocket.

They're gonna go get it when it's -- when it's -- when it's too far gone.

>> Right.

So, Dr.

Mitchell, the current policy is gonna actually increase the overall cost of being an American.

You know, in other words, they're trying to cut costs of health care by putting people out, but if more people get sick, that's gonna raise everybody's health.

>> That's right.

It's gonna raise everybody's cost.

And what is gonna happen is, is that we go back to the bad old days when you have lines in your emergency department, where individuals are utilizing their emergency department for their primary care.

>> Some people say that's the good old days.

>> Well, I mean, those individuals, they don't realize that if overcrowding happens in any hospital, it happens in all hospitals.

And those individuals with the insurance that have access -- they're gonna have to wait in those lines, too.

They're gonna have to be seen in those emergency departments that are overcrowded because those safety-net hospitals, like Howard University Hospital, that requires Medicaid patients to have good-paying Medicaid, rural hospitals throughout the country -- they're gonna close.

And when those close, then where are the people gonna go?

They're gonna go to the hospitals that people are suggesting are the better hospitals.

>> What can people do, working with the National Medical Association, to turn some of this around, to come back to value-, evidence-based medicine, rather than the disorder that's going on today?

>> Boy, I mean, you know, one of the things is that we have to mobilize.

The National Medical Association, like I said, has been around since 1895.

In the '60s, it was Montague Cobb that was at the forefront of the creation of Medicaid and the signing of Medicaid into law.

It was the National Medical Association... >> Is that right?

>> ...that was advocating for national health care when other associations that I won't name were against it.

>> I understand.

>> 60 years ago.

>> Well, one of the reasons why you have the National Medical Association was 'cause of the exclusion... >> That's right.

>> ...from the American Medical Association.

>> I'll let you say it.

Right?

>> Yes, sir.

>> 'Cause there's repentance.

There's a repentance to be paid for this, right?

And today we're still at the forefront.

We're still at the forefront.

So mobilization is critical.

And what I've told my members is that, "Hey, let's get ready.

We got to get ready to make sure that we don't withhold the care that we can give just because the government is not willing to pay for it.

There are people that are dying and will die.

If we don't correct the way we're going surrounding the policies in this country, millions and millions of people will die.

And that's not hyperbole.

>> Millions?

>> Millions of people will die.

We're not -- That's not hyperbole.

There are people that are going to be shut out of access.

And if people don't seek care when they think they need it, when they have to have it, it's often too late.

It's often too late.

And often they will not even get to care.

So we'll be picking them up in their homes.

And that's when the forensic pathologist comes into play.

So, this is -- this is the preamble.

The prophets of old told what was coming, right?

And so we are to tell what is coming.

And we have to respond to that now with a sense of urgency before we start really feeling the effects.

Those that are making these decisions hope that we will forget that these decisions are made by the time the effects are kicking in.

It is time now that we need to act and respond and to galvanize and mobilize surrounding the health of our community.

>> Dr.

Roger A. Mitchell Jr., thank you for joining "The Chavis Chronicles."

>> My pleasure.

>> For more information about "The Chavis Chronicles" and our guests, visit our website at TheChavisChronicles.com.

Also, follow us on Facebook, X, LinkedIn, YouTube, Instagram, and TikTok.

Major funding for "The Chavis Chronicles" is provided by the following.

At Wells Fargo, we continue to look for ways to empower our customers.

We seek broad impact in our communities, and we're proud of the role we play for our customers and the U.S.

economy.

As a company, we are focused on supporting our customers and communities through housing access, small-business growth, financial health, and other community needs.

Together, we want to make a tangible difference in people's lives.

Wells Fargo -- the bank of doing.

American Petroleum Institute -- our members are committed to accelerating safety, environmental, and sustainability progress throughout the natural gas and oil industry.

Learn more -- api.org/apienergyexcellence.

The Reynolds American organization -- on a mission to grow a better tomorrow by building a smokeless world.

Today, Reynolds American is jobs, and manufacturing to grow tomorrow right here in America.

♪♪ ♪♪ ♪♪ ♪♪