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Updated: Apr 14, 2022

Breast cancer is bad news. One out of every 8 women will get diagnosed and 1 out of every 30-40 will die from it. Keeping a straight poker face while nervously and cautiously palpating a suspicious breast mass is an art, but unfortunately we get quite good at it. I remember the first time I felt a rock hard lump in my patient's breast. I couldn't keep a straight face back then and she noticed. I got super nervous and so she did too. She was in her thirties and came in for a routine exam because of her family history. The breast cancer diagnosis was confirmed shortly after when she got her mammogram and biopsy. She lost her hair, her dignity and her left breast. She smiled throughout though, and had a "fake it til you make it" approach. Funny how some people turn into superheroes after a crushing cancer diagnosis, while others just give up and fade away. If she's reading this right now, I want you to know that I regret reacting the way I did. I can't imagine what it was like getting that news from a visibly shook doctor. I now recognize that patients need rocks to lean on more than a stranger's shoulder to cry on.

My approach has changed quite a bit since 2007. Over the years, I've perfected and personalized my approach to giving bad news. It's not that I like to do it, but I'd rather do it myself than delegate it to my interns, knowing that this moment will be ingrained in my patient's mind forever. I've put lots of energy into learning how to give bad news appropriately. Nowadays, I'd rather use that same energy into preventing bad news from being given in the first place. Over the last 3 months, I have had well over a hundred messages from you, the readers, thanking me for educating you about prevention. I have had other doctors do the same and deep down I know I'm making a difference. What I had imagined a year ago, while staring out into space while my wife was signaling me to "snap out of it", was reaching way more people through my blog than the 30-40 patients per month who are actually interested in hearing me talk about how they could make lifestyle changes.

Most people aren't ready to change. But do you know who is? The people whom I've just given a crushing diagnosis to. It’s impressive how these people will clean up their nutrition, start exercising, walk in n