[00:00:00] Adam Walker: From Susan G Komen, this is Real Pink, A podcast exploring real stories, struggles, and triumphs related to breast cancer. We’re taking the conversation from the doctor’s office to your living room.
[00:00:17] Welcome to the Komen Health Equity Revolution podcast series on Real Pink. I’m your host, Adam Walker. Each month in this series, we bring together patients, community partners, healthcare providers, researchers, and advocates to talk about real challenges and real solutions driving the health equity revolution.
[00:00:36] Today in honor of Black History Month, we’re exploring what happens when inequity itself becomes a risk factor for breast cancer in the Black community, shaping who gets screened, how quickly they’re diagnosed, and ultimately who survives. Our guest, Dr. Lori Pierce, is a renowned radiation oncologist, former ASCO president and Komen scholar and national leader in advancing equity in cancer care.
[00:01:02] She has dedicated her career to improving outcomes of women with breast cancer, with a focus on the underserved by transforming not just treatments, but the systems that deliver them. Her perspective is rigorous, passionate, and urgently needed. Dr. Pierce, welcome to the show.
[00:01:21] Dr. Lori Pierce: Thanks so much, Adam. I’m delighted to be here with you today.
[00:01:24] Adam Walker: Well I love the work that you’re doing, so thank you for that to start with and thanks for joining us. For listeners that may not know you yet can you share a little bit about your journey into radiation oncology? What drew you to focus on breast cancer and health equity, and particularly health equity for Black women?
[00:01:42] Dr. Lori Pierce: Sure. I studied engineering as an undergrad because I was interested in physics and I always was fascinated by x-rays.
[00:01:52] But I knew that I wanted to go into medicine and somehow bring in my love of physics into medicine. So I applied to medical school, was fortunate to get in after taking a bit of time to work in the pharmaceutical industry.
[00:02:06] And while I was in medical school, like many others, my life was touched by cancer. I had a, an aunt, a favorite aunt who was diagnosed with inflammatory breast cancer and died when I was in medical school. So that certainly inspired me to think about pursuing a career in cancer. And then that love of physics
[00:02:29] Made me think about how I could apply that into my goals of being a cancer doctor. So there was this thing called radiation oncology that combined physics, combined cancer biology. And I had done some biology research when I was in medical school and allowed me to work with patients. I am at my best when I’m with patients.
[00:02:54] And so this was a, an easy decision for me to go into radiation oncology. And within radiation oncology I specialized in breast cancer. But also when I was in medical school, that was the first time that I really heard the statistics regarding outcomes from cancer by race and ethnicity and in just about every cancer that you can think of and just about all categories.
[00:03:22] There was a poor survival for patients of color patients who were economically disadvantaged who did not represent the mainstream. And so I think it was a combination of that being determined to, to try to make a difference in that. And my love of radiation oncology that led me to pursue a career in breast radiation oncology and with a focus on health equity.
[00:03:48] Adam Walker: That’s such an interesting path. I love that. It’s so interesting that you found, sort of found your way Yeah. Into what sounds like a kind of a perfect fit for you. Yeah.
[00:03:58] Dr. Lori Pierce: So, yeah. Yeah. So many ways. It really was.
[00:04:00] Adam Walker: Wow. That’s amazing. So we often think about breast cancer risk in terms of genes or age or lifestyle.
[00:04:10] But when you talk about inequities as a risk factor, tell us what you mean by that.
[00:04:15] Dr. Lori Pierce: Well, when we think about inequities of the risk factor, kinda looking at the big picture with the exception of patients who have a genetic predisposition to breast cancer. I mean that those are patients who, multiple members of a family have cancer and you test them and they find out that they have a gene that causes cancer.
[00:04:34] But the exception of those people that population, for most of the patients who get cancer, we really don’t know what factors lead to cancer. And we don’t know what factors lead specifically to breast cancer. But with respect to system and structures as risk factors, it’s clear that factors such as access to quality care, neighborhoods where we live access to healthy foods, exercise, psychosocial factors, those things clearly impact outcomes.
[00:05:04] And, you know, all patients need to have access to good medical care. They need to have primary care physicians who order the right screening tools such as mammograms. They need to have physicians who are accessible if and when patients find a new breast mass, so that these masses can be evaluated in a timely fashion.
[00:05:23] So we see clearly data showing that delays in healthcare, especially delays in diagnosed new breast cancer that will negatively impact a patient’s outcome. So when you can see later stages of disease due to significant delays, which in turn can be more difficult to treat, those factors all result in lower rates of survival.
[00:05:45] So that’s one example. You know, living in safe communities where people can exercise. To help maintain a healthy weight and help reduce the risk of breast cancer and in patients who already have breast cancer Being treated for breast cancer, exercise helps them to tolerate the treatments that much better and minimize fatigue.
[00:06:04] That’s another example of how systems and structures can affect you as risk factors. Access to healthy foods. You know, we know a diet rich in fruits and vegetables, whole grains that can help to maintain a healthy weight, which in turn can help to lower breast cancer risk. And this one factor that I talk about quite a bit, there’s increasing evidence that allostatic load, which basically means the cumulative wear and tear on the body from chronic stress, that’s being associated with higher rates of breast cancer.
[00:06:37] And so all of these factors are systemic factors that can, increase the risk of cancer and they represent systemic racism and socioeconomic eco disadvantage. We’re seeing these societal factors play out every day, particularly in the Black community. So there, there’s a lot to your question. It’s a great question about systems and structures as risk factors for breast cancer.
[00:07:05] Adam Walker: So I wonder if you could elaborate just a little me, because you mentioned several things, right? You mentioned income, transportation neighborhood fact. Like, like the fact that if you don’t live in a safe neighborhood, you can’t exercise, which I never would’ve thought of.
[00:07:19] Dr. Lori Pierce: Yep.
[00:07:20] Adam Walker: Talk, but can you talk a little bit about what your research is revealing, and especially what it’s revealing for Black women?
[00:07:27] Dr. Lori Pierce: So, right. So I talked a little bit about this before, but these are social drivers of health. Because and I prefer to call them social drivers rather than social determinants. I should mention that because I think most people know these factors of social determinants. Determinant means that it’s a done deal, right?
[00:07:44] Whereas a driver means that there’s still way to influence outcome. So I refer to them as social drivers of health. We, with regard to Black patients and those who are economically disadvantaged we know that income impacts the ability to access healthcare and to access to get adequate health insurance.
[00:08:05] And we’re living at a time when the loss of the a CA subsidies are you’re gonna see a higher number of uninsured people and most likely, there’ll be a disproportionate number of those that are African American. And this will impact the rate of early diagnosis. And this will likely impact outcomes, you know to be able to access healthcare in a timely fashion
[00:08:32] You also need to have transportation. You know, I often say that we as breast cancer researchers, we focus on creating and moving the field, the treatment field forward in terms of new therapies that we have. But if we don’t, if we don’t have transportation, patient can’t get there. It’s all for not, right?
[00:08:51] So we have to as a community, we have to make sure that our patients can access many of these therapies.
[00:09:01] Adam Walker: So I know you’ve also spoken and written about medical racism and bias in cancer care. Can you talk about how bias and racism show up in the breast cancer journey from, you know, symptoms to screening, to diagnosis to treatment?
[00:09:15] Dr. Lori Pierce: Yeah that’s a great question. So there are years of oppression. That have led to economic disadvantages for people who don’t look like the mainstream and don’t have the mainstream demographic. Economic disadvantage leads to lack of access of healthcare at leads to later stage of disease and worse survival.
[00:09:36] So that’s the unfortunate continuum. When you have economic disadvantage. You can also, even if you get treatment, you can perhaps receive inferior treatment. And so receive less sophisticated treatments that give you a be better chance of surviving in part because maybe you can’t access them in part because maybe the provider that you are seeing does not provide them, so you can’t get to the best possible care.
[00:10:05] Other examples of racism, there’s redlining. That is a classic example of systemic racism where you are denying financial services such as loans and insurance to people who live in certain neighborhoods. And so those under those neighborhoods remain under-resourced and you don’t have high quality food, you have higher rates of pollution.
[00:10:29] You don’t have the chance to pursue healthy lifestyle choices such as exercise. And you also see a disproportionate representation of people who smoke, fast foods, those kinds of things. So redlining is a great example of explicit bias where it is conscious and it’s deliberate. The other type of bias is implicit bias.
[00:10:52] And that’s something where you are unconscious in what you’re doing. And I, and an example of that unconscious bias that also has negative effect is something like the following example I often give, let’s say you’re a physician, an oncologist, and you are in a very busy clinic. And you know that there are clinical trials that your, you want your patients to go onto trials, but you hear that Black patients don’t go on trials very often.
[00:11:21] So you think, okay, I’ve got a busy clinic. I just won’t even take the extra time that it takes to present this study to my patients of color because they’re not gonna go on trials anyway, that is so problematic from every level. Right? Because if you look at it from an objective standpoint, there have been studies, a classic one by Dr.
[00:11:41] Joe Unger, published a few years ago looking at clinical trial participation for cancer patients. And it found, if you ask patients to go on a study, if you present the study to cancer patients, they will go on the study at equal numbers, whether they’re Black, white, Asian, Hispanic. It makes no difference.
[00:12:03] You just got, as a clinician, you’ve got to ask. So those are examples. And I also want to note that Komen and others have shown that concerns of Black women are sometimes ignored by their providers. So, you know, as a take home to our listeners, we as Black women, we have to have the tenacity to get our questions out there and get them answered.
[00:12:25] So our medical concerns are appropriately evaluated. We have to do a little bit extra work to get the care that we should, that we deserve.
[00:12:33] Adam Walker: Yeah. Yeah. I’m glad you shared that about the implicit bias. Yep. The myth, the way of thinking like that example really I think helped bring that home in a way that I had not heard before.
[00:12:47] And that, that was really helpful. So I really appreciate you, you sharing that.
[00:12:50] Dr. Lori Pierce: Sure.
[00:12:52] Adam Walker: Your research has looked into how to make radiation therapy more effective for aggressive breast cancers, but even the best treatment doesn’t help if people can’t get high quality care. Where do you see inequities affecting the quality and consistency in consistency of treatment
[00:13:10] Black women receive, especially around radiation and comprehensive care?
[00:13:14] Dr. Lori Pierce: All places, all clinics where patients receive treatment should offer up to date contemporary state-of-the-art treatments but sometime that’s not always the case. And to get back to your question, one of the things we looked at is the course of radiation for breast cancer.
[00:13:34] And not to bore you with all the details, but recent studies have shown that we can give a shorter course, three to four weeks of radiation as opposed to the six or seven weeks that was historically done and give, and the patients have the same excellent outcome in terms of tumor control and they have less side effects.
[00:13:55] So the shorter course is definitely what you want to get.
[00:13:57] Adam Walker: Now I know you’ve done work with patients who carry the BRCA one and BRCA two mutations, and we know Black women have historically had less access to genetic counseling and genetic testing. How do inequities in genetic services show up as a risk for Black families?
[00:14:14] Dr. Lori Pierce: With regard to patients of color,
[00:14:18] we know that Black women have a higher risk of being diagnosed with triple negative breast cancer. And triple negative breast cancer is a cancer where the tumors are not receptive to hormonal therapy or a receptor called, excuse me, receptor called HER2 new. These are three receptors that can be on the breast cancer
[00:14:39] cell and why it’s important for these triple negative breast cancers. If those cancers don’t have those receptors, then treatments that bind to those receptors won’t work in triple negative breast cancer. So hormonal therapies, which are very commonly used for breast cancer will not benefit a patient who has triple negative breast cancer and HER2 new therapies for those patients, those breast cells that have a HER2 receptor will not
[00:15:08] benefit these patients and those treatments are very effective treatment. So for triple negative breast cancer, we have chemotherapy. And so that’s a good thing, but it’s not something called a targeted treatment. A targeted treatment means that it combine directly to that receptor. It targets that receptor With triple negative, you don’t have that.
[00:15:27] And so one of the many areas of research is looking at finding targets and better therapies for triple negative breast cancer. But putting that aside. As I mentioned, Black women have a much higher risk of getting, of being diagnosed with triple negative breast cancer. Now, if you look at all breast cancer, patients have triple negative disease, which is gonna be primarily white.
[00:15:49] If you look at the overall numbers, about 10 to 15% of that overall population will have a mutation, a gene that caused that. Black women have two times that risk. So, but yet they are not tested at rates similar to white patients. And so organizations like Komen are so important for, offering resources for genetic testing and counseling to help patients understand the importance of genetic testing for high risk patients and helping patients to ask the right questions through the healthcare providers.
[00:16:25] So Black women have a higher risk of triple negative breast cancer. They have a higher risk of having a mutation. They have a lower risk of being tested. They need to be tested because there are therapies specifically that we use for patients who have a mutation in breast cancer that they would not be
[00:16:39] receiving if we don’t know that they have a mutation.
[00:16:42] Adam Walker: Yeah, that’s right. That’s right. I appreciate you sharing that. Like we talk about inequities a lot, but I think we can often glance over it as sort of one thing, like it’s inequities and we miss the, we miss, we see the breadth of it. We miss the depth of the inequity.
[00:17:00] Right. And I think what you’re helping to share in this conversation is that. It goes really deep and there’s a lot of layers to this that need to be pulled back and dealt with in order to have better outcomes for all communities. Right. And that’s so important. So so I know you’re the only African American serving president of ASCO.
[00:17:23] Have continued to be recognized for leadership in equity, including the ASCO Excellence in Equity Award. From that vantage point, what systemic changes are most urgent? If we want to make equity a reality for breast cancer care and how health systems, policy makers, and even everyday listeners can commit to this?
[00:17:44] Dr. Lori Pierce: Basic premise.
[00:17:45] Every cancer patient deserves high quality, equitable cancer care That is their that is a fundamental principle, right? And when we’re talking about care, we’re talking about routine care, we’re also talking about care on clinical trials. All of this must be equitable. So think something that I mentioned earlier,
[00:18:04] we must look at our institutional outcomes by race and ethnicity to see for those patients that come in our doors. Are they receiving comparable care? We have to look at our outreach programs. This is so important to be sure that we’re bringing in the voice of the communities into our care processes.
[00:18:23] You know, there has to be a dialogue. There is so fundamental that healthcare systems be in constant dialogue with the communities that they serve. So we as the health, as the medical community, we need to help improve access and make it easier for patients in our catchment areas to be treated.
[00:18:44] You know, so most health systems have a central, a flagship location, but it’s important to also have community practices that are aligned with that flagship institution, clinical trials and talking about this, trying to make this brief RA mentioned that clinical trials a woefully underused in Black communities, largely because Black communities aren’t asked.
[00:19:08] And so, but there are other barriers as well. Besides. The ultimate one, not asking patients to participate in clinical trials. And so when I was president of ASCO, which is the American Society of Clinical Oncology, we worked with ACCC, which is the Association of Cancer Care Centers, all these acronyms.
[00:19:29] And we worked with them and we developed something called a site self-assessment tool. And let me just explain why that’s important. Basically what that tool was a series of questions where whether you were a university setting, whether you were a community practice, no matter what setting you were in, that allow you to look at various aspects of the of
[00:19:54] the clinical trial process to make sure that your process was optimal. Let me give you an example. Let’s say you had a hundred patients last year who were Black who, cancer patients who came into your cancer center, and three of them ended up going on clinical trials. Well, that’s great for three, but what happened with the other 97?
[00:20:16] You know, we know clinical trials. It pushes the envelope, gives you the best possible care gives you the standard care, and then offers a treatment that may be even better than the standard care or maybe less side effects. It is the state of the art. It is the highest quality care is delivered on cancer trials.
[00:20:33] You want to have where people go on cancer trials. So it’s important that we work in cancer teams. So patients can have access to many members of the team, not just the attending physician. You know, sometimes patients interact far better with the nurses or o other members of the team. We are all working together on clinical trials.
[00:20:54] With regard to policy. You can look at policy at a national level looking policy at a state level. We know from a national level, the ACA implementation and the marketplace expansions back in what, 2014 dramatically decreased the number of people who were uninsured. We know now that we’re living at a different time, those subsidies have been taken away.
[00:21:20] And this is something I often tell patients and families: tell your stories. Your stories are so very powerful. I’ve been on Capitol Hill a few times, met with some of our senators and people in Congress and their staff and, you know, you can go there and you can have all these data and you know, they can listen.
[00:21:41] Yeah. When you start to tell a story of a real patient. That’s what makes a difference. So tell your stories. Advocate in every way. Talk about the barriers of your treatment to elected officials, local, state, and national. It truly makes a big difference.
[00:21:59] Adam Walker: Love that. Love that. And we have so many people that come on the show and tell their stories, and there’s so much power in that.
[00:22:06] So I appreciate you advocating for it. Yeah.
[00:22:10] So, so we’ve talked a lot about disparities and inequity. I wonder if I can ask it from a different angle. What gives you hope right now as it relates to all these things?
[00:22:22] Dr. Lori Pierce: There are many programs that I know of that are pushing the boundaries and that continue to focus on equity because the needs and the mission hasn’t changed.
[00:22:33] Right? Komen has an incredible program stand for HER Meaning Health Equity Revolution, and it, it’s, I probably won’t do this justice. It’s a comprehensive framework. For working with Black communities to help dis address the disparities that Black women are experiencing with breast cancer. And it, it’s an initiative that really focuses on education so that you can empower communities.
[00:23:02] So that they have the knowledge they need to ask the important questions and to get their questions answered. That’s one part of it. They also work on include workforce development, and that’s vital. We have to have a workforce that looks like the patients that we serve. One thing and two, not every patient will have or needs to have a provider that looks like them, but you need to have a provider who has cultural competence to understand what patients are going through more broadly.
[00:23:38] So we need to focus on educating the workforce and creating the workforce. Another part of the initiative is public policy including grassroot advocacy which is vital goes back to what I said. Patients need to tell their stories. And then of course, Komen has been a huge source of
[00:23:56] funding for critical breast cancer research to benefit all women with breast cancer, with emphasis on those who are underrepresented, like Black women. So there’s a lot of work being done by Komen that is on this front that is so important. So that’s one one. American Cancer Society, ACS, they have launched an aggressive initiative that many of your listeners may have heard of.
[00:24:19] It’s called Voices of Black Women. And what voice has done it is doing is it seeks to understand the root causes that lead to breast cancer in Black women and the disparate outcomes that we have. And so what this study is doing, it’s aiming to enroll at least 100,000 Black women, age 25 to 55, who have not been diagnosed with breast cancer.
[00:24:45] And to follow them over time to try to understand those. Contributing factors of social drivers of health that may then subsequently increase their risk of getting breast cancer, increase their death rates from breast cancer, as well as other health conditions that disproportionately affect Black women. Breast Cancer research Foundation.
[00:25:05] Which I know very well has a health equity initiative that’s funded by the Estee Lauder Company’s charitable Foundation. I’m part of the steering committee on this initiative, so I know this very well, and it’s looking at the social drivers of health in Black women with breast cancer as well as genetics.
[00:25:23] Looking at the biology in these tumors and looking at the interplay between these factors to help reduce breast cancer disparities. And we’re able to do this because for those of you who know BCRF, Breast Cancer Research Foundation, there is an increasing number of researchers that are funded by BCRF.
[00:25:41] I’m very fortunate to be among them, and in those researchers are some who have established databases, years and years ago, specifically of Black women with cancer. So they have a lot of longitudinal information, they have tumor samples, they have a lot of information biology, and we are bringing these databases together, merging these databases so that we have an even stronger database to then be able to look at these factors of social drivers, of health, of genetics and biology.
[00:26:12] And so. We hope that with this work we will find some of the multifactorial contributions to breast cancer in Black women, their outcomes. And what’s great about this is that we’re picked Black women as our initial group to, to do this work in. because of course, they have the highest risk of death of breast cancer in any of the major racial or ethnic groups.
[00:26:37] But this approach can then be extrapolated to other populations as well. So. It will have a broad range, and then another program that I’m also on the steering committee with the Robert A Winn Excellence in Clinical Trials Award Program. Very briefly, this is a two year program for early career physicians to help them to be better
[00:26:58] clinical trialists in the community to help them to carry out clinical trials in the community. A lot of this stuff we’re not taught in medical school. And so and so this program teaches the very basics of doing clinical trials, takes them up to a level of sophistication for how best to engage communities and to translate that engagement into active participation in clinical trials.
[00:27:19] So I’m very excited about that. This is a initiative that is funded by the pharmaceutical industry industry. There are multiple companies, and the curriculum is developed largely by AACR, which is the American Association for Cancer Research by their faculty. And then finally, advocacy, ADV advocacy gives me great hope.
[00:27:39] It is a fundamental part of Komen. It’s a fundamental part of AACR of ASCO at the lo, at the local, state, and national levels. Advocacy brings change.
[00:27:50] Adam Walker: Yeah. Love that. That’s a good way to end that a advocacy is so important. And we do that a lot on this show. We talk to a lot of people that are important in that work.
[00:27:59] So I’m curious for for Black women that are listening who may be worried about their risk or feel like the system hasn’t always shown up for them. What are the most important steps they can take right now around knowing their risk, getting screened or advocating for themselves?
[00:28:20] Dr. Lori Pierce: Yeah. Take charge of your health.
[00:28:23] You know, where there are resources that can provide the answers that you need, that you’re seeking for so that you feel empowered to take charge. Komen, I’ve mentioned them many times they are there to advise where to get mammograms, particularly for those who are uninsured or need financial assistance and they can help to connect patients to resources. The American Cancer Society has 24 7 information for patients and families. There’s phone numbers. The website, cancer.org talks about cancer treatment outcomes, treatment options, you know, transportation, lodging, all these kinds of things. They really are very comprehensive and actually for both Komen and ACS, the information is
[00:29:04] evidence-based. And ACS recently developed a collaboration with ASCO, the American Society of Clinical Oncology. And I think that’s a very powerful connection so that you get very rich evidence-based information that will empower you to ask the right questions and advocate for yourself, for your loved ones.
[00:29:23] It helps us to use our voices because our voices are so very powerful in this space.
[00:29:30] Adam Walker: All right, last question. I think. An important one for this conversation. So as we recognize Black History Month
[00:29:37] What does it mean for you to be a part of this generation of leaders that are working to transform breast cancer care and what vision do you hold for the next generation that’s coming behind you?
[00:29:49] Dr. Lori Pierce: That’s a great question to end up on. It has been, it’s just an absolute honor to be a breast cancer doctor and a researcher. Yeah, I may get emotional about this. My, my patients have always been my north star. My patients, my patients inspire me every day. They also educate me as to the questions that we, as researchers need to ask and study
[00:30:15] To help improve survival and improve quality of life for our patients with breast cancer. And it is, it’s an honor to also work alongside so many incredible other breast cancer researchers who together collectively we can try to move the needle and we move the needle, obviously a goal is to improve care.
[00:30:35] Moving the needle is also to improve the quality of life. And we’re learning more and more than in some cases less is better. So we can be very judicious in improving treatment outcomes and then being able to cut back where we see that we can do so and improve quality of life for our patients.
[00:31:00] And so then with that, my vision for the next generation is that there will be an even greater focus on individualizing our care so we can personalize our care for, so that the right treatment is given to the specific patient. The patient sitting in front of me that we know information about specific tumor, we know what mutations drives that tumor.
[00:31:21] We know what that tumor needs to survive. We know what the patient needs to survive. We know. The social drivers of that, of health for that individual. And collectively, we can individualize and recommend the appropriate care for our each individual patient.
[00:31:39] Adam Walker: I love that. Love that. Well, Dr. Pierce, the work that you’re doing it is just important across the board and like, like I said earlier, like I really appreciate you coming on the show and really helping us to better see
[00:31:54] the depth of some of these problems and peel back so many of those layers that have and we haven’t even scratched the surface, I’m sure. But I just..
[00:32:04] Dr. Lori Pierce: We can take another hour easily.
[00:32:06] Adam Walker: We could. No, but this, I mean, this is just so good. It I mean, I mean, even having talked about this so many times and having so many conversations.
[00:32:17] I feel like the way you were able to peel back some of those things was just even more helpful in, in, in gaining my own understanding about this. And I just, I genuinely appreciate it. I really do.
[00:32:27] Dr. Lori Pierce: It’s been a pleasure.
[00:32:28] Adam Walker: Yeah. And for anyone listening, if you or someone you know, if you or someone you love needs support navigating breast cancer from understanding your risk to finding local resources or financial assistance.
[00:32:41] Komens Patient Care Center is here to help. Call 1 8 7 7 Go Komen or visit komen.org/patient care center. Thanks for joining us for another episode of the Komen Health Equity Revolution series. We’ll keep bringing you conversations that shine a light on the inequities that drive risk and outcomes, and the people working every day to dismantle those barriers so that everyone has a fair chance at better breast health.
[00:33:09] Thanks for listening, and we’ll see you next time on Real Pink.
[00:33:17] Thanks for listening
[00:33:17] to Real Pink, a weekly podcast by Susan G Komen. For more episodes, visit real pink.Komen.org. And for more on breast cancer, visit Komen.org. Make sure to check out at Susan G Komen on social media. I’m your host, Adam. You can find me on Twitter at AJ Walker or on my blog adam j walker.com.