atthewellhealth

What I Tell My Own Patients About Breast Health

Sun, 07 Jun 2026 05:44:19 GMT

Don't let "no family history" make you complacent

If you've spent any time with me, you know I'm not the kind of provider who hands you a pamphlet and sends you on your way.

I ask questions. I want to know what's going on in your life, not just your labs.

And when something is weighing on a patient, I want to understand it well enough to actually help , not just well enough to check a box and move on.

Breast health comes up a lot in my practice. More than people might expect. And over time I've noticed that most women are carrying around the same handful of concerns, quietly, without quite knowing who to bring them to.

So today I want to share what I actually tell my patients when the subject comes up. Not the clinical version. The real version .

This is the thing I find myself saying most often, and I mean it every time.

So many women use family history as their primary measure of whether they need to pay attention. No mother with breast cancer, no aunt, no sister, so they assume they're in a lower risk category and they can relax a little.

I understand why. It's a reasonable shortcut. But it's not the whole picture.

The truth is that the vast majority of women who develop breast cancer have no family history of it at all . No genetic marker. No obvious warning sign.

It is far more common than most people realize for this to come completely out of the blue.

I'm not telling you this to scare you. I'm telling you because I want you to take your breast health seriously regardless of your family tree.

Because you deserve that level of attention, and because catching anything early, if there is anything to catch, is always better than the alternative.

"Normal" is a starting point, not a finish line

When a patient gets a normal mammogram result, I'm glad. I really am.

But I also know that a normal result answers a specific question, and it doesn't always answer the question the patient actually had.

It doesn't tell you whether your dense breast tissue is making that image harder to read.

It doesn't tell you whether your hormonal history is a factor worth thinking about.

It doesn't tell you whether the thing you noticed last month is worth mentioning to someone.

Normal means there's nothing acutely alarming on that particular image on that particular day. It doesn't mean you have a full picture of your breast health. And for a lot of women, the full picture is what they were really looking for.

If you leave a mammogram with questions still unanswered, those questions are worth asking somewhere.

Your instincts are data

This one is close to my heart, because it applies to women's health broadly, not just breast health.

If something feels off, that matters.

If you have a concern that three different people have waved away, and you're still not at peace with it, that matters too. Your body knows things. Your instincts about your own health are not nothing.

I have seen too many women apologize for bringing up a concern, as if noticing something about their own body is an inconvenience. It is not an inconvenience. It is exactly what you should be doing.

A good provider listens to that. A good appointment makes room for it. If you haven't had that experience yet, you deserve to.

Why I brought Dr. Hoagland in

I'll be honest with you. For a long time, when patients came to me with breast health concerns that went beyond my scope, I didn't have a great answer for where to send them.

The conventional system is good at acute findings. It is not always great at the kind of thorough, unhurried, personalized conversation I just described.

That's exactly why I was so glad when Dr. Bill Hoagland came on board with us here at At The Well Health. He spent 40 years in breast surgery. He has seen and reviewed more breast health cases than almost anyone practicing in Louisville today. And he now has something that career rarely gave him: time to actually sit with a patient and go through her full picture.

If you have questions about your breast health that haven't been fully answered, I genuinely think a conversation with him is worth your time. Not because something is necessarily wrong, but because you deserve clarity, and he is very good at providing it.

You can request an appointment with him right here on our site.

As always, I'm here too if you want to talk it through first.

With love,

Becca

What 40 Years in Breast Surgery Taught Me About the Question Women Are Asking Wrong

Sun, 07 Jun 2026 05:21:00 GMT

The statistic that changes everything

Most women approach breast health the same way. They ask: Do I have a reason to worry?

They look at their family tree. No mother with breast cancer. No aunt. No sister. And so they conclude, reasonably enough, that they are probably fine.

They get their mammogram when reminded.

They do their self-exams, more or less.

And they don't think about it much in between.

I spent 40 years in breast surgery, and I want to gently tell you that this approach, as reasonable as it feels, is missing something important ...

One in eight women will develop breast cancer in their lifetime.

Let that sit for a moment. Not one in eight women with a family history. Not one in eight women with a genetic mutation. One in eight women, across the board.

Here is what most women don't know: only about 10% of breast cancer cases are linked to an inherited genetic predisposition.

That means roughly 90% of the women I cared for over my career, women who received a breast cancer diagnosis, did not have a family history that predicted it. They had no BRCA mutation. No obvious warning sign. No reason, by conventional thinking, to expect it.

It came anyway.

I am not telling you this to frighten you. I am telling you this because it matters for how you think about your own breast health, and because I watched too many women be genuinely blindsided by something they had every reason to take more seriously.

"But my mammogram was normal."

This is the other thing I heard constantly, throughout my career and still hear now.

Mammograms are important. I want to be clear about that. They save lives and I support them fully. But they are a screening tool, and like all screening tools, they have limits.

Dense breast tissue, which affects nearly half of all women, can make mammograms significantly harder to read. A normal mammogram result in a woman with dense breasts is not the same level of reassurance as a normal result in someone with fatty breast tissue. The imaging is simply harder to interpret, and things can hide.

Beyond that, a mammogram answers a specific question: is there something acutely concerning right now ?

It is not designed to answer the broader question of what your overall breast health picture looks like, what your personal risk actually is, or what you should be paying attention to over time.

Those are different questions, and they deserve real answers.

What I wish more women would do

After four decades in this field, if I could give every woman one piece of advice, it would be this: don't wait for a reason to pay attention.

Get your mammogram, yes. But also take some time to actually understand your breast health. Know whether you have dense tissue and what that means. Have a real conversation about your risk factors, not just your genetics, but your hormonal history, your lifestyle, your imaging history over time. Understand what you're looking for and why.

That kind of informed attention is not fear. It is the opposite of fear. Women who understand their own breast health situation are not more anxious. They are less anxious, because they are not operating in the dark.

Why I'm here

I joined At The Well Health because I wanted to have exactly these conversations.

In a traditional surgical practice, there wasn't time. A patient came in with a finding, we addressed the finding, and the appointment ended. The broader questions, the ones women actually wanted to ask, rarely got answered because there wasn't space for them.

Here, there is space.

A Breast Health Clarity Evaluation is a real appointment, with enough time to actually review your history, your imaging if you have it, your risk factors, and your questions. You leave with a clear picture of where things stand and what, if anything, you should do next.

If you have been putting this off because you don't think you have a reason to worry, I'd ask you to reconsider.

Ninety percent of the women who needed me most didn't think they had a reason to worry either.

You don't need a family history. You don't need a prior diagnosis. You just need to decide that your breast health is worth an honest conversation.

I hope you'll come have one.

To request a Breast Health Clarity Evaluation with Dr. Hoagland, click here .

I Want to Introduce You to Someone

Sun, 07 Jun 2026 05:05:25 GMT

I Want to Introduce You to Someone

I've been wanting to write this post for a while now, because I'm genuinely excited about what it means for the women I care for.

A few months ago, Dr. Bill Hoagland joined us here at At The Well Health. And if you've been a patient of mine for any length of time, you know I don't bring people into this practice lightly. This is my life's work. The women who walk through our door trust me, and I take that seriously.

So let me tell you why I said yes to Bill, and why I think this might matter to you.

He spent 40 years doing one thing: breast surgery.

Not a little bit of everything. Breast health, specifically.

Diagnosing it, treating it, operating on it, and sitting with women through some of the scariest moments of their lives.

He has seen more breast imaging, reviewed more cases, and had more of those hard conversations than most physicians will encounter in several lifetimes.

That kind of experience doesn't come from a textbook. It comes from decades of showing up and paying attention.

And now he's here. In our office. With time.

That last part matters more than it might sound.

One of the things that frustrated me most about the conventional medical system, and honestly one of the reasons I built this practice, is that time is the one thing it never gives you.

You get seven minutes. Maybe ten.

You get a result and a callback, and if everything looks "normal," the conversation ends there.

But normal doesn't always mean clear .

And clear doesn't always mean you feel okay about it.

I hear this from women constantly. They had a mammogram. Something was flagged, or maybe nothing was flagged but they still feel uneasy. They have dense breast tissue and nobody really explained what that means for them. They have a family history that weighs on them. They have a lump that three different doctors have told them not to worry about, but they're still worried.

That's exactly who Dr. Hoagland is here for.

What he's offering is something he's calling a Breast Health Clarity Evaluation.

It's a one-on-one appointment, just you and him, where he takes the time to actually review your full picture.

Your history, your imaging, your risk factors, your concerns.

And then he explains, in plain language, what it all means and what you should do next.

No rushing. No vague reassurances. No leaving with more questions than you came in with.

He's not a functional medicine provider. I want to be honest about that. He's a traditionally trained physician with deep, specialized expertise. But he practices here because he believes, like I do, that women deserve more than the system typically gives them. More time. More explanation. More genuine attention.

I think you'll like him. He's the kind of doctor who actually listens , the kind we all grew up hoping we'd find and rarely did.

If any of this sounds familiar, if you've been sitting with uncertainty about your breast health, I'd really encourage you to book an appointment with him.

You can do that right here on our site. Just head to this page and learn more about the evaluation.

And as always, if you have questions, you can reach us directly. That's what we're here for.

With love,

Becca