The Silent Signs of Breast Cancer & How to Know Your Cancer Risk With World-Renowned OB-GYN

Episode of The Mel Robbins Podcast · November 12, 2026 · 57 min

OB-GYN and breast cancer survivor Dr. Thaïs Aliabadi tells Mel Robbins how women can assess cancer risk, which screenings to request by age, and how to self-advocate.

Summary

Mel Robbins hosted Dr. Thaïs Aliabadi, a Los Angeles OB-GYN who said she had not lost a patient to cancer in 25 years among those who followed her advice. Aliabadi recounted her own breast cancer diagnosis at 48: despite no family history or genetic mutations, an atypical biopsy raised her calculated lifetime risk to 37%, and she pushed for a double mastectomy over doctors' objections, after which invasive cancer was found. A later MRI revealed residual breast tissue, leading to a second mastectomy.

Aliabadi urged every woman to calculate her lifetime breast cancer risk with the Tyrer-Cuzick model, explaining that a risk of 20% or more warrants imaging starting at 30, including 3D mammography, ultrasound and MRI. She discussed dense breast tissue, genetic testing by age 25 for those with family history, polygenic risk scores revealed by whole genome sequencing, and preventive options such as tamoxifen or mastectomy.

She then covered ovarian cancer, advocating annual pelvic ultrasounds and removal of fallopian tubes for high-risk women; uterine cancer, monitoring postmenopausal endometrial thickness; and cervical cancer, which she described as nearly entirely preventable through HPV vaccination and screening. She outlined a decade-by-decade screening schedule including AMH egg counts, hormone panels, egg freezing, perimenopause and hormone therapy, colonoscopy and bone density.

For longevity, Aliabadi recommended testing APOE4 for Alzheimer's risk and ApoB for cardiovascular risk. She closed by urging women to bring a written list to appointments, seek second or third opinions when dismissed, and become their own health advocates.

Chapters

0:00
Introduction of Dr. A
Mel Robbins introduces OB-GYN Thaïs Aliabadi and her mission to help women advocate for their health.
6:37
Dr. A's breast cancer story
Aliabadi recounts how calculating a 37% lifetime risk led her to demand a double mastectomy that uncovered invasive cancer.
11:46
Calculating lifetime breast cancer risk
Aliabadi explains the Tyrer-Cuzick tool, risk thresholds, dense breast tissue and when to start imaging.
17:22
Genetics and polygenic risk
Aliabadi describes whole genome sequencing, polygenic risk scores, and genetic testing by age 25.
24:15
Screening checklist and risk reduction
Aliabadi lists tests to request and discusses MRI insurance coverage, tamoxifen and mastectomy.
27:11
Ovarian cancer and fallopian tube removal
Aliabadi advocates annual pelvic ultrasounds and salpingectomy for high-risk women.
32:22
Uterine and cervical cancer
Aliabadi covers endometrial lining monitoring, HPV screening, and the HPV vaccine.
39:14
Decade-by-decade well-woman visits
Aliabadi outlines AMH testing, hormone panels, egg freezing, perimenopause, HRT, colonoscopy and bone density.
46:05
Longevity tests: APOE4 and ApoB
Aliabadi recommends testing for dementia and heart disease risk markers.
Linked moment · 50:23Skip to 50:23 using a listen link in the info box.
50:23
Preparing for appointments and parting advice
Aliabadi urges women to bring a written list, seek second opinions and refuse to be dismissed.

Key points

What was said, by whom, with the exact words. Timestamps jump to the moment.

Thais Aliabadi
Aliabadi argues that most women are dismissed by the current healthcare system, with their pain minimized or attributed to anxiety or stress.
“I want you to know that majority of women get dismissed in the current healthcare system. Their pain is minimized. They're told it's in their head”
Listen from 4:39 · Patient self-advocacy
Thais Aliabadi
Aliabadi recounts that after an atypical biopsy, recalculating her lifetime breast cancer risk produced a figure of 37%.
“So I recalculated my lifetime risk of breast cancer and this number popped up on my screen, 37%. I almost fell off my chair”
Listen from 7:30 · Breast cancer
Thais Aliabadi
Aliabadi says invasive breast cancer was found in her right breast after the double mastectomy she had to push for.
“They found invasive breast cancer in my right breast when they removed the tissue”
Listen from 7:47 · Mastectomy
Thais Aliabadi
Aliabadi says a second mastectomy revealed that 35% of her breast tissue had been left behind after the first.
“I'm so glad you had me do it. They had left 35% of your breast tissue behind”
Listen from 11:39 · Mastectomy
Thais Aliabadi
Aliabadi says women with a lifetime breast cancer risk of 20% or more are high risk and should start breast imaging as early as 30, calling the age-40 guideline misleading.
“these women need to start their breast imaging as early as 30. So don't come to my office and tell me that you have no family history”
Listen from 14:11 · Tyrer-Cuzick model
Thais Aliabadi
Aliabadi explains that dense breast tissue both hides cancer on mammograms and raises breast cancer risk, requiring 3D mammography and ultrasound.
“dense breast tissue on mammogram looks white and cancer looks white. So it all blends and it's hard for the radiologist”
Listen from 16:19 · Dense breast tissue
Thais Aliabadi
Aliabadi says whole genome sequencing showed her polygenic risk score made her three times more likely than others to get breast cancer, despite negative standard genetic tests.
“this full genome sequencing showed my polygenic risk score at three times more likely to get breast cancer than another person”
Listen from 17:22 · Polygenic risk score
Thais Aliabadi
Aliabadi states that 85% of women who develop breast cancer have no family history of it.
“85% of women who get breast cancer don't have a family”
Listen from 17:22 · Breast cancer
Thais Aliabadi
Aliabadi recommends that women with a family history of breast, ovarian or pancreatic cancer take genetic testing by age 25.
“There are 11 gene mutations, if I'm not mistaken, that are directly linked to breast cancer. You have to take that test, and I want you to take that test by 25”
Listen from 20:09 · Genetic testing
Thais Aliabadi
Aliabadi says women at 35% or higher lifetime risk can take tamoxifen for five years to halve their risk or opt for double mastectomy.
“They can take tamoxifen, which is a hormone blocker, for five years. And by taking that, they can reduce that risk by 50%, which is huge”
Listen from 26:35 · Breast cancer
Thais Aliabadi
Aliabadi says she would make annual pelvic ultrasounds mandatory for every woman.
“If there is one other thing I would change in this country and make it mandatory, I would have every single woman on the planet get an annual pelvic ultrasound”
Listen from 27:47 · Ovarian cancer
Thais Aliabadi
Aliabadi says removing the fallopian tubes significantly reduces ovarian cancer risk because most ovarian cancers start in the tubes.
“if you remove someone's fallopian tubes, you can significantly reduce the risk of ovarian cancer. Because they did a study, 65, some people say 85% of ovarian cancers start in the tube”
Listen from 28:49 · Salpingectomy
Thais Aliabadi
Aliabadi says postmenopausal endometrial lining should be under four millimeters and she biopsies when it exceeds that.
“After menopause, you want that lining less than four millimeters”
Listen from 33:30 · Endometrial cancer
Thais Aliabadi
Aliabadi argues that with Pap smears and HPV screening, cervical cancer is almost entirely preventable.
“get your pap smears and get screened for HPV, there is no reason why anyone should ever die of cervical cancer. It's almost 100% preventable”
Listen from 33:34 · Cervical cancer and HPV vaccine
Thais Aliabadi
Aliabadi says she pushes patients without pregnancy plans to freeze eggs between 28 and 32 because egg count and quality decline with age.
“between 28 and 32, I push my patients to freeze eggs. How come? Because as we get older, the count goes down and the quality of the egg goes down”
Listen from 39:49 · Egg freezing
Thais Aliabadi
Aliabadi says recent data show that hormone replacement within the first seven years of menopause can reduce Alzheimer's risk in APOE4 carriers.
“if you put patients with APOE4 on hormone replacement within the first seven years of menopause, you can reduce their risk of Alzheimer's in life”
Listen from 46:20 · Apolipoprotein E4
Thais Aliabadi
Aliabadi says every woman should know her ApoB level and that she aims to keep it below 60.
“I always tell my patients it's not a magical number, but I want to keep that number below 60”
Listen from 49:27 · Apolipoprotein B
Thais Aliabadi
Aliabadi urges women who are dismissed by doctors to seek second and third opinions.
“If you get dismissed, go get a second opinion. If you still get dismissed, go get a third opinion. No one said you need to be stuck”
Listen from 53:01 · Patient self-advocacy

People

In the conversation

Mel RobbinsAmerican author, podcast host and former lawyer who hosts The Mel Robbins Podcast
Thais AliabadiOB-GYN and fertility expert previously interviewed on the podcast

Discussed

Angelina JolieAmerican actress and Pitt's ex-wife

Topics

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From the publisher

This episode is a MUST listen. It’s one of the most important conversations about women’s health we’ve ever had on The Mel Robbins Podcast. Today, you’re going to learn life-saving information every woman needs to know about cancer prevention, the screenings and tests that could help detect cancer early, and how to advocate for your health at every age. Mel is joined by Dr. Thaïs Aliabadi, MD, a world-renowned OB-GYN, gynecological surgeon, breast cancer survivor, and women's health advocate. Known as Dr. A, she's spent decades caring for women, performing advanced gynecological surgeries, and teaching medical students and residents at Cedars-Sinai Medical Center. Dr. A is also a breast cancer survivor and her story will change how you think about your own health. How many of us assume that if something needs to be checked, our doctor will tell us? So you leave an appointment without asking the question in your mind because you don’t want to seem like you’re overreacting. Dr. A believes all women deserve better health care, and she’s on a mission to help you get it. That starts with knowing what to ask for and how to speak up for yourself. Today, she’s walking you through what might be missing from your annual visit and exactly what to ask your doctor about. You’re going to want to take notes for this one because you’ll walk away with specific questions, a detailed list, and resources that could save your life. In this episode, you'll learn how to: - Calculate your lifetime risk of breast cancer - Understand why you can develop breast cancer without a family history - Find out if you have dense breast tissue - Learn what genetic testing can reveal about inherited cancer risk - Recognize important warning signs of ovarian, uterine, and cervical cancer - Learn which screenings to discuss with your doctor at every age - Prepare a list of questions for your annual doctor's appointment - Advocate for yourself and know when to seek a second opinion By the end of this epi…

Summary, chapters and key points were generated from the episode transcript on November 15, 2026. Quotes are checked word for word against the transcript.

Categories: Medicine·Health & Fitness