A critical tool in the fight against breast cancer is population screening. Early detection, surgical intervention +/- further treatment has dramatically reduced advanced disease and mortality rates but it still remains the most common cancer worldwide.

In this episode, we focus on the history of breast cancer, the development of mammograms and early detection with our understanding of the underlying pathology. Our special guests include:

Associate Professor Michelle Reintals is the Director of BreastScreen South Australia and an Australian trained radiologist with extensive and international experience in breast screening and mammography.

Associate Professor Wendy Raymond is a histopathologist who has specialised in breast pathology and cytology. A/Professor Raymond is a past president of the Australian Society of Breast Disease and co-edited the IAC Yokohama system for reporting breast FNA biopsies.

This is the first part of a two-part series on breast screening, focusing on the present. The second part (coming soon) will focus on the future.

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Our understanding of the world today is constantly changing. What was once considered truths and facts can, in hindsight, be seen as misguided or wrong. It may be challenging to accept but becomes evident over time that the things we learn today may become irrelevant or superseded in the future and this is particularly relevant to medicine.

Scientometrics is the quantitative study of science and the rate at which change occurs. Today, we discuss this topic with scientist and author Sam Arbesman, to ask the following question: what is the rate of change of facts in the field of medicine?

Our special guest is Sam Arbesman who is a scientist and author of Overcomplicated: Technology at the Limits of Comprehension and The Half-Life of Facts.

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Vitamin D has been a controversial topic in recent times with the debate continuing over appropriate testing, adequate levels, and the evidence for treatment. We discussed the appropriateness of testing and chemical pathology component with Professor Ken Sikaris (Episode 25), but what does the research tell us about diseases associated with Vitamin D and the utility of replacement? We discuss this with Professor Scott Byrne from The University of Sydney.

Our special guest is Professor Scott Byrne from the Westmead Institute for Medical Research. Professor Byrne is also Co-director of the Centre for Immunology and Allergy Research and Head of the Cellular Photo-immunology Group in the School of Medical Sciences at Sydney University.

This is the second chapter in the story of Vitamin D.

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Professor Peter Doherty trained as a veterinarian before venturing into immunology research. Professor Doherty travelled extensively throughout his career and has undertaken numerous research posts around the world. The achievement that he is most noted for is he was able to demonstrate how the body distinguished between virus-infected cells from non-infected cells and was awarded the Nobel Prize for Physiology or Medicine in 1996. However, there is far more that he has achieved throughout his career.

Professor Doherty has been a strong advocate for science communication to the general public at large. He has written numerous books, commented extensively on environmental sustainability and climate change, as well as an active participant and medical voice to the public during the recent Covid-19 pandemic.

Our special guest is Professor Peter Doherty, Nobel Prize winner in Physiology or Medicine 1996, Author, Science commentator, and Professor at the faculty of medicine at the University of Melbourne.

This is the story of Professor Peter Doherty.

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The double helix structure of DNA was the discovery of the century. However, the story about the discovery is mired in controversy as one of the major contributors, Rosalind Franklin, was conspicuously absent from acknowledgements and died (and subsequently not named) before the Nobel Prize was awarded.

In 1968, James Watson wrote the book ‘The Double Helix: A Personal Account of the Discovery of the Structure of DNA’ and reads more like a fictional detective novel than an autobiographical account with the portrayal of Franklin as a forceful, gruff and confrontational. Recently, an article in Nature shows an unpublished news article from 1953 (at the time of the discovery) that Franklin’s contribution was crucial to uncovering the structure of DNA.

Today, we talk to one of the authors of the article in Nature, Nathaniel Comfort, who is Professor of the History of Medicine at John Hopkins University. Link to the article: https://www.nature.com/articles/d41586-023-01313-5

Our special guest is Professor Nathaniel Comfort from the John Hopkins University. His interest lies in the histories of genetics, eugenics, genomics and biomedicine. He has authored two books (The Tangled Field and The Science of Human Perfection), written for Nature, The Atlantic, The Nature as well as appeared on PBS, National Public Radio and the BBC.

This is the story of the DNA double helix.

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Essentially every culture, modern or ancient, understood that health and faeces are inherently linked. The Ancient Chinese practiced ‘copromancy’ which was the assessment of health based upon the shape, size and texture of faeces. Today we have the Bristol Stool Chart that helps us to classify faeces/poo into seven different groups. As disconcerting as it may be, the state of our poo can tell us a lot about our own health and this is only going to increase as our knowledge about our faecal microbiome expands.

The faecal microbiome is the composition of all the microorganisms within our faeces. We are learning that the composition not only affects our health but can also be contributory to diseases we experience. In some circumstances, this has also become a treatment with faecal transplantation to manage treatment resistant clostridium-difficile colitis.

This is the story of the faecal microbiome.

Our special guests:

• Dr Piers Mitchell, who is a hospital specialist consultant in the NHS and co-editor of the International Journal of Osteoarchaeology. Dr Mitchell has trained in paleopathology, osteoarchaeology, parasitology, medical history, and orthopaedic surgery.
• Dr Vincent Ho, who is a Gastroenterologist practicing in NSW, is an Associate Professor at Western Sydney University and head of a research laboratory.

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In 1891, Guido Werdnig documented two cases of brothers who had global progressive muscular weakness. In 1935, Dr Dorothy Anderson conducted an autopsy on a young child who had died from malnutrition due to suspected coeliac disease despite being on the upon treatment. In 1943, in inherited form of intellectual disability in boys was described by Martin and Bell. The diseases are Spinal Muscular Atrophy, Cystic Fibrosis, and Fragile X syndrome respectively. The learning curve for genetics in the last 100 years has been a steep one.

Recessive genes circulate in the general community and for the most part, they are hidden and play no part in day-to-day life. Some may even have had a survival advantage in pre-modern times. However, if two parents each carry matching recessive genes, there is an increased chance that their children can have a severe or even life-threatening illness. Carrier screening provides a test for parents to assess this risk, however, it also requires an understanding of the testing paths, risks and cost from requesting doctors.

This is the story of carrier screening

Our special guest is Professor Graeme Suthers who is the Director of Sonic Genetics Australia.

Additional information:

Link to further information about reproductive carrier screening: https://www.sonicgenetics.com.au/patient/test-information/rcs/

Link to carrier screening online patient course: https://www.sonicgenetics.com.au/patient/test-information/rcs/carrier-screening-online-patient-course/

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Seasonal influenza causes significant morbidity and mortality every year but can often fall into the underestimated category. Between 10-30% of the general population are infected each year with influenza that leads to an increase in hospital and intensive care unit admissions, the onus for prevention and early intervention has never been more important.

Our special guest is Associate Professor Paul Griffin from the School of Medicine at the University of Queensland and is an Infectious Disease Specialist at Mater Health.

This is the story of influenza.

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In 1998, a 6 page report published in the Lancet that would later be described as one of history’s great science frauds. The article was titled “Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive development disorder in children” but the news headlines ran with a much shorter version: the MMR vaccine causes autism.

The article was written by Andrew Wakefield, a British gastroenterologist turned researcher, who had taken it upon himself to deceive the medical community and general population at large. Fortunately, investigative journalist Brian Deer uncovered the truth behind this ‘study’ through hard work, significant obstacles and persistence.

Although Wakefield’s claims have been thoroughly discredited, we still feel the impact of this fraud to this day and he has become an icon of the anti-vax movement.

Our special guest is Brian Deer who is an award winning investigative journalist and bestselling author for The Doctor that Fooled the World, published in 2020.

This is the story of the MMR vaccine fraud.

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In 1834, Robert Graves gave a lecture series on the ‘Newly observed affection of the thyroid gland in females’. He presented three women who had violent palpitations, enlarged thyroids, and an apparent enlargement of the eyeballs (later it would be called ‘exophthalmos’).

In 1912, Hakaru Hashimoto reported a new disease in a German journal after examining microscopically the thyroid tissue from four middle-aged women. He noted the lymphocytic infiltration and likened it to other conditions containing lymphocytes (ie. Sjögren syndrome) and named it ‘Strum lymphomatosa’.

It would not be until the 1950s that the underlying mechanism of these diseases would be known: autoimmunity. The former, now known as Graves’ disease, and the latter Hashimoto disease are the most common causes of hyperthyroidism and hypothyroidism respectively.

Our special guest is Dr Daman Langguth who is an immunology and Head of the Immunology Department at Sullivan Nicolaides Pathology.

This is the story of autoimmune thyroiditis.

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