Breast Health Series: Part VI – Improving the Odds for Healthy Breasts
We are offering this series of papers by local practitioners from both western and eastern practice that provide valuable information for wellness and disease prevention.( Click here for the entire Introduction )
Part VI -Improving the Odds for Healthy Breasts By Michelle LeBlanc, M.D., Western Carolina Women’s Specialty Center, breast specialist
Improving the Odds for Healthy Breasts By Michelle LeBlanc, M.D., Western Carolina Women’s Specialty Center, breast specialist
Each day I treat women with a variety of breast issues. I see the fear and anxiety in their faces as we explore causes for their issues, so I understand how important it is to determine a diagnosis quickly, using all my skills and the technology available in our office. The vast majority of the time these issues are treatable and not life threatening. It brings me great satisfaction to assure and treat women who come to me for help.
Many women ask me how to keep their breasts healthy, how they can prevent breast cancer, and what to do if they suspect cancer. The basic tools for healthy breasts are similar to things we all should do to be healthy in general—a diet that is low in fat and high in fresh fruits and vegetables, regular exercise, minimal alcohol, maintaining a healthy weight and avoiding smoking.
One in eight women will develop breast cancer in her lifetime—that’s a sobering statistic. So what can we do to prevent this or catch it early when cure rates are very high? In my opinion, one of the most important screening tests a woman can have is an annual mammogram starting at age 40, sooner if you are at higher risk for breast cancer. Mammography remains the gold standard for discovering early breast cancer, and most major medical societies that treat breast cancer recommend this annual diagnostic tool.
Some patients have asked me about the use of thermography as a diagnostic tool—I do not recommend this, nor does the FDA. There are no compelling studies and no efficacy results.
I also recommend starting an annual office exam at age 25. Regular self exams are also important—we should all be familiar with our own breasts so we know when something changes. When you conduct a self exam, be sure to look for skin dimpling, thickening or redness, new lumps, nipple discharge or breast pain. If any of these are present contact your physician.
Not sure how to do this? Here’s a link to learn more. You can also ask your doctor to show you how.
There are several factors that increase the risk of breast cancer. Some of the factors include:
getting older; most women diagnosed are in their 50s and 60s
age when your periods started
age when you go through menopause
If you have a family history of breast or ovarian cancer, whether it’s in your immediate family or extended family, your risk is somewhat higher. If you know about this history, you may want to consider proactive measures such as more extensive and frequent physical exams, and possibly gene testing. Science has discovered a specific gene that indicates a predisposition to cancer. However, about 75% of women with breast cancer do not have a family history.
Ask your doctor about genetic testing or consider seeing a breast specialist to discuss your family history and personal risks for breast cancer.
Long term use of hormone replacement therapy (combination of estrogen and progesterone) also increases your risks for breast cancer. You should weigh the benefits versus the risks before deciding to begin or discontinue this therapy, and discuss the pros and cons with your doctor.
Regardless of what we do or don’t do, we are all at risk – even thin, active women who run 20 miles a day may develop breast cancer—it’s an equal opportunity disease. The most important things you can do to lower your risk are to be aware, to take advantage of the diagnostic tools available today, and to find a gynecologist or other physician you trust and schedule regular appointments for checkups.
Michelle LeBlanc, M.D., is a board certified gynecologist specializing in breast issues. She is a principal in Western Carolina Women’s Specialty Center in Asheville, NC. She is also a Fellow of the American Board of Obstetricians & Gynecologists. Dr. LeBlanc treats benign and malignant breast conditions using breast ultrasound, minimally invasive stereotactic biopsy and surgical biopsy, and performs breast-conserving procedures and standard surgical treatment. Please send questions or comments to firstname.lastname@example.org
Nutrition and Breast Cancer Prevention By Jeffrey Whitridge RD LD CSO
Hippocrates once stated, let thy food be thy medicine and thy medicine be thy food. Nowhere is this statement truer than in our relationship to health, cancer risk and disease. The focus of this segment will nutrition and cancer prevention in relation to breast cancer. Also, as a health educator I am providing important resources that promote or facilitate lifestyle change. These references demonstrate key points about the optimal diet and nutrition guidelines to follow for breast cancer prevention.
First lets look at the cancer prevention information from the American Cancer Society and the American Institute of Cancer Research. Both are similar in that they emphasize health maintenance behaviors that reduce cancer risk through prevention. The American Cancer Society guidelines include maintaining a healthy weight throughout life, adopt a physically active lifestyle and eat a healthful diet with an emphasis on plant sources. The American Institute of Cancer Research guidelines recommend choosing mostly plant foods, limit red meat and avoid processed meats, be physically active every day for 30 minutes or more and aim to maintain a healthy weight throughout life. They also provide evidence based research in their report Food, Nutrition, Physical Activity and The Prevention of Cancer: A Global Perspective for pre and postmenopausal breast cancer prevention. So why all this insistence on maintaining a healthy weight? The rational is that an increased body mass index (BMI) toward obesity ranges is an increased risk factor for breast cancer. This is just one reason why breast cancer prevention and weight management are important.
Next lets review anti-inflammatory eating and breast cancer prevention. Dr Andrew Weil in his book, Healthy Aging outlines a style of eating known as anti-inflammatory. Anti-inflammatory eating includes: choosing a variety of food, eating as much fresh food as possible, minimizing consumption of processed or fast foods and eating an abundance of fruits and vegetables. A component of dietary intake that influences breast cancer progression includes hormonal regulation from estrogens, progesterone, insulin and growth factors. The reason this concept is so important for breast cancer prevention has to do with the consumption of saturated fat and cholesterol influencing the inflammatory process. Cancer prevention and nutrition focuses on reducing cancer risk through plant based eating to reduce saturated fat and cholesterol to lower the bodies overall exposure to inflammation. Ways to do this include changing the composition of fats consumed from processed, saturated fats high in cholesterol to plant-based fats rich in beneficial fats from omega 3 fatty acids like walnut, flax and fish oil. The positive recommendation is to increase your intake of monounsaturated and polyunsaturated plant-based fats instead of animal-based fats rich in saturated fat and cholesterol.
There is not enough that can be emphasized about the importance of eating enough fruits and vegetables. We have been hearing about high antioxidant, phytonutrient, phytochemical constituents of fruits and vegetables for a long time. Also, the 5 A Day campaign has been around for years – plain and simple, eating more fruits and vegetables will help protect you from cancer.
This leads to another area of cancer prevention that has to do with altered carbohydrate metabolism. Early we talked about insulin and growth factors in hormone regulated cancers like breast cancer. There is a growing body of research that is looking into the alteration of metabolism as a potential mechanism in the development of cancer. This is why we have been hearing that not all carbohydrates are created equal. A fundamental component of cancer prevention and eating now focuses on low glycemic index carbohydrate eating. Anticancer by Dr David Servan-Schreider gives a list of foods to include as well as foods to avoid for cancer risk reduction eating. Also included is a dedicated website for low glycemic index eating.
In summary, an eating pattern to follow for breast cancer prevention is plant based in nature, low in fat and animal proteins, high in fruit and vegetables that includes nuts and seeds. Benjamin Franklin’s words hold true for cancer prevention: an ounce of prevention is worth a pound of cure.
American Cancer Society: http://www.cancer.org/Healthy/EatHealthyGetActive/index
American Institute of Cancer Research: http://www.aicr.org/site/PageServer?pagename=reduceyourcancerrisk_home
Positive Health Wellness, Anti-Inflammatory Foods: https://www.positivehealthwellness.com/diet-nutrition/9-top-anti-inflammatory-foods-put-kids-diet/
Dr David Servan-Screiber Anticancer http://www.anticancerbook.com/
Low Glycemic Index Eating http://www.glycemicindex.com
Jeffrey Whitridge RD, LCD, CSO is a registered dietitian nutritionist, and certified specialist in oncology nutrition with 15 years of clinical experience. Jeffrey.email@example.com
Part III – Herbs for Healthy Breasts By Amy Branum, Herbalist
Breast Cancer Prevention begins with observing our entire being; what foods we eat, the environment we live in, and even our attitude about ourselves. When considering our health, we must look at all aspects of our lives, including who and what we surround ourselves with.
Regular exercise is important for all aspects of a healthy person. In regards to our breasts, we want to reduce stagnation. Exercise gets your blood pumping, increases circulation and stimulates the lymphatic system. Strengthening the body and our immune system is our first defense against breast cancer.
Let your breasts free! Many women have experienced a reduction in breast lumps when they reduce the length of time wearing a bra. If you are not comfortable with going bra-less in public, at least take it off as soon as you get home. Bras can reduce proper circulation to the breasts, reducing the natural ability to remove any toxins and blocking the flow of the lymph.
Defend your self with your diet. Good foods are necessary to aid in decreasing breast cancer risks. Eat at least 5 servings a day of fresh fruits and vegetables. Be sure to incorporate garlic, onions, and members of the cabbage family- kale, broccoli, turnips, radishes, and cauliflower as these are especially beneficial. They are more abundant in the anti-cancer compounds, glucosinolates and myrosinase enzymes, than any other food.
Only eat organic meats and dairy. Commercially produced meats are usually full of antibiotics, PCBs, dioxins, and growth hormones- all of which have a negative effect on breast health. Grain fed meats and dairy are high in Omega 6 fatty acids, which when eaten in excess of Omega 3s, can cause inflammation, blood clotting, and promote cell proliferation.
Animals that are grass fed and naturally raised do not have these effects and are perfectly safe to eat in moderation. The fats in natural dairy products may even be beneficial for breast health.
Avoid Xenoestrogens. Xenoestrogens are synthetic chemicals such as PCBs, BPA, and dioxins that mimic natural human estrogen. Considered hormone disruptors, their chemical structure allows them to fit into estrogen receptors which can increase cell proliferation, and increase the risk of breast cancer. Xenoestrogens can also disrupt menstrual cycles and contribute to fibroids, endometriosis and polycystic ovarian syndrome. These chemicals are all around us, in plastics, fertilizers, pesticides, detergents, non-organic meats, chlorine, and other cleaners, even on your store receipts! Reduce your exposure by using as little plastic as possible, especially when storing and heating up foods, choose biodegradable cleaners and detergents, avoid fabric softeners, choose non-bleached paper products- including tampons and menstrual pads, eat organic, wash your veggies, determine that your meat products are organic and hormone and chemical free.
Get some help from the plants. Herbs have always assisted women in improving breast health. As of 2005, it was found that 80% of women with breast cancer were using some sort of alternative medicine. In herbal medicine, it is first important to consider the overall immune system, strengthening it with herbs such as reishi, astragalus, and eleuthero which help to modulate the immune system. Lymphatics such as red root, violet leaf, and poke root are also important in keeping the lymph system moving and working properly.
any herbs have been clinically proven to be effective against breast cancer. Reishi, Ganoderma lucidum, and Chenopodium album, also known as lamb’s quarters, have been found to suppress the growth of breast cancer cells. Chenopodium has also been found to enhance cell toxicity in breast cancer cells. Lamb’s quarters is a weed that you probably pull up in your yard. An accessible and tasty wild green, its leaves can be cooked like spinach or kale and can be easily incorporated into your diet or infused in an oil as mentioned below. Check a field guide or with a local botanist for positive identification.
Ganoderma lucidum has long been a cancer remedy in Chinese medicine and other herbal traditions. It is an immunomodulator, meaning it helps to regulate the immune system, therefore reducing the inflammatory response. This makes it beneficial when working with cancers and autoimmune disorders. Reishi has been shown in clinical studies to suppress invasive breast cancer and inhibit cell proliferation.
Red clover, Trifolium pretense is probably one of the most commonly known herbs used for breast cancer. It contains all four classes of phytoestrogens: lignans, coumestans, isoflavones and resorcyclic acid lactones. These phytoestrogens are used to help alleviate menopausal symptoms, as they bind to estrogen receptors without causing the effects of estrogen abundance. In a 2004 clinical trial, red clover, used in place of hormone replacement therapy (HRT), was found to not increase mammographic breast density as HRT does.
These herbs all work great as an internal tonic. Use extracts, capsules or teas, but make sure that you purchase a quality product.
Externally, herbal infused oils are great for massaging into the breasts. They can both help to prevent and reduce breast lumps. Violet leaf, red clover and Chenopodium are easily accessible (usually in your yard!) and have all been used effectively to dissolve lumps. An infused oil can be made by placing the dried plants in a jar and covering with olive or another quality oil. Cap the jar and keep in a warm place away from direct light, shaking every day for at least 2 weeks. Strain and massage onto the breasts weekly. Use daily if lumps are present.
Poke root oil is a slightly stronger oil that has been used effectively in cases of stubborn breast lumps, but can be more harsh and irritating. This can often be acquired through your local herbalist.
Improving breast health with herbs is not a complicated process. Most of the herbs that have been found to benefit the breasts are easy to find- many of these are even in your back yard! It can be as simple as celebrating yourself with a daily cup of tea. Let go of any issues you may have surrounding your breasts, and give them some herbal love. Women have worked with the plants for support through many generations. When we look at the science, it seems almost a miracle that these plants were made so perfectly to work for us. It is difficult to argue that this is not part of a divine plan. Take advantage of this magic and enjoy these plant gifts, nourishing your breasts, body, and spirit.
Links to research referenced in this article:
Part – II Lymphatic Drainage Creates Healthy Breast Tissue By Lynn Harris, LMT
Study of the body’s lymphatic system show that breast tissue contains an abundance of lymph vessels. Unlike other areas of the body, however, the breast lacks sources of external compression, such as muscles or strong overlying fascia that promote natural lymphatic drainage. As a result, fluid has a tendency to stagnate, which may lead to breast pathologies (mastopathy). This is where gentle, non-stimulating techniques such as lymphatic drainage can be applied to aid fluid recirculation.
Lymph drainage therapy (LDT) is a gentle technique with few contraindications. We are able to open up pathways for the lymph to flow more freely, allowing it to flush through the body unimpeded as it’s meant to do. The lymphatic flow can stagnate for many reasons, such as swelling, chronic inflammation, lack of physical activity, stress, fatigue, emotional shock, age, poorly fitted brassieres, or brassieres worn for an excessive amount of time. When lymphatic circulation slows down, the regeneration of cells becomes less effective. This condition allows toxins and proteins to accumulate around the cells, causing cellular oxygenation to decrease and tissue regeneration to diminish.
LDT is particularly effective for treating breast tissue because it involves extremely light pressure. Numerous mastopathies respond well to lymphatic breast care, including: menstruation related problems such as breast pain or swollen breasts, and edema; pregnancy and breast-feeding problems – sore nipples, inflammation/infection – mastitis, plugged ducts, and stretch marks; chronic nonmalignant lumps, breast implant complications, cosmetic concerns, and lymphadema.
Within the context of breast care, LDT can help alleviate numerous conditions related to pregnancy, including engorgement, sore nipples (transient, chronic), plugged ducts, wounds, fissures, ulcerations, bruises and dermatitis (eczema). This therapy also can provide relief from chronic inflammation and pre- and post-surgical applications, and can be used for cosmetic applications, such as scars.
It is time for gentle and efficient breast care to be brought into the realm of accepted practice. Lymph Drainage Therapy is a gentle, light-touch, noninvasive technique that offers qualified therapists a natural complement to their existing health care protocols. Of the many modalities I have studied and practiced throughout my career, lymphatic work is always the first approach I turn to in treating the breast.
Lynn Harris, LMT is a licensed massage therapist with advanced training in Lymphatic Drainage from the Chikly Health Institute. Her office is in Asheville NC. Click here for her website
This article was written using references from articles written by Bruno Chikly, MD. Please visit http://www.chiklyinstitute.org for more information.
Part I – How Do We Maintain Breast Health? By Susan Shinn, OGNP
What does that phrase mean? Can we really avoid breast cancer by our lifestyle choices? This article is meant to begin a conversation about breast cancer and breast health. I’m writing from my perspective as a women’s health nurse practitioner. For years now, my work has specialized in cancers that affect only women: breast and gynecologic tumors. Every day in my practice I meet women with breast cancer, and frequently spend an hour or more with women who are newly diagnosed and trying to understand how and why this disease has come upon them.
Breast cancer is probably the most dreaded illness for women in this country. We fear it far more than we fear heart disease or diabetes. Women’s feelings about their breasts are complex: very few of us are fully comfortable in our bodies at all—even those who look like models find fault. Many women have a love/hate relationship with their breasts: vaguely or strongly dissatisfied with their appearance, we may nonetheless enjoy erotic sensations and the experience of breastfeeding a child, if we do that. But once our childbearing years are over, many of us look at our chests as time-bombs waiting to explode. If we do breast self-examination, we dread what we might find and often do a patchy job of it as a result. We may avoid mammograms, when they’re appropriate, or worry about symptoms that are normal. To make things even more difficult, it seems as if every time you read or hear something about breast health or cancer, it contradicts something else you thought you knew. And worst of all, most of us know an increasing number of women with breast cancer.
Science has identified a number of risk factors for breast cancer, although the majority of us with some risk factors don’t get the disease. Some things we have influence over and some we don’t: being female is, of course, the main item on the list. You know that breast tissue responds to female hormones, and you may also know that about ¾ of breast cancers are more or less stimulated by the presence of estrogen/progesterone. Other unchangeable factors include age, family history, age at which your periods start, how old you were when and if you had a full-term pregnancy, and when you go through menopause. If you ever took DES (di-ethylstilbestrol, an estrogen used until the early 1970s to prevent miscarriage) your risk is higher. If you had to receive radiation therapy to your chest for something like Hodgkin’s disease, that’s another risk factor. While family history does matter, truly inherited breast cancer is not common: only about 10% of women with breast cancer carry a currently identifiable gene mutation. Other risks over which we have no control include the density of our breast tissue and whether or not we have had a previous breast biopsy—and if so, exactly what the result was.
The majority of women who develop breast cancer do so in their 50s and 60s, although in our practice we do see many younger women as well. It’s very rare for breast cancer to occur before age 30, but it happens. One of the reasons that it seems that there’s an awful lot of breast cancer now is that most of the women reading this article are in an age range where it’s more likely to develop: the older we get, the more of us will develop cancer, even though the overall statistic for incidence is still 1 out of 8 women over a lifetime in this country. The baby boom generation is a big group of people in the age range for breast cancer. According to the National Cancer Institute, at http://www.cancer.gov/cancertopics/factsheet/detection/probability-breast-cancer ,an “average” woman’s chance of being diagnosed with breast cancer is:
from age 30 through age 39: 1 in 233
from age 40 through age 49: 1 in 69
from age 50 through age 59: 1 in 42
from age 60 through age 69: 1 in 29.
A significant contributing factor to what seems an excessive number of people getting breast cancer now is that more and more of us are overweight or obese. We know that excess body fat increases the risk of breast cancers and some other cancers as well. Other risks that we have some control over include our level of alcohol use even a few drinks a week increases our risk, our physical activity level (more is better, for most of us), smoking, and the use of some types of hormone therapy (HRT).
Long term use of combination estrogen/progesterone HRT was found in the Women’s Health Initiative to increase the risk of breast cancer, slightly—and subsequently the same study found that the use of estrogen alone, which is okay if you have had your uterus removed, probably has a slightly protective effect. While current or recent use of hormonal contraceptives means a small increase in risk, having used birth control pills in the past is not a risk factor.
Dietary influences are still being clarified, and you’ll read more about that topic from other writers in this series. Breast augmentation is generally safe, although implants may decrease the accuracy of mammograms and there was recently confirmation of an association between breast implants with a very rare type of lymphoma. Remember that an association doesn’t necessarily mean a cause-and-effect relationship, and no one is recommending that women with implants have them removed.
Many things in our lives get “linked” to cancer, and many reports in the media are misleading or incomplete if not actually false. Some things that are reputed to be risky, like using aluminum-based antiperspirants and underwire bras, haven’t really held up to scientific scrutiny as contributing factors—although avoiding one or both of them won’t hurt you. It’s also not true that having had an abortion increases your risk for breast cancer. Previous concerns about a link between night work and breast cancer seem not to be justified. It is true that flight attendants have a slightly increased risk—probably because they get more daily radiation in their work at high altitude.
What about family history? Having even one first-degree relative (mother, sister) with breast cancer increases your risk. If that woman was post-menopausal when she was diagnosed, that’s less risky than if she was in her 30s. If there are many women in your family with breast and/or ovarian cancers, or if a male in your family has had breast cancer, that’s a reason to consider genetic testing. This is a link to the National Cancer Institute’s information page about BRCA genetic testing: http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA
Clearly we can make some choices to help reduce our risk of cancer, from relatively simple ones like getting more exercise and getting our weight into normal range to more dramatic ones, like taking tamoxifen if our risk is significantly higher than average or having preventive mastectomy if we learn that we have a BRCA 1 or 2 gene mutation. We tend to focus on, and worry about, the things we can’t control instead of acting on what we actually can influence. Yet there really are many environmental influences that we don’t yet measure or recognize, and some of them may turn out to play a role in the development of cancers.
And finally, a word here about breast self-examination: while there’s recently been media coverage of research saying BSE doesn’t save lives, there’s real value in our knowing our bodies and recognizing changes. Rather than doing a monthly sweep for land-mines in our breasts, how about a thorough, nurturing self-breast massage once a month? Pay attention, but use some wonderful oil or lotion that is too special for every day, and consider it an act of love for your body.
Susan Shinn, MSN, OGNP, AOCN is a nurse practitioner certified in women’s health care since 1985. For the past 10 years her practice has focused primarily on women with gynecologic and breast cancers. Originally drawn to nursing from a alternative/complementary perspective, she understands the importance and the limitations of scientific research in defining our knowledge about health and illness. She works for Hope Women’s Cancer Centers in Asheville, North Carolina. Please send questions or comment to firstname.lastname@example.org