Breast Cancer Awareness Month (Let’s Call it Breast Health Month!)

Why Breast Health Matters?

Breasts are a valuable and beautiful part of our bodies, associated with beauty, sexuality, and the best source of nutrition for our children. Breast cancer is increasing in the United States at high rates. And while most women will be cured of breast cancer, it has long-lasting effects on health, and some do not survive.  Prevention is key!  And it’s not just breast cancer we need to be preventing and detecting early, but breast health is reflective of our overall health. Consider setting up an appointment with your doctor to discuss breast health.

How to Keep Breasts Healthy

Movement

Studies show that regular exercise and physical activity reduce breast cancer risk significantly.

Recent updates to the American Cancer Society Guideline for Diet and Physical Activity recommend getting at least 150-300 minutes of moderate intensity or 75-150 minutes of vigorous intensity activity each week. Walking, swimming, biking, tennis, sports, aerobics, really the list is endless.  Find activities you enjoy doing, either with friends or family or alone.

In addition, you should limit sedentary behavior such as sitting, lying down, watching TV, and other forms of sedentary entertainment. This is especially important if you spend most of your working day sitting.  And if you do spend the majority of your day sitting, make sure you get activity breaks where you get up and walk around or do short bout of exercise for 5-10 minutes every 1-2 hours.

Healthy Eating

A healthy eating plan includes 5-8 servings of vegetables and fruits/day with 2-3 servings of healthy protein. When buying organic is an option, that is best, especially when those are on the “Dirty Dozen” list (foods highest in pesticides and herbicides) and avoiding high hormone foods like conventional dairy which has excess hormones added to increase production.  Avoid red meat, processed foods like food that comes in a package with a list of 20+ ingredients, many which you can’t pronounce, and sugar.

Limit Alcohol

Alcohol decreases the liver’s ability to detoxify other compounds, such as estrogen, and industrial chemicals we are exposed to daily.  Studies have shown that excess alcohol consumption increases risk of breast cancer.  Women should consume no more than 1 alcohol drink per day.

Caution with hormone replacement therapy (HRT)

Studies show that HRT using a combination of estrogen and progestin increases the risk of breast cancer. Fortunately, the increased risk returns to baseline within 3 years of stopping the HRT.  Bioidentical hormone therapy is an alternative option to the one-size-fits all approach to pharmaceutical hormone therapy but does not have FDA approval at this time and there is controversy to whether it is safer.  Whether using bioidentical or not, it is recommended to take the lowest possible dose for the shortest duration possible.

If you’ve had a hysterectomy, estrogen alone (delivered via patch or cream preferably, as metabolism through the liver can be problematic with orally taken estrogen) is typically recommended.  If the uterus is intact, progesterone plus estrogen is necessary to balance the estrogen alone risks on the uterus.

Talk with your doctor about all the options.  If someone is more than 10 years post-menopause, it is recommended against starting HRT if not already on.

If you are concerned about your own hormones, talk with your doctor or see a specialist to consider checking an advanced hormone panel, which can identify different hormone metabolites that can increase your risk of hormone-related cancers like breast and uterine cancer. A functional medicine doctor or hormone specialist can help.  There are natural ways to reduce these harmful metabolites.

Self-Breast Exams

Get to know your breasts.  Scheduling a session to examine your own breasts monthly is recommended. Up to 40% of breast cancers diagnosed start when a woman finds an abnormality.  Early detection and treatment are key to curing breast cancer.

Breast Self-Exam, courtesy of the National Breast Cancer Foundation

1) In the Shower

With the pads/flats of your 3 middle fingers, check the entire breast and armpit area pressing down with light, medium, and firm pressure. Check both breasts each month feeling for any lump, thickening, hardened knot, or any other breast changes.

2) In Front of a Mirror

Visually inspect your breasts with your arms at your sides. Next, raise your arms high overhead.

Look for any changes in the contour, any swelling, or dimpling of the skin, or changes in the nipples. Next, rest your palms on your hips and press firmly to flex your chest muscles. Left and right breasts will not exactly match—few women’s breasts do, so look for any dimpling, puckering, or changes, particularly on one side.

3) Lying Down

When lying down, the breast tissue spreads out evenly along the chest wall. Place a pillow under your right shoulder and your right arm behind your head. Using your left hand, move the pads of your fingers around your right breast gently covering the entire breast area and armpit.

Use light, medium, and firm pressure. Squeeze the nipple; check for discharge and lumps. Repeat these steps for your left breast. 

Breastfeeding

Not every woman will choose or be able to bear children, and not every woman will be able to breastfeed their child, but if able to, breastfeeding is not only the best source of nutrition for the baby, but also benefits the mother.  Breastfeeding increases prolactin production suppressing estrogen for the period of time the mother breastfeeds. Researchers have found that for every 12 months a woman breastfeeds, her risk of breast cancer is decreased by 4.3%.

Xenoestrogens and Industrial Chemicals

Every day we face a barrage of chemicals, from turning on our gas-powered car, turning on our tap water used for drinking, cooking and bathing.  We may not realize it, but industrial chemicals and Xenoestrogens (chemicals that mimic estrogen and bind to estrogen receptors abnormally, some which are linked to increased risk of cancer) also are in our soaps, detergents, cosmetics and skin care products.  Paying attention to these and removing them as much as possible from your life, can go a long way in preventing these chemicals from interfering with our health. The Environmental Working Group is a great website to consult when searching for safe products to use in our home and on our skin.

Breast Imaging – for early breast cancer detection

Mammograms are considered for women 40-45, and recommended annually age 45-55 and then every 2 years, with some variations in recommendations from different expert organizations – some recommending annual vs every 2 years (American Cancer Society,  U.S. Preventive Services Task Force (USPSTF) and the American Academy of Family Physicians (AAFP), and American College of Obstetricians and Gynecologists (ACOG) and the American College of Radiology (ACR).  Thermograms are an increasing method for imaging breast tissue.  There is a perceived benefit of lack of radiation exposure, but also, there appears to be likely a lower detection rate and these are not approved currently by the FDA as a reliable method of breast cancer screening.  If a woman is high risk for breast cancer, screening may need to begin earlier and more frequently.

Breast Augmentation or other Cosmetic Surgery

Whether pursuing breast surgery for cosmetic reasons or as reconstruction after a mastectomy, carefully consider the risks and benefits and discuss these with your trusted physician.  Breast implants now have a black box warning for increasing risk of a rare cancer, breast implant associated anaplastic large cell lymphoma (BIA-ALCL) or systemic symptoms described as “breast implant illness.”  In addition, some breast implant patients have reported systemic symptoms such as fatigue, memory loss, rash, brain fog and joint pain, and the term breast implant illness has been used to describe the symptoms. Additionally, there is concern for increased risk of autoimmune disease.