An Integrative Approach to Breast Health and Cancer Prevention

In honor of Breast Cancer Awareness Month, today’s article will dive into what you need to know about breast cancer and offer an integrative perspective. We can use the best of both worlds – allopathic screening tools and holistic cancer prevention approaches.

Keep reading to learn more about:

• Breast cancer statistics
• Perimenopause, menopause, and breast health
• Risk factors for breast cancer
• Breast cancer screening recommendations
• Breast health lifestyle suggestions

Let’s get started with this critical information for every woman!

Breast Cancer Statistics

Breast cancer is a global health challenge. It’s the most common cancer globally and the leading cause of cancer deaths in women, with 2.26 million cases in 2020. Once thought of as a more Western disease, half the diagnoses are now in developing countries, where breast cancer deaths are higher.

In the United States, one in eight women will be diagnosed with breast cancer in their lifetime. Most breast cancer cases in the U.S. occur in postmenopausal women, and the median age of diagnosis is 62.

Breast Changes in Perimenopause and Menopause

Estrogen (link to estrogen article) plays a crucial role in breast health. Estrogen promotes breast growth in puberty and supports breast changes in pregnancy and lactation for milk production. Estrogen also supports skin structure and elasticity.

In perimenopause, estrogen levels fluctuate, and you may experience months where your breasts feel sore or lumpy. Often, these changes resolve when your period starts, but if not, check in with your doctor.

In menopause, estrogen levels settle at a much lower level than the reproductive years. You will no longer experience monthly breast changes with your cycle but may notice that your breasts in menopause look and feel different than they did before. Some women report smaller breasts, and others see an increase in breast size, possibly because of changes in weight or metabolic health. It’s always good to discuss breast changes with your healthcare provider.

Breast Cancer Risk Factors

Several hormonal and reproductive factors correlate with an increased risk for breast cancer. These include:

• Early puberty
• No pregnancies or fewer pregnancies
• Older age with first pregnancy
• Older age at menopause
• Not breastfeeding or breastfeeding for a shorter duration
• Prolonged use of oral contraceptives

Essentially, the data shows lifetime exposure to estrogen is associated with more risk.

It’s important to note that estrogen isn’t the cause of breast cancer. Cancer is a multifactorial chronic disease involving genetics, inflammation, metabolic and immune dysfunction, estrogen detoxification, and many other factors. Women in menopause have the lowest estrogen levels in their lives, yet the risk is most significant after menopause.

Other breast cancer risk factors include:

• Obesity
• Increased alcohol consumption
• Sedentary lifestyle
• Late night work schedule/shift work
• Poor diet
• Smoking
• Environmental toxicants
• Race or ethnicity – more common in black women, higher death rate
• Genetics

Genetics only accounts for 5-10% of cancer risk, involving the BRCA1, BRCA2, or other genes. Most women diagnosed with breast cancer don’t have a first-degree relative with breast cancer.

The lifestyle and environmental risk factors are largely within our control. We can reduce risk with lifestyle change and preventative, integrative medicine.

Breast Cancer Screening and Diagnostic Testing

Monthly self-breast exams are no longer recommended; however, it’s important to be aware of how your breasts look and feel. If anything changes, see your doctor.

The standard of care in breast cancer screening is the screening mammogram, which is a low-dose x-ray. The current guidelines for women with an average risk vary by the organization making the recommendation. Here are the guidelines from the American College of Obstetricians and Gynecologists (ACOG), the U.S. Preventative Services Task Force, and the American Cancer Society.

Cancer Screening Recommendations

As you can see the recommendations are inconsistent; work with your healthcare provider to determine the best screening schedule for you, especially if you are at higher risk because of genetics, family history, or other factors. 

Other screening tools include a screening ultrasound called the automated breast ultrasound (ABUS), which may be helpful for women with dense breasts in addition to screening mammograms.

Thermography is another possible screening tool. This method uses infrared cameras to measure heat that indicates inflammation. Women may be more comfortable with this tool because it doesn’t use radiation or touch the skin; however, it has a low sensitivity, and interpretation of the results is not standardized. Thermography should not replace a mammogram, but it can be used in conjunction and, in some cases, is helpful for the early detection of breast changes.

If mammography detects an abnormality, the next step is a diagnostic mammogram and ultrasound to look closer at the specific area of the breast. If the radiologist determines a mass is present, they will refer for a biopsy. This process can be very stressful, so be sure to have a support system.

Lifestyle Changes to Promote Breast Health

In addition to regular breast screening and awareness of your breast health, specific lifestyle changes promote breast health and address risk factors.

Breast-supportive lifestyle strategies include:

• Eat more fruits and vegetables. Women who eat more fruits and vegetables have a reduced postmenopausal breast cancer risk, up to 27% for specific cancer types. Whole fruits and vegetables are rich in fiber, vitamins, minerals, and antioxidants that protect DNA and promote healthy immunity. Notably, fruit juice consumption is associated with an increased breast cancer risk, so choosing whole, unprocessed food is essential.

• Increase exercise and movement. A sedentary lifestyle and inactivity increase the risk of breast cancer and other chronic diseases and adverse health outcomes. Improving physical fitness and regularly engaging in enjoyable movement help to reduce the risk. In addition, for women with a breast cancer diagnosis, a healthy lifestyle that includes physical activity improves treatment outcomes and extends life expectancy.

• Manage stress and practice self-care. Stress affects sleep, exercise, diet choices, and metabolism. It’s is an underlying factor in many chronic diseases, including cancer. Reducing stress and practicing self-care is part of a healthy lifestyle, but can be challenging for women who are caretakers and habitually put their needs last. It’s good to put self-care in place now vs. later.

• Sleep well. During sleep, your body performs detoxification and essential clean up functions, including identifying and removing abnormal cells. Disruption of normal sleep patterns is a risk factor for breast cancer. Therefore, one prevention strategy is maintaining an optimal circadian rhythm and prioritizing restorative sleep.

• Maintain a healthy weight. Many lifestyle recommendations around nutrition, exercise, sleep, and stress management will support metabolic health, weight loss, and weight maintenance. But sometimes, other factors are at play, such as hormonal imbalances. Read more in the article Medical Factors and Weight Loss.

• Wear comfortable clothing and bras. Restrictive, tight clothing impacts the movement of lymph through the lymphatic system and inhibits waste removal in the body. Many lymph nodes near the breasts and a common area where cancer can spread. Use movement, massage, and other tools to promote healthy lymph flow.

• Support estrogen detoxification. A nutrient-rich diet, including cruciferous vegetables, supports liver detoxification of estrogen. Regular bowel movements are crucial for clearing excess estrogen from the body. Read more about specific strategies here. (link to estrogen article)

• Optimize vitamin D levels. Vitamin D is a fat-soluble nutrient with hormone-like actions in the body. Low vitamin D levels negatively impact bone health, immunity, and disease risk. Vitamin D is involved with anti-cancer actions in the body, and low serum vitamin D levels are associated with several cancer types. Optimal blood levels of vitamin D are associated with a lower breast cancer risk.

• Reduce toxin exposures. Toxins that affect breast cancer include cigarettes, alcohol, and endocrine disruptors found in plastics and personal care products. Many of these chemicals are found in food, water, and air, so choosing to eat organic food and investing in quality in-home air and water filters is helpful.

It’s easy to feel like health is out of your control. But, many factors that influence your health, longevity, and breast cancer risk come down to how you live your daily life. Many cancer risk factors are actually within your control. A healthy lifestyle plus regular breast screenings support prevention and the best possible future health outcomes.

References

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2. American Cancer Society. Key Statistics for Breast Cancer. Accessed October 10. 2023.
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8. Samuelsson, L. B., Bovbjerg, D. H., Roecklein, K. A., & Hall, M. H. (2018). Sleep and circadian disruption and incident breast cancer risk: An evidence-based and theoretical review.Neuroscience and biobehavioral reviews, 84, 35–48.
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