Breast Cancer is a dreadful diagnosis. It’s the most frequently diagnosed cancer in women with one in eight women receiving diagnosis of the disease. [1] There is no doubt breast cancer afflicts women of all ethnicities.
While science offers little insight about the precise causes of breast cancer in any person, there is sufficient information on what might contribute to the manifestation of the disease.
Let’s begin with a brief understanding of breast cancer before exploring how neglecting a healthy diet contributes to its occurrence and recurrence.
TYPES OF BREAST CANCER
Breast cancer can be separated into two groups: Non-invasive and Invasive.
Non-invasive Breast Cancer
Ductal carcinoma in situ (DCIS) exists when abnormal cells remain inside the breast milk duct lining; therefore, the surrounding breast tissue is unaffected. Carcinoma means “cancer” and in situ means “in its original place.”
Here is a picture of what DCIS looks like:
IDC & ILC: Two Types of Invasive Breast Cancer
IDC
General/ Not Otherwise Specified ‘NOS’ Invasive (or infiltrating) ductal carcinoma (IDC) penetrates through the milk duct lining into the surrounding fatty breast tissue; the cancer cells are then able to spread to other parts of the body including, the lymph nodes — small, bean-shaped glands connected to the lymphatic system (LS); the LS carries fluid, nutrients, and foreign material between the blood stream and body tissue (made from joined cells which then form organs).
Lymph nodes filter and trap bacteria, viruses, and other waste material found in the lymph fluid for white blood cells (called “lymphocytes” which is displayed within your CBC blood tests) to destroy.
Here is what the lymphatic system and lymph nodes look like:
NOS IDC can also spread into the bones between the ribs and into the liver, and lungs. Generic IDC represents 80% of all breast cancer, making it the most common form of breast cancer. Generally speaking, the closer to stage 0 NOS IDC is detected determines your likelihood of achieving the approximate survival rate of around 84% from NOS IDC.
Less common forms of IDC with distinct characteristics include: Tubular, Medullary, Mucinous, and Papillary. The special subtypes of IDC generally have a positive predicted course and outcome (prognosis). Below includes a brief summary of each subtype of IDC:
Tubular: Tubular Ductal Carcinomas (TBC) is comprised of slow-growing tube shaped tumor cells (these “tubules” resemble normal healthy cells) the size of 1 cm or less. TC represents less than 2% of all breast cancer.
Medullary: Medullary Ductal Carcinomas (MDC) is comprised of tumor cells that resemble a gray colored soft tissue in the medulla oblongata – a code shaped nerve cell found in the brainstem. MC represents less than 5% of all breast cancer. Unlike TC, MC tumor cells spread rapidly and appear distinctly different than the normal healthy cells.
Mucinous: Mucinous Ductal Carcinomas (MUDC) is comprised of tumor cells with an excessive amount of mucous. MCC represents less than 2% of all breast cancer. MCC tumor cells divide slowly and appear to look normal.
Papillary: Papillary (‘nipple-like’) Ductal Carcinomas (PDC) is comprised of tumor cells that resemble nipples or tiny lumps. PPC represents less than 1% of all breast cancer. Most PDC tumor cells are benign but, like any other invasive breast cancer, malignancy is very much common. PPC therefore, includes in in situ (confined to the site of origin) and invasive tumor cells.
ILC
Invasive (or infiltrating) lobular carcinoma (ILC) is the second most common form of breast cancer representing 10 – 15% of all breast cancer. In ILC, the cancer cells develop in the lobules which are the glands where milk is produced (see picture above).
Below are very rare forms of breast cancer:
Inflammatory Breast Cancer (IBC) is characterized by reddening and swelling of the breast which is caused by cancerous cells blocking the lymph vessels in your lymphatic system. IBC is an aggressive form of cancer; the tumor cells grow and spread quickly. IBC represents 1% of all breast cancer.
Paget Disease of the Nipple is characterized by cancer cells that accumulate in or around the nipple.
Metaplastic Breast Cancer (MBC) is breast cancer that has spread to other parts of your body and not the same or opposite breast.
SIGNS AND SYMPTOMS TO OBSERVE
Performing monthly breast self-exams and leaning what warning signs of breast cancer to watch for can help lead to early diagnosis by a healthcare professional thereby, increasing the odds of positive prognosis. According to the American Cancer Society [2], the most common signs and symptom of breast cancer include the following:
• New lump or mass
• Swelling of all or part of a breast (even if no distinct lump is felt)
• Skin irritation or dimpling
• Breast or nipple pain
• Nipple retraction (turning inward)
• Redness, scaliness, or thickening of the nipple or breast skin
• A nipple discharge other than breast milk
While the signs and symptoms do not undeniably suggest the occurrence of breast cancer, it is critical to visit your healthcare provider immediately if you notice odd changes to your breasts.
POSSIBLE BREAST CANCER RISKS
Mammograms
In my initial article I classify Mammograms as a “questionable test.” False-positives that lead to unnecessarily risky procedures and intense radiation (exposure directly to the breasts) are enough drawbacks that compel me to question the safety and accuracy of Mammograms.
False-positives lead to Unnecessarily Risky Procedures
A 2014 Canadian National Breast Screening Study published in the British Medical Journal (BMJ) compared the rate of breast cancer and mortality for up to 25 years in 89,835 women aged 40-59 who underwent or did not undergo mammography screening.
The studies showed no reduction in breast cancer deaths (beyond that of breast physical examinations alone) from five yearly mammography screenings in women aged 40-49, nor in women aged 50-59. [3] In other words, breast cancer death rates remained the same between women who underwent mammograms and women who didn’t undergo mammograms.
There is still no solid scientific evidence that suggest mammograms save lives instead, the opposite is true: the over-diagnosis (false-positives) in breast cancer exposes patients to unnecessarily risky procedures; mammography therefore, is unsafe and does not save lives (at least for now).
A Caution on Radiation Exposure
Mammography was designed with a good intention however, so far the current data lacks that it helps to prevent cancer. In fact, low doses of ionizing radiation may increase cancer risks over time for the following high-risk women [4, 5]
• Women with genetic mutations of BRCA1 or BRCA2 genes.
• Women with a strong family history of breast cancer despite no known genetic mutations.
Researchers – for their analysis – chose six out of 47 studies on the subject of breast cancer risks from mammography among high-risk women. Four studies included women with breast cancer gene mutation carriers and two studies included women with a family history of breast cancer. Based on data from the six studies, the researchers provided the following estimated breast cancer risks associated with radiation exposure:
“The results showed that among all high-risk women in the study, average increased risk of breast cancer due to low-dose radiation exposure [after age 20] was 1.5 times greater than that of high-risk women not exposed to low-dose radiation. High-risk women exposed before age 20 or with five or more exposures were 2.5 times more likely to develop breast cancer than high-risk women not exposed to low-dose radiation.”
Based on the findings, one of the researchers, Marijke C. Jansen-van der Weide, Ph.D., an epidemiologist in the Department of Epidemiology and Radiology at University Medical Center Groningen in the Netherlands states that careful approach is warranted when considering mammography for screening young women, particularly under age 30; Dr. Jansen-van der Weide therefore, recommends that young high-risk women have mammograms every other year starting at age 30 if no alternative screening methods exist. [6, 7]
Notice the study does not include average women who follow recommendations for yearly mammograms starting at age 40; nevertheless, we know radiation exposure increases the risk of breast cancer, especially for young women. It’s also important to note that the studies discuss the topic of radiation not specific from one source (i.e. mammography). For instance, young girls undergoing radiation treatment for lymphoma have a risk of up to 50 percent in developing breast cancer later in life. Concisely, the chances of developing breast cancer from radiation exposure decreases at older ages and increases at younger ages.
AN EPIC BATTLE BETWEEN HUMAN BEHAVIORS AND CANCER
Your diet plays a very important role in the prevention and battle with breast cancer; Dr. Jaminet’s, “The Perfect Health Diet” (PHD) provides us with the most ideal diet plan using scientific research. I’ll discuss dietary strategies later; for now, let’s discuss how various bad habits contribute to the increased risk of developing breast cancer.
Food additives & Xenoestrogens
Estrogen in women is the hormone responsible for female characteristics like the development of breasts and regulation of menstrual cycles. While estrogen is good, too much estrogen (estrogen dominance) may be responsible for the development of breast cancer and many other cancers.
Compounds are added to food mainly to emulsify (thicken), preserve, add nutritional content, flavor or color, and to balance acid and alkaline; additives however, don’t come without health risks. Estrogenic food additives (EFA) in particular have estrogen-mimicking properties called, “xenoestrogens” (endocrine disruptors) – synthetic chemicals that might potentially affect the epithelial cells of the human breast [8] by binding to and activating estrogen receptors (proteins in and on cells) in our bodies; [9]
Epithelial cells come in layers that line the ducts and lobes of breasts (and other organs and glands) and also produce breast milk (see picture of breast above); breast cancer arises from epithelial cells. Altered epithelial breast cells influence radiological breast density [10, 11] – one of the strongest indicators in assessing risk factors for breast cancer. [12]
Xenoestrogens are everywhere: processed food, skincare, plastics, building supplies, and insecticides. [13] In my blog, I teach balance; therefore, there is no need to be obsessed with avoiding exposure to xenoestrogens entirely rather, simply look for ways to reduce your exposure.
Neglecting a healthy diet likely means you are frequently eating processed foods that increase your exposure to xenoestrogens and hence, your probable risk of developing breast cancer or other cancers and diseases in your lifetime. Processed foods will commonly include:
Preservatives (i.e. sodium benzoate, sodium nitrite, BHA, BHT, Propyl Paraben, 4-hexylresorcinol, Propyl gallate etc.), artificial sweeteners, flavor enhancers (i.e. fructose, high fructose corn syrup, aspartame, sucralose, acesulfame potassium (acesulfame-K), etc.), and artificial colors (FD&C Blue Nos. 1 and 2, FD&C Green No. 3, FD&C Red Nos. 3 and 40, FD&C Yellow Nos. 5 and 6, Orange B, Citrus Red No. 2, etc.). Within the additives, xenoestrogens are found in BHA, FD&C Red No. 3, propyl gallate, propyl paraben, and 4-hexylresorcinol.
Milk Does a Body Good?
While meat, poultry and dairy treated with hormonal substances (i.e. estradiol, progesterone) have a negligible impact on human health, [14] more studies are required in order to gain a better understanding of the possible impact of hormones in dairy foods. Our cumulative exposure to xenoestrogens may influence the level of risk of developing breast cancer and other endocrine related cancers. [15]
Since estrogen (mainly in the form of estrone sulfate or E1S) in dairy consumption might disrupt our endocrine system, [16] limiting dairy to help prevent risks of breast cancer (or other cancers) is therefore, a cautious approach worthy of consideration.
Here is what the endocrine system looks like:
There is conflicting information on whether or not ingesting endogenous estrogens from milk by cows milked in late pregnancy increases the likelihood of developing different types of cancer including breast cancer. Several studies show how estrogen in cow milk (and other dairy products) affects the human body:
One study suggests commercial cow’s milk from pregnant cows containing large amounts of estrogens and progesterone is absorbed in all adults and children. [17] The results showed a decrease in testosterone and gonadotropin (hormones from the pituitary gland that stimulate the testis in men and the ovaries in women) production.
Another study suggests that commercial 1% cow milk contained biologically significant levels of estrogen as evidenced by the uterotrophic activity on the uteri in rats. [18] The results showed that rats given commercial cow milk had a heavier uterus and an increased uterine epithelial cell height.
One more study including a 26-year follow-up (from 1980 – 2006) on the role of milk (and other dairy products) and endometrial cancer suggests high intakes of milk and other dairy products have a moderate potential to cause endometrial cancer among postmenopausal women not using estrogen-containing hormones. [19]
Here is a picture of what the endometrium looks like:
In contrast, one study showed there was insignificant biological estrogenic activity in female rats given commercial cow milk. [20] The results of a two- week study showed no difference in uterine weight between female rats given milk ad libitum (‘ad lib’ is Latin for ‘all they want’ or ‘as much and as often as desired’) and the negative control (rats observed in their natural state).
The evidence showing unwanted effects associated with habitual consumption of cow milk seem to trounce evidence suggesting the safety of consuming cow milk. And as for organic milk: Organic milk might be better than conventional milk but, may still contain endogenous estrogens.
In the grand scheme, compelling scientific evidence can tempt us to completely avoid milk at all costs however, we must remember that milk contains beneficial nutrients like calcium and vitamin D that should never be dismissed.
If you seek to limit estrogen intake, consider goat milk which has lower combined concentration levels of estrone E(1) and estradiol E(2) compared to regular and organic cow milk. [21]
Estrone (the least abundant estrogen) estradiol (the primary female sex hormone that regulates menstrual cycles) and estriol (abundant during pregnancy) are three of seven (that I will only mention) naturally occurring estrogens in men and women; the two major estrogens include estrone and estradiol.
Estrone can convert to estrone sulfate (which lives for a long time in the body) which can then convert as needed into estradiol – the estrogen responsible for increasing risks of developing breast cancer. [22]
Nutrient Deficiencies in a Processed Food Diet
Our propensity to choose unhealthy processed foods leads to obesity from a nutritionally deficient diet [23] that can later promote breast cancer. [24] Worst of all, avoiding healthful foods can create a deficiency in breast cancer-fighting vitamins like, A, C, and D. [25, 26, 27, 28]
What’s also missing from most processed food diets are long-chain omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) which have inflammation-resolving properties and favorable effects on oncogenic proteins [29] – proteins coded by genes that can potentially mutate normal cells into cancerous cells. It’s easy to make unhealthy food choices in our rushed environment.
The consequences in not giving your body the proper nutrients it needs are dire. Make healthy choices now and avoid the unnecessary risks of developing breast cancer later.
DISCIPLINE & HOPE: A JOURNEY WORTH TRAVELING
Breast cancer prevention starts by developing healthy habits that include a healthful balanced diet, vitamin supplementation, physical activity, sun exposure and a happy social life. If you are already diagnosed with breast cancer, take hope and seek support from family and friends.
There are many survivors of breast cancer – seek with all your heart, mind, body and soul to be one of those survivors. I hope this article gives you broad overview of what potentially causes the occurrence and recurrence of breast cancer.
Stay tuned for my next blog piece where I plan to discuss dietary strategies I use to keep me and my family healthy; the strategies may also help for those of you who already have breast cancer.
REFERENCES
[1] 2015. Breast Cancer Facts. Accessed 05 21, 2016. http://www.nationalbreastcancer.org/breast-cancer-facts.
[2] 2015. Signs and symptoms of breast cancer. 10 09. Accessed 05 21, 2016. http://www.cancer.org/cancer/breastcancer/moreinformation/breastcancerearlydetection/breast-cancer-early-detection-signs-symptoms-br-ca.
[3] Miller, Anthony B. 2014. Twenty-five year follow-up for breast cancer incidence. 01 16. Accessed 05 21, 2016. http://www.bmj.com/content/348/bmj.g366.
[4] Andrew Weil, M.D. 2010. Mammograms: Too Much Radiation? 01 12. Accessed 05 21, 2016. http://www.drweil.com/drw/u/QAA400672/Mammograms-Too-Much-Radiation.html.
[5] Pijpe, Anouk. 2012. Exposure to diagnostic radiation and risk of breast cancer among carriers of BRCA1/2 mutations: retrospective cohort study (GENE-RAD-RISK). 08 10. Accessed 05 21, 2016. http://www.bmj.com/content/345/bmj.e5660.
[6] Marijke C. Jansen-van der Weide, Ph.D. 2009. Mammography May Increase Breast Cancer Risk in Some High-Risk Women. 12 01. Accessed 05 21, 2016. https://www2.rsna.org/timssnet/media/pressreleases/pr_target.cfm?ID=446.
[7] Laino, Charlene. 2009. Study: Mammograms May Raise Breast Cancer Risk. 12 02. Accessed 05 21, 2016. http://www.webmd.com/breast-cancer/news/20091202/study-mammograms-may-raise-breast-cancer-risk.
[8] Fernandez, S.V. 2010. Estrogen and Xenoestrogens in Breast Cancer. 07 21. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2907875/.
[9] Rosa, Piergiorgio La. 2014. Xenoestrogens Alter Estrogen Receptor (ER) α Intracellular Levels. 02 20. Accessed 05 21, 2016. http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0088961.
[10] Sprague, Brian L. 2013. Circulating serum xenoestrogens and mammographic breast density. 05 27. Accessed 05 21, 2016. http://breast-cancer-research.biomedcentral.com/articles/10.1186/bcr3432.
[11] Boyd, Norman F. 2010. Breast Tissue Composition and Susceptibility to Breast Cancer. 08 18. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923218/.
[12] 2010. Breast Tissue Composition and Susceptibility to Breast Cancer. 05 28. Accessed 05 21, 2016. http://jnci.oxfordjournals.org/content/102/16/1224.
[13] ND, Amy LaRue. 2012. Xenoestrogens – What are they? How to avoid them. 09 06. Accessed 05 21, 2016. https://womeninbalance.org/2012/10/26/xenoestrogens-what-are-they-how-to-avoid-them/.
[14] Jeong, Sang-Hee. 2010. Risk Assessment of Growth Hormones and Antimicrobial Residues in Meat. 12 26. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3834504/.
[15] Fucic, Aleksandra. 2012. Environmental exposure to xenoestrogens and oestrogen related cancers: reproductive system, breast, lung, kidney, pancreas, and brain. 06 28. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3388472/.
[16] MALEKINEJAD, Hassan. 2015. Hormones in Dairy Foods and Their Impact on Public Health – A Narrative Review Article. 06 01. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4524299/.
[17] K, Maruyama. 2009. Exposure to exogenous estrogen through intake of commercial milk produced from pregnant cows. 05 22. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pubmed/19496976.
[18] D, Ganmaa. 2006. Commercial cows’ milk has uterotrophic activity on the uteri of young ovariectomized rats and immature rats. 05 01. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pubmed/16331633.
[19] Ganmaa, Davaasambuu. 2011. Milk, dairy intake and risk of endometrial cancer: a twenty six-year follow-up. 09 17. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359127/.
[20] C, Furnari. 2012. Lack of biologically active estrogens in commercial cow milk. 01 01. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pubmed/?term=Lack+of+biologically+active+estrogens+in+commercial+cow+milk.
[21] DW, Farlow. 2012. Comparison of estrone and 17β-estradiol levels in commercial goat and cow milk. 08 01. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pubmed/22459818.
[22] M, Kabuto. 2000. A prospective study of estradiol and breast cancer in Japanese women. 06 09. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pubmed/10868691.
[23] n.d. How Our Surroundings Influence What We Eat. Accessed 05 21, 2016. http://www.hsph.harvard.edu/obesity-prevention-source/obesity-causes/food-environment-and-obesity/.
[24] Pergola, Giovanni De. 2013. Obesity as a Major Risk Factor for Cancer. 08 29. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773450/.
[25] Zhang, Shumin. 1998. Dietary Carotenoids and Vitamins A, C, and E and Risk of Breast Cancer. 12 31. Accessed 05 21, 2016. http://jnci.oxfordjournals.org/content/91/6/547.full.
[26] Bakker, Marije F. 2015. Plasma carotenoids, vitamin C, tocopherols, and retinol and the risk of breast cancer in the European Prospective Investigation into Cancer and Nutrition cohort. 11 30. Accessed 05 21, 2016. http://ajcn.nutrition.org/content/early/2016/01/20/ajcn.114.101659.abstract.
[27] Garland, Cedric F. 2006. The Role of Vitamin D in Cancer Prevention. 02 01. Accessed 05 21, 2016. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470481/.
[28] MOHR, SHARIF B. 2014. Meta-analysis of Vitamin D Sufficiency for Improving Survival of Patients with Breast Cancer. 01 09. Accessed 05 21, 2016. http://ar.iiarjournals.org/content/34/3/1163.full.
[29] Fabian, Carol J. 2015. Omega-3 fatty acids for breast cancer prevention and survivorship. 05 04. Accessed 05 21, 2016. http://breast-cancer-research.biomedcentral.com/articles/10.1186/s13058-015-0571-6.
Organize & Realize 