Breast cancer statistics are sobering, with more than 1.7 million new cases diagnosed around the world, annually. One in eight New Zealand women will be diagnosed with breast cancer in their lifetime. Breast cancer is the most common cancer effecting New Zealand women, with 3,000 new diagnoses annually, and more than 600 women dying from it each year. With only 5 – 10% of breast cancer attributable to genetic influence, the majority of breast cancers are thought to result from environmental, nutritional and lifestyle factors.
The female hormone estrogen has much to do with our breast cancer risk. Approximately 70% of all breast cancers are stimulated by estrogen and are called “estrogen positive” cancers. Estrogen causes breast cells to divide and replicate rapidly, also increasing the risk of damage to breast cell DNA. When it comes to estrogen and breast health, it’s not just the amount of estrogen in your body that may be a problem, but also the type of estrogen stimulating your breast cells.
Estrogen is the name given to a group of different hormones, the most important of which are: estradiol (the main form of premenopausal estrogen), estrone, and estriol (a relatively weak form of estrogen). Estradiol causes fast breast cell turn over, while estriol is a much milder and more breast friendly hormone. Once its biological work is completed, estrogen is broken down in the liver, into a range of metabolites, some of which are themselves strongly estrogenic.
It is possible to influence the relative balance of different estrogens in your body, as well as the type and amount of metabolites resulting from their breakdown. Many of the self help recommendations that follow benefit your breast health by decreasing production of the strongest forms of estrogen and metabolites; or increasing estrogen clearance from your body, thus reducing estrogenic stimulation of your breasts.
DAILY CHOICES TO OPTIMISE YOUR BREAST HEALTH
*Maintain a healthy body weight – Body fat influences our estrogen levels. Carrying excess body fat after menopause is a significant risk to breast health. After menopause, the ovaries produce little estrogen, and instead estrogen is produced in the fat cells, with the help of adrenal hormones. Excess body fat often leads to increased post menopausal estrogen levels, and increased breast cancer risk. Where you carry your fat is also of concern. A large bottom and thighs is less of a cardiovascular and breast health risk, compared with carrying fat around the abdomen.
*Stay fit and active – Regular aerobic and weight bearing exercise is a vital part of your breast health plan. Not only does aerobic exercise help you to maintain a healthy body weight, it also stimulates your immune system to detect and destroy abnormal cells. Studies show that healthy weight women exercising aerobically for 4 or more hours a week have the lowest breast cancer risk.
*Minimise exposure to ionizing radiation – There is no safe level of ionizing radiation exposure, and breast cells are especially vulnerable to DNA damage from radiation, around the time of puberty, and up until the age of menopause. Minimise exposure to medical radiation wherever possible – X rays, dental X-rays, CT scans.
*Avoid pharmaceutical estrogens such as the Oral Contraceptive Pill and Hormone Replacement Therapy – The Woman’s Health Initiative Study of 2002 proved that HRT use increases a woman’s risk of breast cancer by 26%. After the widespread discontinuation of HRT prescribing, the incidence of breast cancer in America (previously a heavy prescriber) actually decreased for the first time in decades. There is evidence that the contraceptive pill can also increase breast cancer risk, especially when used by women over the age of 45.
*Limit exposure to environmental estrogens – Xeno-estrogens (foreign estrogens) are everywhere in our environment and food chain. Many pesticides, herbicides and industrial chemicals have an estrogenic effect once absorbed into our body. Over 500 commonly used chemicals are known to be estrogenic. Limit your exposure to estrogenic chemicals by:
- Buying organic food whenever possible. If you are unable to be fully organic, try to eat organic dairy products, meat, eggs
- Avoid using sanitary products, toilet paper and paper towels which have been bleached, as this leaves traces of estrogenic organochlorine chemicals. Instead choose eco friendly unbleached products.
- Limit the use of plastics in your home. Store foods in stainless steel, glass or pottery containers; use a glass or stainless steel kettle; avoid using cling film for wrapping food, instead use aluminium foil or grease proof paper. Never heat microwave convenience foods in their plastic trays and do not re-use disposable water bottles.
- Avoid using all plastics containing BPA (bisphenol-A – recycle code 7) or PVC (polyvinyl chloride – recycle code 3), both contain hormone disrupting chemicals.
- Avoid using Teflon non-stick pans as the coating contains cancer causing PFOA, which can be released in the cooking process.
- Use safety conscious personal care products. Many of the lotions, personal care products and makeup that we use contain chemicals disruptive to our hormonal balance. Your skin is highly porous, and all the products you apply to the surface of your body, find their way through your skin, into the bloodstream. Chemicals especially troublesome for breast health include parabens and phthalates.
- Parabens are a group of preservatives found in many lotions, creams, shampoos, conditioners, deodorants, and cosmetics. Parabens act as a weak estrogen in the body, and studies have found these chemicals stored in cancerous breast tissue. This does not directly imply a cause and effect, but is a cause for concern.
- Phthalates are plasticizers used in the manufacture of plastic, and also added to nail polish, hair spray and perfume. Phthalates are highly disruptive to hormonal health. Ensure your personal care products are phthalate free.
- Avoid using insect sprays made from synthetic pyrethroids (most commercial fly and insect sprays), as these fat soluble chemicals are a suspected xeno-estrogen.
- Avoid the use of chemical pesticide and herbicide sprays in the garden or home. Instead use safe eco sprays which do not contain hormonally disruptive chemicals.
*Check vitamin D and iodine levels
New Zealand soils are very low in the mineral iodine. Global studies show a correlation between low iodine intake and increased risk of breast problems including fibrocystic breasts and breast cancer. Boost dietary iodine levels by using iodized salt (in moderation), and adding seaweed products (sushi, miso and kelp) and seafood to your diet.
Vitamin D deficiency is endemic in New Zealand, partly as a result of widespread use of sunblocks, and partly a result of our low levels of UVA rays during winter months. There is a strong correlation between low blood levels of vitamin D and increased breast cancer risk. A simple blood test (this is an inexpensive pay test now in New Zealand) can check your 25-hydroxyvitamin D levels in autumn to determine your need for supplementation throughout the winter months. For optimal breast health vitamin D levels should be above 50 ng/ml and preferably closer to 80ng/ml. If levels are low, work with a nutritionally trained practitioner to safely supplement with highly absorbable vitamin D3, rather than using the less bioavailable synthetic D2 supplements.
BREAST HEALTHY FOOD
The daily nutritional choices you make can significantly improve your breast health.
Boost intake of fresh fruits and vegetables to maximize cell protective antioxidants.
While all fruits and vegetables will benefit breast health, some especially protective choices include: dark green leafy vegetables rich in folate; brassica vegetables (brussel sprouts, broccoli, cauliflower, bok choy, kale) which reduce levels of potentially troublesome estrogen metabolites, as well as mushrooms and berries which are rich in phenol antioxidants.
Choose healthy fats
Some dietary fats can lead to inflammation in the body, while other fats work as natural anti-inflammatories. For healthy breasts, minimize intake of pro-inflammatory saturated fats (dairy, meat, palm oil) and trans-fats (partially hydrogenated fats such as margarine, shortening, hydrogenated commercial peanut butters; French fries; mass produced commercially baked goods). Instead choose from breast-healthy fats, including: raw nuts and seeds and nut and seed butters that have not been hydrogenated; avocado; oily fish (salmon, sardines, herrings, and mackerel); olives, extra virgin olive oil; flax seeds and flax oil; avocado and avocado oil.
Increasing your dietary fibre intake helps to more effectively remove estrogen break down products from your body, thus lowering the potential estrogenic stimulation of your breasts. Increase fibre by eating a minimum of five servings of fruits and vegetables daily; choosing whole grain bread and crackers instead of white; whole grain muesli or porridge for breakfast rather than refined cereals; add oatbran to your muesli or porridge; choose brown rice instead of white and cook with beans and lentils.
Lignans and Phytoestrogens
A diet high in phytoestrogens (plant based estrogen like compounds) is a breast healthy diet. Cultures with a traditionally high intake of phytoestrogens also have low breast cancer incidence. Soy products are high in phytoestrogens, but while some soy foods may be safely added to your diet (fermented soy such as miso, and tempeh) it is not advisable to simply drink lots of soy milk as the results of safety studies are conflicting. Instead choose from a wide range of phytoestrogen rich foods, including: fruit and vegetables; lentils and legumes; flax seed (linseed); rye bread; sprouts; nuts and seeds; wholegrains; black, green and white tea.
Flax seeds are rich in phytoestrogens called lignans, which are highly protective of breast health. Add a dessertspoon of ground flax seeds to your morning cereal, or mix with stewed fruit daily.
Choose more vegetarian meals
Studies clearly show that vegetarians have a lower risk of breast cancer than meat eaters. Reduce intake of meat, while increasing the number of vegetarian and fish based meals. Avoid all processed deli style meats, which are high in carcinogenic nitrite preservatives.
Cut back on refined carbohydrates and sugars
Refined grains, highly processed snack foods, and foods containing large amounts of added sugar, cause blood sugar spikes, and a resulting rise in the blood sugar regulating hormone, insulin. High insulin levels are associated with increased breast cancer risk. Healthy, energy boosting carbohydrates include: fresh fruits and vegetables; whole grains; beans and lentils and brown rice. Minimise your intake of refined sugars found in cakes, biscuits, lollies, snack bars, breakfast cereals and other processed foods.
Alcohol – not at all or in moderation
As alcohol intake increases, breast cancer risk increases in both pre and post menopausal women. Risk increases with more than one alcoholic beverage daily, irrespective of the type of alcohol consumed. Alcohol is especially detrimental to breast health in women who are deficient in folate (load up on green vegetables to super boost this B vitamin).
Choose breast health “superfoods”
The following foods are breast health “superfoods”. Make them regular dietary staples to boost your breast health:
*Brassica vegetables (cauliflower, cabbage, broccoli, brussel sprouts, bok choy);
*dark green vegetables
*beans and lentils
*flax seed (linseed)
*extra virgin olive oil
*seaweeds and fermented soy products (miso, natto and tempeh)
*fermented foods which enhance a healthy gut bacterial balance (microbiome) – sauerkraut, yoghurt, fermented soy products, kimchi, kombucha
Supplement for breast health
Some nutritional supplements are especially beneficial for breast health. For maximum safety and benefit, it is advisable to work with a nutritionally trained health practitioner when supplementing. Commonly prescribed breast care supplements include: purified fish oil; selenium; iodine; vitamin D3; DIM or I3C; B complex and vitamin C; CoQ10 and curcumin (turmeric), probiotics.
Holistic therapies and breast health
Holistic therapies may play a useful role in maintaining optimal breast health. Both acupuncture and homoeopathy work to balance the energetic aspects of your wellbeing (qi or life force), in turn supporting your physical and emotional health. Traditional Chinese Acupuncture understands breast lumps to be the end result of long term stagnation of qi in the acupuncture meridians influencing the breasts. This stagnation can be prevented through regular acupuncture and a healthy, balanced lifestyle.
Wholistic Women’s Health Specialist