Whole Health
September/October 2007

Beyond the PINK RIBBON

The causes of breast cancer are still largely a mystery, but there are ways to keep your breasts healthy. And they’re surprisingly simple.
by Katy Neusteter

I was in the shower when I noticed what felt like a small hard-boiled egg buried deep inside my left breast. I was freaked. “Feel for abnormalities,” I’d always been told. Was this what an abnormality felt like? As a premenopausal 29-year-old, my risk of having breast cancer was low, and after an ultrasound and a needle biopsy, I was diagnosed with a fibroadenoma—a bulbous, benign tumor common in twenty- and thirtysomething women. I was relieved but confused: you mean there’s more to breast health than cancer?

Age, race, and genetic history are among the uncontrollable factors that may increase a woman's risk of breast cancer.

In fact, the American Cancer Society estimates that up to
80 percent of tumors are not cancer related. (For more on benign irregularities, see sidebar,“Get to Know Your Breasts.”) Still, nearly 211,000 women will be diagnosed with breast cancer this year.
Of course, everyone’s breasts are different, and the risk of experiencing breast cancer in your twenties and thirties is much lower than it is after menopause. Although advances in breast cancer technology have led to a comparatively low mortality rate, however, surprisingly little research has examined what actually causes noncancerous and cancerous tumors in the first place.

“We’ve focused so much on screening and treatment without putting energy into prevention,” says Julia Brody, MD, director of Silent Spring Institute, a Massachusetts-based consortium of doctors who study the correlation between environmental exposure and women’s health.

Age, race, and genetic history are among the uncontrollable factors that may increase a woman’s risk of breast cancer. And recent evidence has shown that controllable factors may also play a role. But when it comes to lifestyle and diet, the American Cancer Society’s recommendations are general and vague: stay active and maintain a healthy weight.

In fact, there is no substantial evidence to suggest any link between diet and breast health, say researchers from Brigham and Women’s Hospital and Harvard Medical School. The team’s review of observational studies, published in the May issue of the
journal Cancer, showed no association between nutrients—fats, antioxidant vitamins, and calories—and cancer risk.

“Breast cancer is the bogey man because we don’t know what causes it,” says Sandra Walters, RN, founder of the Denver-based Andre Center for Breast Cancer Education and Navigation. “Many more women die from heart disease and lung cancer—which we know how to prevent—than breast cancer. So I like to tell women that it’s about making healthy lifestyle decisions overall. Eat well, exercise, don’t smoke. These are good guidelines for everyone.”

There is one piece of advice proven to lower breast cancer incidence: cut down on booze. The American Cancer Society
has long urged that women curtail alcohol consumption to one drink or less per day. True, the antioxidants in red wine appear
to have some heart disease–fighting benefits, but multiple
studies, including research published in Breast Cancer Research and Treatment in April, have shown a direct correlation between alcohol and malignant breast tumors.

Beyond that the research grows sparse and controversial.
In a 2006 epidemiological study, red-meat consumption was linked to increased risk. Conversely, 2007 research suggested a reduced incidence of breast cancer in women with high intakes of vitamin D and calcium. Still more research associated lowered risk to high soy intake during a girl’s teenage years. None of the studies was conclusive.

So what can you do to keep your breasts healthy? Try cutting down on caffeine, for one. Many foods increase breast sensitivity
or pain, and caffeine may also affect lumpiness. Other prime
culprits include fatty and salty foods, such as cheese, nuts, and—
sadly—chocolate. Wine and bananas may also increase tenderness because they produce arachidonic acid, which contributes to
tissue sensitivity. Walters recommends adding 200 IU of vitamin E to your daily diet to help ease painful symptoms.

Monitoring your household toxins may also be wise. “There is substantial evidence from lab studies that environmental exposure may heighten the risk of cancer,” says Dr. Brody. Need proof? Developed countries in which processed foods and beauty products are ubiquitous have the highest rates of breast cancer
in the world, she says.

In May Dr. Brody and a team of researchers issued a review
of 216 chemicals—97 of which humans are exposed to regularly—
that cause breast cancer in animal studies. Published in the
journal Cancer, their findings showed a connection between
polychlorinated biphenyls—chemicals found in fish as a result
of pesticide runoff—and polycyclic aromatic hydrocarbons—a byproduct of combustion that exists in auto exhaust, cigarette smoke, and grilled meats—and breast cancer in animals. Of the chemicals found to have the highest risk, 89 were endocrine
disrupters commonly found in household products.

“Unfortunately, we have an innocent-until-proven-guilty
attitude toward chemicals in the United States,” says Brody. “There is no health assessment before a chemical can be put in products. We need to join together to advocate for things like stricter fuel-efficiency standards, public transportation, and electric mowers.”

In the meantime, look for cleaning agents that contain natural or, better yet, organic ingredients. Clear detergents and eco-friendly dishwashing soaps are optimal. And, though controversy exists over the use of parabens—a preservative of which traces have been found in breast tumors—when it comes to skin care, cosmetics, and hair products, choose brands that contain a natural preservative, such as vitamin C or citric acid. Likewise, if you’re concerned about chlorine and dioxins in feminine care products, look for unbleached, organic alternatives.

The one universal recommendation doctors agree on is that we should all get to know our breasts. Some breasts are naturally dense or prone to benign irregularities. Other breasts might be tender all the time or just during menstruation. Try to think about exams as opportunities to experience and understand what “normal” means for you instead of imagining scary scenarios that result in finding the “big C.” Once you know your baseline, have confidence that you’ll notice a change.

Living through Cancer
These moms and athletes are fighting cancer in the best way they know how—by staying active and positive. In their own inspirational words, they share a little bit about their experiences.

Lisa Pevateaux, age 36 Former Broncos cheerleader, owner of Elite Dance Academy in Denver Diagnosed with hormone ER/PR–negative breast cancer when she was eight weeks pregnant, Lisa was not sure her second child would make it. After seeing many doctors, some of whom told her that the only option was to terminate her pregnancy, Lisa found one who would treat her case as that of two patients: Lisa and her unborn baby. Coupled with her healthy lifestyle, her current treatment plan is working beautifully for both patients—and the one is due in October. “I feel great and have a wonderful support team behind me. I just want others to know that you can go through cancer and live, survive, and still be beautiful. “My vision is not clouded by the cancer and treatment, but is lightened by the fact that after going through all of this, I’ll have a baby.”

Julie Borgerding, age 34 Triathlete An active mother of two, Julie didn’t expect that breast cancer could happen to her. Although she was familiar with the trials of a cancer patient (her mom has ovarian cancer and was diagnosed with a brain tumor a week after Julie’s diagnosis), she was surprised by how taxing the chemotherapy drugs were. Now finished with her rounds of chemo, Julie is training for her return as a triathlete and is busy keeping up with her two kids. “Exercise has given me the opportunity to get some control of my body back. For a while, you are actively treating cancer, beating it, and you have a plan. When chemo is over, it’s like, Now what do I do? “Having cancer has given me a different perspective on life. I’ll have days when the sky looks extra-blue, the cheese I’m eating tastes extra-good, or my time at the zoo with my kids seems so precious. I don’t let things bother me like they used to.”

Glenna Biehler, age 39 Runner, Pilates practitioner After being diagnosed with breast cancer at age 37, Glenna realized how important exercise was for her survival. She practiced yoga and visualization and exercised daily. Two years after her diagnosis, she is doing well and is occupied with her three kids. “I was diagnosed with cancer four weeks after having a baby. I thought to myself, Now I’m going to be bald from the chemo and fat from post-pregnancy weight—not fair! “I compare having cancer to being robbed: my body is my home, and I have been invaded. When I push myself to my limits through exercise, it helps me regain some trust with my body. I feel that I have more control over what happens to it.”

Julie Zaveral, age 34 Marathon runner, triathlete in training Just after setting her wedding date, Julie found out she had breast cancer. It was a shocker because she has no family history of cancer and had just had her annual exam a couple of months before her diagnosis. Through running, Julie’s found it easier to deal with chemo because she found the treatment to be a methodical regimen akin to training for a marathon. “Preparing for a marathon helped me get through chemo. When you get to the last round of treatment, it’s like mile 26 of the marathon—you’re almost there. “My advice: to steal a quote from Tim McGraw, ‘live like you’re dying.’ Speak softer, love deeper, etc.”

Get to Know your Breasts

Not sure what to look for during monthly self-exams? Here we demystify four common benign breast “changes.”

Fibroadenoma. Round, smooth, moveable growth usually occurring in the top quadrant of the breast. Common in women ages 25 to 35, fibroadenomas arise spontaneously and are not linked to a higher risk of cancer.

Cysts. Liquid-filled growths that are typically smaller in size and often get larger during menstruation. More common in women over 35.

Blocked ducts and mastitis. When milk ducts get clogged they feel swollen and firm. Both blockages and mastitis, which is the result of an infection, are painful, though mastitis can be treated with antibiotics. Both are usually associated with breast-feeding.

Fibrocystic breasts. Feeling lumpy or grainy, fibrocystic tissues are often the result of fluctuating hormone levels. Occasionally associated with tenderness.