Breast Cancer Explained

Breast cancer affects individuals from all walks of life.  Dr. Multari supports patients throughout their journey with breast cancer.  She offers whole-person, integrative cancer care for those undergoing treatment and recovery. 

We’ve compiled important information we think every individual should know about breast cancer.  We will discuss risk factors, screening, conventional treatment options and naturopathic support.  

Non-modifiable risk factors we can’t change: 

  • Being a woman
  • The strongest risk factor for breast cancer, with more than 99% of newly diagnosed breast cancers occurring in women
  • Age
  • The risk of breast cancer increases with age, with 2/3rds of invasive breast cancers occurring above the age of 55
  • Family history
  • Those with one first-degree female relative (sister, mother, daughter) with breast cancer have double the risk of being diagnosed themselves, and the risk is five times higher than average if there are two first-degree relatives that have been diagnosed.
  • Mutations in genes such as the BRCA1 or BRCA2 may account for up to 10% of all breast cancers; however, having a BRCA mutation does not always lead to breast cancer.
  • Personal history
  • Being previously diagnosed with breast cancer infers a 3-4 times increased risk of developing new cancer in a different part of the same breast or the other breast.
  • Race/ethnicity
  • Caucasian women are at an increased risk of developing breast cancer than African-American, Hispanic and Asian women. African-American women are more likely to develop aggressive and advanced-stage breast cancer and are often diagnosed at a younger age.
  • Although the above non-modifiable risk factors exist, diet and lifestyle remain within our control, and it is important to know that women can decrease their overall risk of developing breast cancer by making lifestyle changes. 

Modifiable risk factors, we can influence: 

  • Being overweight.
  • Elevated BMI increases the risk of being diagnosed with breast cancer.
  • Pregnancy history
  • Pregnancy reduces the total number of lifetime menstrual cycles, decreasing hormonal exposure and the risk of breast cancer with each full-term pregnancy.
  • Menstrual History
  • Reaching menarche before 12 years of age and menopause over the age of 55 also increases risk.
  • Alcohol
  • Compared to non-drinkers, women who consume three alcoholic drinks a week have a 15% increased risk of breast cancer.
  • Dense breasts
  • Dense breast tissue may make it more challenging to detect early-stage breast cancer on screening mammography.
  • Lack of exercise
  • Those who exercise regularly for 4-7 hours per week have a lower risk of breast cancer.
  • Smoking
  • Smoking has been linked to a higher risk of breast cancer in young, premenopausal women.
  • Vitamin D levels
    • Research has suggested that women with low levels of vitamin D have a higher risk of developing breast cancer.
  • Shift work
  • Women working at night have a higher risk of developing breast cancer compared to those working during the day, which may be linked to low melatonin levels.
  • Exposure to ionizing radiation
  • Radiation to the chest, neck and armpit areas puts women at an increased risk of developing breast cancer.

In addition to the above, other factors may increase the risk of developing breast cancer. These can be discussed with Dr. Multari and include poor blood sugar regulation, exposure to xenoestrogens (man-made estrogens), hormone replacement therapy, oral contraceptives, breast implants and stress. 

Screening Guidelines: 

Guidelines for screening vary between Canadian provinces, making it essential to be familiar with the guidelines in the jurisdiction where you practice.

  • Breast cancer screening guidelines for British Columbia can be found here.
    • http://www.bccancer.bc.ca/screening/breast/get-a-mammogram/who-should-get-a-mammogram
  • In British Columbia, women ages 50-74 without a family history of breast cancer are to be screened every other year with mammography.
  • Based on the screening guidelines, patients with known risk factors will begin screening earlier than those with average risk. It should be noted that mammography is not a perfect test as it may detect false positives that can cause unnecessary treatment (4). Mammograms may also miss some cancers (4).

Conventional Care: 

The stage of cancer at diagnosis will determine conventional care, which can include surgery, chemotherapy and radiation therapy.

Surgery options include lumpectomy, partial mastectomy, total mastectomy, modified radical mastectomy and radical mastectomy.

In Canada, the first-line chemotherapy regimens include (5):

  • FEC-D (fluorouracil, epirubicin, and cyclophosphamide followed by docetaxel)
  • Dose-dense AC-T (Adriamycin, cyclophosphamide, followed by docetaxel or paclitaxel)
  • TC (Taxotere/docetaxel and cyclophosphamide)

If you undergo breast-conserving surgery (lumpectomy or partial mastectomy), you may also be offered radiation therapy.

In addition, if your cancer was hormone receptor-positive, you will be offered hormone therapy to reduce any circulating estrogen and progesterone in your body.

Naturopathic Support for Breast Cancer: 

Various natural supports for breast cancer can support quality of life during and after treatment.  It is vital that the foundations of health – nutrition, sleep and exercise – are all supported during treatment, as this can improve outcomes, but also in the recovery and prevention stage, to help keep you cancer-free.

Some well-researched natural therapies to consider include:

  • Vitamin D
    • Improving vitamin D status should be considered if you are deficient at diagnosis. A study has shown improved survival rates in patients with optimal vitamin D levels compared to those with chronic deficiency (9). Maintaining optimal vitamin D status at diagnosis is important for improving the survival rates of breast cancer patients (9).
  • Melatonin
    • Melatonin has antioxidant and immune properties that inhibit the growth of breast cancer cells (6). Melatonin has been studied and shown to improve sleep parameters among breast cancer survivors and improvement in depressive symptoms for breast cancer patients undergoing surgery (7,8).

These are general recommendations; however, for case specifics and dosing, consider consulting with a naturopathic doctor who is a Fellow of the American Board of Naturopathic Oncology (FABNO).

  • NDs who are board certified in naturopathic oncology, holding the FABNO designation, have additional, focused training in combining conventional cancer treatment with safe and evidence-based natural therapies.
  • Dr. Catherine Multari, ND has obtained the FABNO designation.



Author: Dr. Catherine Multari 
My hope is that this blog will give individuals a basic understanding of the risk factors, screening guidelines and naturopathic approach to breast cancer. I am a naturopathic doctor at Clementine Natural Health in Vancouver, British Columbia (https://www.clementinenaturalhealth.com).  If you would like to book an appointment to discuss your breast health, please call (604) 566-3345. 

 

 

Resources: 

1) Breast Cancer Society, www.breastcancer.org 

2) Canadian Cancer Society, www.cancer.ca 

3) Centers for Disease Control and Prevention, https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm 

4) Cancer Care Ontario- Breast Cancer Screening, https://www.cancercareontario.ca/en/types-of-cancer/breast-cancer/screening 

5) BC Cancer- Chemotherapy Protocols, http://www.bccancer.bc.ca/health-professionals/clinical-resources/chemotherapy-protocols 

6) https://www.ncbi.nlm.nih.gov/pubmed/25876649 

7) https://www.ncbi.nlm.nih.gov/pubmed/24718775 

8) https://www.ncbi.nlm.nih.gov/pubmed/24756186 

9) https://www.ncbi.nlm.nih.gov/pubmed/25824788

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