An Integrative Medicine Approach to Breast Cancer Prevention

Simply put, cancer arises when a cell or group of cells starts to get out of control. If you think of a cell as a car on a city street, a "law-abiding" cell stops at the red lights, slows down at the yellow lights, and drives through the green lights. However, a cancer cell disregards the stoplights and drives straight through the green, yellow, and red lights. As one can imagine, this reckless cell can cause great destruction and damage along the way. A key differentiator between a normal cell and a cancer cell is that a cancer cell disregards the body's stoplights. The body has innate mechanisms to ensure cells don't grow uncontrollably (i.e., stop lights). However, cancer cells are able to override these mechanisms.

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What is Breast Cancer?

A group of cells that have grown uncontrollably form tumors. A tumor made up of cancer cells is known as a malignant tumor. A malignant tumor located in the breast is known as breast cancer. It can arise in either or both of the breasts. This diagnosis is not gender specific and can affect men as well.

How Common is Breast Cancer?

Breast cancer is the most common type of cancer in women and the most common type of cancer worldwide. Currently, it affects 1 out of every 8 women. This means as a woman living in the US, the risk of developing breast cancer in your lifetime is about 13%. While the incidence of being diagnosed increases by 0.5% per year, there has been a decline in deaths related to breast cancer in recent years. This is largely due to increased awareness, more screening, and treatment advancement. The majority of women diagnosed with breast cancer are middle-aged.

Can Men Get Breast Cancer?

Breast cancer is not a gender-specific diagnosis and can also affect men. 1 out of every 100 breast cancer diagnoses is in a male. For a male in the US, the lifetime risk of developing breast cancer is about 0.12%. The breast anatomy amongst genders is similar. However, male breast tissue lacks the specialized lobules needed for milk production. The risk factors for developing breast cancer in men and women are largely the same. Family history and genetic factors can increase the risk of developing male breast cancer.

Breast Cancer Symptoms

The majority of breast cancers are found on a screening mammogram. These cases usually are asymptomatic and have no warning signs. It's important that each person is familiar with their own breast tissue, as changes to this can be the first warning sign. Here are some other things to look out for:

• Changes in breast size or shape
• Dimpling of the skin
• Discharge from the nipple
• Pain in the breast or underarm
• Lump or mass in the breast or underarm
• Changes in the appearance of the nipple (redness, flaky skin)

Remember, in menstruating women, it is normal to have changes to the breast tissue around menses. The breast can also become sore, tender, or swollen around menstruation. However, if these symptoms persist beyond your cycle, you should check in with your physician.

What Causes Breast Cancer?

Statistics can provide general patterns and trends amongst a group of people. However, they aren't predictive on an individual level. There are many risk factors for cancer and specifically breast cancer. Some risk factors are modifiable (i.e., body mass), while others, like family history, are not. It's important to remember that risk factors can increase a person's risk. But they are not causative factors in disease.

The risk of being diagnosed with breast cancer can increase if you have a strong family history of breast or ovarian cancer, specifically in a first-degree relative (mother, father, sister, or brother). It can increase if you inherit a mutation known as BRCA1 or BRCA2, which can increase your risk for both breast and ovarian cancer. Additionally, if you had an early start to your menses, a late start to menopause, or have dense breast tissue, your risk status increases. This is mostly due to the presence of circulating hormones (like estrogen and progesterone) in the body.  

There are risk factors that a person can modify over their lifetime. For example, those who live sedentary lifestyles are more at risk. Those with a higher body mass index (BMI) are at higher risk. Regular alcohol consumption can also increase your risk status. Chronic inflammation can also influence the development of breast cancer. These are all modifiable risk factors and can be mitigated through lifestyle and behavioral changes. It is now understood that there is a slight increase in the risk of developing breast cancer in those with elevated blood sugar or type 2 diabetes.

Functional Medicine Labs to Test for Root Cause of Breast Cancer

As of right now, there are no labs that screen for breast cancer. However, there are laboratory markers that can help us assess whether a person's terrain is fertile for cancer development. Here we go beyond the standard genetic testing to see if a patient has an inherited mutation that may increase their risk status (like BRCA1/2).

Inflammation

As discussed earlier, chronic inflammation is a modifiable risk factor for breast cancer. There are many lab markers to assess for inflammation. Some of the most common are c-reactive protein (CRP) and erythrocyte sedimentation rate (ESR). CRP is a protein made by the liver that can also be a predictor of cardiovascular events and persistent inflammation. ESR is less sensitive than CRP as an inflammatory marker but is helpful when assessing for acute inflammation.

Hyperglycemia

Being diagnosed with type 2 diabetes is now a risk factor for developing breast cancer due to persistently elevated blood sugar levels. There are many labs to help assess glucose control. The most accessible test is known as fasting blood sugar (FBG) and is part of a routine blood test known as a comprehensive metabolic panel (CMP). This can be helpful in real-time to see if there is poor glycemic control. Additionally, a hemoglobin A1c (HbA1c) can assess a patient's average glucose level over the past three months.

Hormones

There are no standard hormone tests that can predict the development of breast cancer. However, if the female hormones are out of proportion and resulting in symptoms like irregular menses, premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), adult acne, endometriosis, or fibroids, it could be helpful to comprehensively look at hormone levels, specifically estrogen, using a DUTCH test.  

Genetics

By providing a detailed examination of a person’s genetic makeup, the 3X4 Genetics Test + Blueprint Report is beneficial for patients who want to understand better how their genetics can impact health and make optimal decisions to prevent/delay illness and maintain/improve health.

The report includes insights into nutrition, fitness, illness prevention, weight management, and de-stressing recommendations.

Women’s Health & Breast Profile

The Women’s Health and Breast Profile reports hormone levels and calculates two important ratios - the Estrogen Quotient to assess breast cancer risk and the Pg/E2 ratio to assess the relationship between estradiol and progesterone.This profile could be considered for those with increased risk of developing breast cancer or history of breast cancer or other hormonally sensitive cancers

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Complementary Integrative Medicine Therapies for Prevention

The development of breast cancer is multifactorial, and many things need to be taken into consideration. It's important to test and understand your genetic history and speak with a physician about how you can impact your modifiable risk factors. There are evidence-informed ways to decrease your risk status and also support your body during and after cancer treatment.

Nutrition for Breast Cancer Prevention

Dietary changes are one way to modify your risk status for developing breast cancer. There is good evidence that the Mediterranean Diet can decrease the development of cancer. Specific dietary recommendations include increasing the number of plants in your diet, particularly cruciferous vegetables. Cruciferous vegetables include broccoli, cauliflower, brussels sprouts, cabbage, collards, kale, and bok choy, to name a few. It is also important to decrease alcohol consumption and limit nitrates and food additives.

Supplements for Breast Cancer Prevention

Supplement recommendations should be personalized based on your medical history, risk factors, and current symptoms. For example, a breast cancer patient with a history of Hashimoto's thyroiditis will be recommended a very different supplement protocol than a breast cancer patient with type 2 diabetes.

Ultimately, your physician should do a thorough history (including family history), physical examination, and run labs that apply to your medical history. Then personalized supplement recommendations can be made.

Below are some commonly suggested supplements recommended to most patients:

Antioxidants

Polyphenols are a group of naturally occurring compounds found in plants. Polyphenols are a type of antioxidant. Polyphenols such as curcumin and epigallocatechin gallate (EGCG) show promise regarding breast cancer prevention. Some evidence shows that these polyphenols can act on epigenetics to help turn off cancer growth.

Indole-3-Carbinol

Indole-3-Carbinol (I3C) is a compound found in cruciferous vegetables. Because there is evidence that a diet high in cruciferous vegetables can be preventive, subsequent research has been done to see if supplementing I3C can affect cancer prevention. A study on 60 women at increased risk for breast cancer suggests that daily dosing of I3C is a promising chemopreventive agent for breast cancer prevention.

Sulforaphane

There is growing evidence that a phytochemical compound known as sulforaphane in green leafy vegetables effectively prevents and treats various cancers, including breast cancer. This component is naturally present in broccoli sprouts, kale, cabbage, cauliflower, and garden cress. It is available as a supplementary pill called Broccoli extract, and researchers have named it "Green chemoprevention."

Vitamins and Minerals

Vitamins, minerals, essential fats, and amino acids are vital nutrients for our bodies. Eating a variety of these nutrients gives us energy and helps our bodies grow and repair. A lifestyle rich in these nutrients also can be chemopreventative. If you are working on improving your nutrition or healing chronic gut issues that prevent you from fully absorbing the nutrition from your food, supplementing vitamins and minerals can be cancer preventative. For example, vitamin D deficiency is directly related to breast cancer occurrence.

Complementary and Alternative Medicine for Breast Cancer Patients

For those who may already be diagnosed with breast cancer, a lot can still be done. Integrative Oncology is a field of medicine that can combine root cause medicine with the wisdom of conventional medicine. Meaning integrative oncologists take the best of functional medicine to help enhance and adjunct conventional cancer care. For breast cancer, this could look like a combination of dietary and nutritional counseling around chemotherapy and surgery to enhance outcomes. It could also involve a personalized supplement protocol during chemotherapy and radiation to decrease side effects and improve life quality. If you or someone you know has been diagnosed, encourage them to seek a qualified integrative oncologist to join their care team.

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Summary

Breast cancer can be a scary diagnosis, but it doesn't have to be. More evidence than ever exists that integrative oncology can make a real difference in the lives of those affected by breast cancer. Trained physicians can work with patients to assess their risk factors and recommend ways to modify their risk status. They can also work with patients actively undergoing cancer treatment to decrease their side effects and improve their quality of life.