Breast cancer is a cancer that starts in the cells of the breast in men and women. Worldwide, breast cancer is the second most common type of cancer after lung cancer and the fifth most common cause of cancer death. However breast cancer mortality worldwide is just 25% greater than that of lung cancer in women. In 2005, breast cancer caused 502,000 deaths worldwide . The number of cases worldwide has significantly increased since the 1970s, a phenomenon partly blamed on modern lifestyles in the Western world.
Because the breast is composed of identical tissues in males and females, breast cancer also occurs in males. Incidences of breast cancer in men are approximately 100 times less common than in women, but men with breast cancer are considered to have the same statistical survival rates as women.
Signs and Symptoms
The first symptom, or subjective sign, of breast cancer is typically a lump that feels different than the surrounding breast tissue. According to the Merck Manual, greater than 80% of breast cancer cases are discovered as a lump by the woman herself. According to the American Cancer Society (ACS), the first medical sign, or objective indication of breast cancer as detected by a physician, is discovered by mammogram.
Indications of breast cancer other than a lump may include changes in breast size or shape, skin dimpling, nipple inversion, or spontaneous single-nipple discharge. Pain is an unreliable tool in determining the presence of breast cancer, but may be indicative of other breast-related health issues such as mastodynia.
When breast cancer cells invade the dermal lymphatics, small lymph vessels in the skin of the breast, its presentation can resemble skin inflammation and thus is known as inflammatory breast cancer (IBC). Symptoms of inflammatory breast cancer include pain, swelling, warmth and redness throughout the breast, as well as an orange peel texture to the skin referred to as peau d’orange.
Another reported symptom complex of breast cancer is Paget’s disease of the breast. This syndrome presents as eczematoid skin changes such as redness and mild flaking of the nipple skin. As Paget’s advances, symptoms may include tingling, itching, increased sensitivity, burning, and pain. There may also be discharge from the nipple. Approximately half of women diagnosed with Paget’s also have a lump in the breast.
Occasionally, breast cancer presents as metastatic disease, that is, cancer that has spread beyond the original organ. Metastatic breast cancer will cause symptoms that depend on the location of metastasis. More common sites of metastasis include bone, liver, lung and brain. Unexplained weight loss can occasionally herald an occult breast cancer, as can symptoms of fevers or chills. Bone or joint pains can sometimes be manifestations of metastatic breast cancer, as can jaundice or neurological symptoms. These symptoms are “non-specific,” meaning they can also be manifestations of many other illnesses.
Most symptoms of breast disorder do not turn out to represent underlying breast cancer. Benign breast diseases such as mastitis and fibroadenoma of the breast are more common causes of breast disorder symptoms. The appearance of a new symptom should be taken seriously by both patients and their doctors, because of the possibility of an underlying breast cancer at almost any age.
Steps to Prevent Breast Cancer
1. Maintain a healthy body weight (BMI less than 25) throughout your life. Weight gain in midlife, independent of BMI, has been shown to significantly increase breast cancer risk. Additionally, and elevated BMI has been conclusively shown to increase the risk of post-menopausal breast cancer.
2. Minimize or avoid alcohol. Alcohol use is the most well established dietary risk factor for breast cancer. The Harvard Nurses’ Health study, along with several others, has shown consuming more than one alcoholic beverage a day can increase breast cancer risk by as much as 20-25 percent.
3. Consume as many fruits and vegetables as possible. Eat seven or more servings daily. The superstars for breast cancer protection include all cruciferous vegetables (broccoli, cabbage, brussels sprouts, cauliflower) ; dark leafy greens (collards, kale, spinach) ; carrots and tomatoes. The superstar fruits include citrus, berries and cherries. Note: it is best to eat cruciferous vegetables raw or lightly cooked, as some of the phytochemicals believed to offer protection against breast cancer are destroyed by heat.
4. Exercise regularly the rest of your life. Many studies have shown that regular exercise provides powerful protection against breast cancer. Aim for 30 minutes or more of moderate aerobic activity (brisk walking) five or more days a week. Consistency and duration, not intensity, are key!
5. Do your fats right! The type of fat in your diet can affect your breast cancer risk. Minimize consumption of omega-6 fats (sunflower, safflower, corn and cottonseed oils), saturated fats and trans fats. Maximize your intake of omega-3 fats, especially from oily fish (salmon, tuna, mackerel, sardines, lake trout and herring). Consume monounsaturated oils (canola, olive oil, nuts/seeds, avocados) as your primary fat source, as these foods have potential anticancer properties. Specifically, canola oil is a good source of omega-3 fats; extra virgin olive oil is a potent source of antioxidant polyphenols, including squalene; and nuts and seeds provide you with the cancer protective mineral, selenium.
6. Do your carbs right! Minimize consumption of the high glycemic index, “Great White Hazards” – white flour, white rice, white potatoes, sugar and products containing them. These foods trigger hormonal changes that promote cellular growth in breast tissue. Replace these “wrong” carbs with whole grains and beans/legumes. Beans/legumes because of their high fiber and lignan content are especially special.
7. Consume whole food soy products regularly, such as tofu, tempeh, edamame, roasted soy nuts, soy milk and miso. Only consume organic, non-GMO (genetically modified) soy. Epidemiologic studies have shown a positive association between soy consumption and reduced breast cancer risk.
8. Minimize exposure to pharmacologic estrogens and xeno-estrogens. Do not take prescription estrogens unless medically indicated. Lifetime exposure to estrogen plays a fundamental role in the development of breast cancer. Also avoid estrogen-like compounds found in environmental pollutants, such as pesticides and industrial chemicals. Buy organic produce if you can afford it; otherwise, thoroughly wash all non-organic produce. Minimize exposure to residual hormones found in non-organic dairy products, meat and poultry.
9. Take your supplements daily. A multivitamin, 500-1,000 mg of vitamin C in divided doses, 200-400 IUs of vitamin E as mixed tocopherols, and pharmaceutical grade fish oil. Also take 200 mcg of the mineral selenium or eat one to two Brazil nuts as an alternative. If you have a chronic medical condition or take prescription drugs, consult your physician first.
10. Maintain a positive mental outlook. Engage in self-nurturing behaviors regularly. Develop rich, warm and mutually beneficial relationships with family and friends. Get adequate sleep (7-8 hours per night). The mind-body associations with breast cancer are significant.
After a breast cancer diagnosis, you and your doctors will put together a treatment plan specific to your situation, based on your pathology report. Your treatment plan will be made up of one or more specific treatments that are intended to target the cancer cells in different ways and reduce the risk of future breast cancer recurrence. You and your doctor will base your treatment decisions on YOUR unique situation, including consideration of your overall medical condition and your personal style of making decisions. You may have to re-evaluate your decisions periodically. Your medical team will be your guide.
Treatment of Breast Cancer
There are two methods of treatment – local and systemic.
Local treatments are used to remove or destroy the cancer cells in a specific area. Surgery and Radiation therapy are examples of local treatments.
Systemic treatments are used to destroy or control cancer cells all over the body. Chemotherapy and hormonal therapy examples of systemic treatments.
The right treatment method, however, depends on the size and location of the breast tumor; the results of the pathologist’ s review of the tumor specimen, the woman’s age, menopausal status, and general health; and the stage of the disease.
