Monday, September 30, 2013

Bumps and Breasts and Bras ... Oh My!

A woman arrives at her doctor's office in a state of fear. She found a lump in her breast and is worried it might be serious. She has already been diagnosed with Fibrocystic Breast Disease (FBD), and she's no stranger to lumps, bumps and cysts. Yet this routine is far from old hat for her. Whenever a new abnormality develops in one of her breasts, she's always worried it will be the one that turns out to be cancer.

A scenario just like this plays out thousands of times a year in doctors' offices across the country. Countless women have sensitive, painful, lump-prone breasts and live in fear of breast cancer. And because of their FBD, they often go through numerous scar-producing biopsies and cyst aspirations. For these women, their breasts are battlefields, complete with war wounds and surprise attacks.

It doesn't have to be this way; women can make peace with their breasts by identifying and treating the causes of FBD. In the process of doing so, they may also help reduce their breast cancer risk.

Evaluating Breast Health
When a woman presents with a lump in her breast, an integrative physician usually asks the following questions:
  • At what age did you start your period?
  •  Do you smoke? Or, were you exposed to prolonged secondhand smoke at any point during your life, particularly childhood?
  • How many X-rays have you had?
  • Do you take birth control pills? And, if so, how many years have you been taking them?
  • Do you have children? Did you breastfeed them?
  • Do you have painful periods? What about premenstrual syndrome (PMS) symptoms?
  • Have you ever suffered from endometriosis or ovarian cysts?
  • Have you had previous breast lumps or cysts, and have you ever been diagnosed with FBD?
  • Do you have a family history of breast, uterine or prostate cancer?
  • Do you wear a bra? If so, for how many hours a day?
  • What is your diet like? Do you consume a lot of caffeine, sugar and red meat?

The answers the patient provides help uncover important details about her breast health and how it can be improved. For instance, many women with FBD experienced an early onset of menstruation, and were also exposed to secondhand smoke and X-rays as children. Those contributing factors, combined with longtime use of birth control pills and unhealthy diets, are indicators of an increased risk for breast cancer. On the other hand, breastfeeding, multiple pregnancies and a family history devoid of breast, uterine or prostate cancers are signs that a woman might have protection against developing breast cancer down the road.

If a woman has a history of endometriosis, premenstrual syndrome (PMS), painful periods and previous breast lumps, her body is probably producing too much estrogen compared to progesterone. This hormonal imbalance can lead to a number of women's health issues including FBD, breast cancer, menstrual issues, and ovarian cysts.

In addition, two extremely common, but often unrecognized, risk factors for both FBD and breast cancer are chronic low-level toxin exposure and excessive bra wearing.

Everyday environmental and food-borne toxins such as phathalates (plastic wrap), hydrocarbons (cigarette smoke, automobile exhaust, grilled foods) and bisphenol-A (heavy plastic bottles, test tubes, canned food liners) enter breasts through the bloodstream. Without a healthy lymphatic flow, the breasts won't detoxify, and this can make them vulnerable to disease.

Wearing a bra puts pressure on and around the breasts and restricts lymphatic flow. Consider this: lightly resting one finger on your arm will create about 5mm of mercury pressure in that location, which is enough to stop lymphatic flow. The restriction of lymphatic flow that tight bra straps have around the breasts, shoulders and back is much more significant.

Exploring Deeper
Of course, learning about a patient's personal habits and health history isn't the only way to find out what's causing her to have breast lumps, pain and sensitivity. There are several tests that can tell a physician what's going on behind the scenes. These include:
  • An iodine skin patch: Healthy levels of iodine are needed for good lymphatic flow, and will frequently eliminate or prevent breast cysts from recurring. To determine a patient’s iodine levels, a physician can paint a patch of iodine onto the skin. The quicker the iodine disappears, the more likely there is a deficiency. Ideally, the patch should last around 24 hours. For a more definitive result, the physician may order an oral iodine loading test.
  • A 25-hydroxy vitamin D test: Vitamin D is essential for maintaining healthy breasts and reducing the risk of breast cancer. Many women with FBD don't have enough vitamin D. African-American women are particularly susceptible to low levels.
  • A progesterone blood level: Women with low levels of progesterone in the two weeks leading up to their period are more likely to experience breast and ovarian cysts, PMS, and are at a greater risk of developing breast cancer later in life.
  •  A thermogram: Thermograms are infrared pictures of the breasts. "Hot spots" in a thermographic image indicate unhealthy, inflamed breast tissue. While a thermogram isn't used to diagnose active cancer, it can give a physician a good idea if a woman is heading down the road toward breast cancer. Mammograms, on the other hand, usually don't detect a cancerous area until years later when it has already developed into a mass about the size of a pea. In women who are on hormone replacement therapy or who are less than 50 years-old, a mammogram can be unreliable. This is because of the woman's increased breast density. Thermograms are helpful because they provide an earlier look at breast health.  Unlike mammograms, there's no exposure to additional radiation which is something that can increase the risk of cancer. Mammograms are complimentary to thermograms. Mammograms and ultrasound are most useful in women who have a new lump.
An Action Plan
Once the causes of unhealthy breasts are discovered, action can be taken to help you reduce the occurrence of FBD and, potentially, the risk of breast cancer.

First, the levels of essential vitamins and minerals should be optimized. Iodine/iodide supplementation can improve FBD and reduce congestion of the breasts.  Supplementing with 12.5 mg of iodine/iodide is a great starting point. Take iodine with food. Topical iodine can reduce the tenderness and size of breast cysts in a few days. Vitamin D3 helps to reduce cancer risk; supplementing with 2000 IU per day is a safe dose for any adult without having levels tested. It should be taken with food. Patients taking over 5,000 IU of the supplement for a prolonged period of time should make sure levels are monitored to prevent toxicity.

Other helpful supplements include flax seeds with phytoestrogens, which help protect against environmental estrogens and di-indole methane 150-300 mg daily which enhances the metabolism of stronger estrogens into weaker estrogens. Eating 1-2 Tbsp. of ground flax seeds per day on cereal, salads, or in smoothies is a great way to increase your estrogen lowering lignans which block the stimulation of estrogen receptors and enhance detoxification of stronger estrogens.

Vitamin A 10,000-25,000 IU per day should be taken with food. Omega-3s from fish oil or algae oil are anti-inflammatory. A healthy dose is 1200-2400mg per day with food to include DHA 400 IU.  Green tea extract enhances detoxification. The optimal dose is 600 mg per day between meals. Tocotrienols 100mg which are extracted from rice bran oil are taken at night and mixed tocopherols or Vitamin E 400IU should be taken in the morning away from the tocotrienols. These both support breast health and reduce cancer risk.

Curcumin, 1000-2000mg in divided does between meals per day is isolated from turmeric; an age old spice that prevents and treats many types of cancer including breast cancer. A dose of curcumin reduces inflammation and enhances detoxification. Eating more Indian food and taking curcumin supplements is good insurance against many cancers.

Estrogen dominance coupled with progesterone insufficiency, which is often the case, should be treated with bio-identical progesterone, which should be taken days 15-26 of the menstrual cycle. Supplements containing isoflavones from red clover and kudzu, and DIM, Rosemary 100mg, Resveratrol 50-75 mg per day can all be taken with food to normalize high estrogen levels.

While implementing these treatments and changes, a physician will monitor any existing breast lump(s). With the prescribed treatments, the lump(s) should become smaller and less tender over several weeks to a month. If it continues to grow, it needs further evaluation.

Lifestyle changes are also important. A high-fiber, anti-inflammatory diet that includes increased consumption of cruciferous vegetables like broccoli, cauliflower and cabbage, and decreased consumption of red meats will go a long way toward reducing breast cancer risk. Decreased intake of caffeine and high-sodium foods can also minimize breast pain and tenderness.

Any woman who smokes should quit. Smoking is not only harmful to the lungs, heart and skin; it's bad for breasts, too. Non-smokers should avoid secondhand smoke. Cigarette smoke contains cadmium and other toxic metals which are estrogenic metalo-carcinogens.

Undergoing regular cleanses and reducing exposure to other toxins will also improve breast health.

Finally, take off that bra! At the very least, wear it less than 12 hours a day. Ideally, though, avoid wearing it whenever possible. Visit for tips on how to easily and discreetly make the transition.

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