Monday, May 25, 2015

Breast Health: Take Control (Part 2)

Last month in Part 1 of this two-part series, I talked about the early warning indicators that breasts often provide when something within the body is out of balance. I also discussed the importance of uncompromised lymphatic flow with respect to reducing one’s breast cancer risk, and how brassieres are one of the top contributors to lymphatic flow restriction. I continue below by discussing what options women have for early detection, methods for prevention, and additional steps to take for continued good breast health.

Screening Options
There are a number of tests available to screen women for their breast health. Most commonly, conventional doctors recommend mammography. Ultrasound, 3D mammography and MRI scans are now also used. Interestingly, most conventional doctors do not endorse the use of thermography, which is infrared imaging of the breasts; however, thermography is widely used around the world and has a long history of use in Europe.


What’s the difference between mammography and thermography?
The difference between thermography and mammography is simple. Mammography is able to diagnose changes in the anatomy, or physical structure, of the breast tissues. Specifically, mammography identifies masses, density of the breast tissue, and microcalcifications. These anatomic changes result from chronic physiologic changes in the breasts. The most common finding of a mammography is “dense breast tissue”. 50% of younger women have dense breasts. Dense breasts increase the risk of breast cancer to some degree. They also make it harder to interpret mammograms. In other words, it is harder to see a breast cancer lurking within dense breast tissue. Abnormal mammograms are a call to action; usually in the form of more mammograms, other tests, and biopsies.

Thermography, on the other hand, examines the physiology, or the health, of the breast tissues. Specifically, it utilizes a change in the predicted pattern of heat in the breasts to identify hot spots where there may be either early cancer or inflammation, or both. Remember; where there is inflammation, there is increased risk of cancer. Thermography does not diagnose cancer. It detects increased heat in an area, signifying a physiological change. Physiological changes in tissue ALWAYS precede anatomic changes. Thermography picks up abnormalities in the breasts five to eight years before mammography.

To repeat; changes in the functioning health of a single breast cell or of the breast tissue always precede anatomic changes. Thermography can pick up an abnormality when there are fewer than 300 abnormal breast cells; even that early, those wayward cells are increasing the heat locally. On the other hand, it takes more than 4 billion abnormal cells to be detected by a mammogram. Detection via mammogram may take up to five to eight years later than a thermogram, depending upon the doubling time of a breast tumor. So there is more lead time to correct those factors that may be increasing the risk of breast cancer.

Does thermography pick up all breast cancer? Does mammography pick up all breast cancer?
Neither screening modality can detect all breast cancer. Period. Mammograms may miss fast-growing tumors. Thermography may miss very slow-growing tumors. Slow-growing tumors may never develop to the point that they are problem for a woman.

This is true also of prostate cancers. It is estimated that 90% of men over age 70 have prostate cancer, but not all of them are treated for it. We have learned in the past decade that many men suffer from urinary incontinence, impotency and chronic pain because of overaggressive treatment of small prostate cancers that would never have bothered them. The same holds true for many breast cancers. They may not need to be treated aggressively.

In large-breasted women, thermography may miss problems that are deep within the breast. In such cases, and especially for high-risk patients, using the both screening procedures in conjunction is appropriate. That said, a 2008 study at New York Presbyterian Hospital-Cornell found that Breast Thermography (Digital infrared thermal imaging (DITI),had a 97% sensitivity in discovering malignancies; the use of a digital infrared camera identified 58 out of 60 malignancies in breast tissue. The authors reported that DITI is especially useful in women with dense breasts.

As with an abnormal mammogram, an abnormal thermogram is a call to action. The woman will be encouraged to follow-up with her family doctor or OB/GYN, or with the physician who performed the thermography. A breast exam and assessment of risk factors for breast cancer should be included in this follow-up visit. A mammogram, ultra-sound or MRI may then be ordered at this stage if there is a high suspicion of breast cancer; if the suspicion is low the woman will be encouraged to implement a Healthy Breast Lifestyle for several months, and then repeat the thermogram. Most of the time, the hot spot will have either disappeared or stabilized, signifying that it is not a cancerous growth.


What’s the point of a repeat thermogram?
If the repeat scan in three, six, or nine months shows that the area of heat is stable or has resolved by making appropriate lifestyle changes, then the woman does not need to worry whether or not she has breast cancer. Her body has taken care of whatever the problem was with the additional support that she has provided during that period of time. And she has reduced her overall risk for breast cancer by helping her breasts get healthier.

If there is a breast cancer that cannot be controlled by lifestyle changes and appropriate supplementation, the hot spot will get worse and that will be a second call to action. Again, it’s worth repeating that this approach to detection recognizes problems years before they can be seen on mammograms. So there is more time to address the underlying causes and potentially reverse the condition.

Is there a downside to mammography?
It would be nice to have a screening test that was 100% accurate every time and had no negative consequences on the body. Unfortunately, that test does not yet exist. Mainstream mammography advertising says, “I want peace of mind.” It is an empty promise. A normal mammogram does not rule out breast cancer.

Mammograms were implemented conventionally as the optimal screening test for breast cancer in this country in the 1970s. However, review of several large studies – by task forces in the United States in 2009 and in Canada in 2011 – have documented that mammograms really don’t do what we want them to do: the risk-benefit ratio does not add up. Both task forces recommended screening women aged 50-74 every 2-3 years. Neither recommended that women less than 50 get screening mammograms if they had no recognized major risk factors. These were striking reductions from annual screenings starting at age 40 that were previously recommended. And it used to be age 35!

Last July, a panel of the National Cancer Institute concluded that improved screening has resulted in the over-diagnosis and over-treatment of cancers that are not life-threatening, without significantly reducing the death rate from the disease.

The Cochrane study in 2013 found “trials with adequate randomisation did not find an effect of screening on total cancer mortality, including breast cancer, after 10 years (RR 1.02, 95% CI 0.95 to 1.10) or on all-cause mortality after 13 years (RR 0.99, 95% CI 0.95 to 1.03).” In plain English, this means screening mammography did not save lives.

“For every 2000 women who have a mammogram, one of them will have her life prolonged, but 10 healthy women will suffer from unnecessary treatment including breast surgery and additional treatments for their cancers. Without screening, they would have been OK.” 200 will experience a false alarm with significant psychological stress. For further information go to: http://www.cochrane.dk/screening/mammography-leaflet.pdf

More recently, on April 29, the U.S. Preventive Services Task Force updated its recommendations on screening for breast cancer but made virtually no changes to its 2009 guidelines. As it did six years ago, the panel suggested that women between the ages of 50 and 74 should have mammograms every two years. In particular, women aged 60 to 69 are most likely to avoid death from breast cancer through such screenings.

On the more controversial question of beginning mammography for women between 40 and 49 years old, the task force again said that the decision should be made on a case by case basis by a woman and her doctor. Women at higher risk may benefit from earlier screening. Positive close family history, known BRCA1, 2 genes, history of chest irradiation early in life and DES exposure all suggest a need for increased screening.

This does not mean that mammography is not useful. If one has a breast lump, mammography is the way to go. But in terms of a screening tool, it is not very good and it exposes a woman to low-level radiation that was once thought to be fairly benign. We now know that it is not benign and that radiation, in and of itself, damages DNA and increases the risk of breast cancer. The aforementioned Canadian study found that women who had more mammograms did not live any longer and, in fact, lived a shorter life span compared to women who performed self-breast exams and were examined annually by their physicians. Mammograms do not work as screening tools.

Thermography may well be the best screening tool for younger women, especially those with dense breasts. No radiation, no compression and earlier information about the health of the breasts.

What if I am diagnosed with breast cancer?
If a woman is diagnosed with breast cancer, she should follow the advice below and also seek out information about the use of supplements and alternative medicine treatments for breast cancer. Some of these are very effective and some women may avoid some of the harsher treatments that are offered by conventional medicine.

At the very least, there is a place for nutritional supplementation as a woman goes through conventional therapies. Dr. Ralph Moss, who has a Ph.D. and studies the diagnosis and treatment of cancer around the world, has a website which is a great place to start: cancerdecisions.com. So much more information is available than people realize.

First Things First
To implement a Healthy Breast Lifestyle, a woman first needs additional information about her own health.

Check Vitamins A and D
Adequate levels of Vitamin D and A are essential for optimal breast health. Optimal blood levels to reduce the risk of breast cancer are between 65 and 85 ng/mL for 25-hydroxy Vitamin D and 65 -200mcg/dl for Vitamin A. (Realize that these levels of Vitamin D are higher than those recommended for bone health.)

Reduce Sugar Intake
While there is still debate between integrative and conventional doctors over whether “sugar feeds cancer”, there is no question that high blood sugar levels accelerate aging and generate extreme inflammation. Where there is inflammation, there is a greater risk of disease – including cancer. To screen for excess inflammation due to elevated sugar levels, obtain a Hemoglobin A1c (HgbA1c). If this level is 6.5 or greater, it signifies that the patient has diabetes. If it’s 5.7 or greater, the patient is a pre-diabetic and is still getting older faster. Optimally, HgbA1c should be as close to 5.2 as possible. The lower the number, the less inflammation and the slower one will age.

Check Sex Hormone and Thyroid Levels
Additional blood tests are very useful to assess the ratio of estrogens to progesterone in pre- and post-menopausal women. (See previous article.) A relative excess of estrogen to progesterone over years increases ones risk of breast and uterine cancer. Healthy estrogen levels do not cause breast cancer. High levels, however, may cause it and can certainly feed it once it’s established. On the other hand, progesterone triggers “cell suicide” in early cancer cells and other “wannabe cancer” cells. This is one of the arguments for almost always putting a post-menopausal woman on bio-identical progesterone if she goes on estrogen, regardless of whether she has had a hysterectomy.

Women who are hypothyroid have a greater risk of breast cancer. Blood tests to determine if thyroid function is optimal are helpful. Other hormone testing may be helpful.

Other Test Options
There are many other tests that can be obtained beyond these first tests and may be helpful in women who are at higher risk:

  • Urine tests to determine how a woman is metabolizing her estrogen. Is she producing carcinogenic metabolites or not? Usually it’s not estradiol that is the bad actor; it’s the breakdown products of estradiol. Supplements can correct this imbalance when identified. 
  • Urine tests to determine methylation capacity. Methylation is a chemical reaction that protects a woman from breast cancer. If metabolites of estrogen are not completely and optimally metabolized there is an increased risk of cancer. Supplements can correct this imbalance when identified.
  • Blood tests for omega-6/omega-3 ratios indicate the health of body membranes and the degree of inflammation in the body. Supplements can correct this imbalance when identified.
  • Beyond body fluid testing, a percent body fat analysis can prompt women to take action and make lifestyle changes to reduce percent body fat. Obesity, especially in post-menopausal women, has been associated with increased risk of breast cancer.
Healthy Breast Lifestyle
Once these tests have been obtained and reviewed, a woman can move forward with implementing a Healthy Breast Lifestyle, which will actually make all of her body healthier; not just her breasts.

Be certain to get a breast thermogram that includes immersing the hands in ice cold water for 60 seconds after the first set of pictures and before the second set. This helps to distinguish between hot spots due to normal blood vessels compared to blood vessels feeding a tumor.

The top 10 things that women can do to reduce their risk of breast cancer or to reverse hot spots detected with thermography are listed below:

  • Take sufficient Vitamin D 3 to optimize blood levels. 
  • Take sufficient Vitamin A to optimize blood levels.
  • Take Vitamin E 400 IU daily.
  • Take oral iodine – at least 12.5 mg of a combination supplement that has both iodine and iodide – to enhance immune function and lymphatic flow. Iodine kills breast cancer cells in tissue culture studies. A 12.5 mg dose is the approximate amount of iodine that Japanese women consume in their diet on a daily basis; it is thought that this is the reason that they have a much lower rate of cancer. 
  • Apply liquid Lugol’s Solution 50% (aka Lugol’s Iodine)* to the region of the breast that contains the hot spot or, if one has fibrocystic breast disease, to the lumpy, bumpy regions of the breast. Apply it at night by painting the affected area with a drenched Q-tip. Very large-breasted women may need a second Q-tip. Let the area dry before putting on older pajamas, as the solution can stain your clothing. Do this daily for several weeks and monitor the breast. Fibroid cysts should soften and get substantially smaller. Iodine rarely causes a rash. If this happens, stop the treatment. It can also dry out the skin. If this happens, use it less frequently, and apply a good moisturizing cream in the morning. As the breasts get healthier, decrease the frequency of use of the solution. * Lugol’s Solution requires a physician’s prescription.
  • Minimize use of bras; certainly no more than eight to twelve hours a day. Avoid underwires. Drs. Susan Love and Christiane Northrup both agree with this. 
  • Take 1-2 tablespoons of ground flax seeds daily to enhance detoxification of estrogens and to protect the breasts from environmental xenoestrogens and high estrogen levels made in the body. Flax has components that work like a weak Tamoxifen or Evista®. All of these are SERM’s (Selective Estrogen Receptor Modifiers), which block the stimulatory effect of stronger estrogens, regardless of their origin.
  • Eat a healthy diet. This will be different for each person, but in general, healthy fats, adequate, good quality protein, lots of vegetables, some fruit, lower simple sugar intake and avoiding processed and restaurant foods all play a role. Avoid GMO foods. 90% are saturated with Roundup®. Demand that processed foods be labeled as to GMO content. Know what you are eating and feeding your family. Don’t buy them. Don’t grow them. Don’t eat them.
  • Do not put cell phones in the vicinity of your breasts. In fact, do not put cell phones anyplace on your body. Whatever tissues the cell phones are closest to will be altered. Individuals who use cell phones adjacent to their ear for long periods of time, i.e. over 10 years of usage and for long conversations, and especially those who are further away from cell phone antenna, clearly have an increased risk of three different tumors: parotid gland cancers, brain tumors, and acoustic neuromas. It is thought that some of the increased rate of breast cancers in young women is because they are wearing their cell phones in their bras. Don’t do this.
  • Exercise daily. Walk as much as possible. Go to a gym, or make your world into a gym. Human bodies thrive on exercise.
Stress management and adequate sleep are also critical components to a Healthy Breast Lifestyle. Know that the recommendations above have been used by many women with successful results.

Reducing Further Risk
We cannot avoid getting older. We cannot avoid being women. We cannot change our family history (although most women who are diagnosed with breast cancer do not have a family history of breast cancer).

Many physicians feel that the exponential increase in all cancers in recent decades is due to environmental factors and an aging population. We can reduce our exposure to toxins in our home, in our car, and in our workplace. We can take supplements, clean up our diets, and do periodic cleanses to help reduce the amount of toxins in our own bodies. Then, we can choose to stay on a low, daily dose of supplements and detoxifying foods to help us keep our levels of toxins low. We can also avoid overconsumption of alcohol, cigarettes, and toxic foods. These steps will not only reduce our risk of breast cancer; they will reduce our risk of or delay onset of chronic disease.


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