Breast Health 101
In early January, I went in for a routine mammogram. My annual physical was at the end of November and I was deemed to be in good health, including the annual manual breast exam by my doctor. I've spent my whole life devoted to healthy living, my personal prerequisite for working in the mind-body medicine field. And with decades of healthy eating, regular exercise, meditation, psychotherapy, stress reduction practices and meaningful work as the foundation for my life I felt I was doing as much as I could to take care of my health.
I found myself in a state of disbelief when the mammography technician brought me back into the room for "some extra films." As one who likes to know what is going on, I started asking a whole bunch of questions and was only told that a radiologist would look at my films and the next step was an ultrasound for further diagnostics if the radiologist deemed it necessary. It was my right breast in question, the area closest to my rib cage, based on the way I was compressed into the mammogram machine.
Sure enough, the call came in that afternoon and I was told they had found a "new density" in my right breast. My stomach clenched, my heart started racing, and the vulnerability of being a sole custody single mom with a young teen permeated my being. When I called the doctor's office to get some information and the ultrasound scheduled I was told, "We can't talk about it and there is no radiologist here to talk to you." This unwelcome news launched me into a confusing medical maze where getting complete answers or even people who can answer your questions is neither easy nor predictable.
The good news is that while I do not have total assurance that everything is okay, the ultrasound, while labeled "inconclusive," did not find any specific thing that could be biopsied. When an MRI was then prescribed as the next step but proved to be problematic for me, the radiologist concluded that I could just come back in July for another mammogram and ultrasound without the MRI.
It took 2 months of doing enough research for me to truly grasp what was going on and what it might mean. Much of my support and research was provided by friends, colleagues and support organizations outside of the medical practice I go to for regular care. As I was going through my two-month ordeal, I became aware of a film called "Toxic Bust," which examines the backdrop for why, despite advances in breast cancer detection and treatment, breast cancer rates continue to rise. The rate has nearly tripled since 1940. Now, 1 in 7 American women will be diagnosed with breast cancer in their lifetime. Over 50% of these breast cancer cases cannot be explained by personal risk factors or hereditary causes and are "unknown."1
This article is the result of my own research and conversations, including interviews with breast cancer survivor, Meg Wolff, nutrition pioneer, T. Colin Campbell, Massachusetts Breast Cancer Coalition Executive Director, Deborah Shields, bodyworkers Mimi Rhys and Eileen Beasley, with expertise in the lymphatic system, and members of the personal and professional communities I am fortunate enough to be part of who supported me in my quest for truth and understanding of breast health and breast care.
Why Is The Rate of Breast Cancer Rising?
While the question of why the rate of breast cancer is rising is a controversial one, two key factors appear to be environmental toxins and the American diet.
Massachusetts Breast Cancer Coalition Executive Director Deborah Shields notes that, "researchers know that at least 216 compounds act as endocrine disrupting compounds or mammary carcinogens. These compounds are in every day use in all kinds of consumer products such as baby's sippy cups, hard plastic sports bottles, beauty care products (mascara, lipstick, nail polish, perfumes, shampoo), skin care products (moisturizers, skin whiteners and skin darkeners/self-tanning products) cleaning products, floor coverings, food additives, drinking water, lawn care products and building products."
Shields continues, "The U.S. National Toxicology Program has said that every person encounters 200 chemicals per day that are known or likely carcinogens. Additionally, the Environmental Working Group studied the umbilical cord blood of newborns and found nearly 200 toxins in their blood, and these are beings only minutes outside of the womb! Research in this area is difficult because we are exposed to so many different chemicals every day that it's nearly impossible to sort out only 1 or 2 that might be the primary causes of breast cancer. And how these chemicals act alone versus in combination with each other is another difficult but necessary question to consider. There is almost no way to design a study of exposure to a combination of chemicals in a way that is ethical."
Six substances have been consistently identified in breast cancer tumors:
Phthalates: Phthalates are used to make plastic soft and flexible. Phthalates are everywhere, from vinyl shower curtains to new cars (the phthalates account for some of the "new car smell") to even sex toys. "The Center for Disease Control tested 289 people for phthalates and 100% of the people tested positive," Shields notes.
Parabens: Parabens are found in personal care products that have water, including face products, sunscreen, shampoos, conditioners, cosmetics and personal lubricants.
Bisphenol A (BPA): Used as a plastic hardener, BPA is found in food can linings, baby bottles and sippy cups, water bottles, dental sealants and even in the coating on register receipts. In the CDC study of adults, 95% had measurable amounts of BPA in their blood and urine.
Benzene: Benzene is found in high concentration in air pollution, gas and diesel fumes, exhaust and cigarette smoke. Male marines who served at Camp LeJeune in the 1980's developed breast cancer, where it was later discovered that the water was full of benzene and PERC, which is a compound used in dry cleaning.
Excessive or synthetic estrogen: Breast cancer has been linked to excessive estrogen or estrogen that cannot be properly utilized by the body.
Heavy metals: Mercury, which is sometimes found in fish and most commonly in dental fillings, is a neurotoxin and also a mammary carcinogen. Lead has been found in lipstick. According to Shields, "The largest cosmetic companies like Avon and Estee Lauder reformulate products for European markets but refuse to sell the less toxic products on the U.S. market. The EU bans 1,100 chemicals from use in products sold there, but we still use them in the U.S. due to our lack of chemical and environmental regulations."
The American Diet
Even if we face unavoidable exposure to environmental toxins in our daily lives, a very fundamental line of defense to both internal and external health threats that we can impact is what we eat.
T. Colin Campbell, author of The China Study (2009, BenBella Books), has spent 54 years researching the relationship of food with both cancer and other diseases.
"Most simply," notes Campbell, "is that whole plant-based foods are beneficial for cancer prevention. They can also stop and even reverse the progression of heart disease and diabetes."
As our bodies evolved over eons, they became facile at gathering macronutrients like protein, fat and carbohydrates in an integrated context. In today's world, we separate out nutrients into compartmentalized boxes. We remove white flour from plants, sugar from plants and oils from plants, and mix the individual parts together and make a donut. This is the thought process underlying processed foods, where individual parts are mixed together, instead of eating foods in their whole state of being, the way they are created in nature.
"Plant-based foods have the right combination and level of carbs, proteins and fats," acknowledges Campbell.
According to Campbell, we have deviated from this model in two critical ways: we have substituted animal-based foods (including meat, milk and eggs) for plant-based foods and we have developed a lot of processed foods.
"One of the foods that has a particularly strong relationship with breast cancer," says Campbell, "is dairy – cow's milk. The protein in cow's milk was what we used to turn on cancer cell growth in experiments with laboratory animals over a 27-year period through NIH-funded studies. Casein, the main protein in cow's milk, is the most relevant carcinogen we consume in our diets. Human milk is the perfect food for human infants, cow's milk for calves."
Processed foods have become a food of convenience in a work-addicted culture over the past several decades. Elements that are fine in plants as part of the whole (including sugar, white flour and oils) can become a problem when removed from the plant context and turned into processed foods.
"Consuming a lot of processed foods combined with consuming a lot of animal foods is a deadly combination," says Campbell. "We try to shortcut our problems and rely on the use of nutritional supplements, which has grown into a multi-billion dollar industry in the past two decades. But it doesn't work. When we get the diseases, we rely on the use of harsh chemicals called drugs to alleviate some of the pain. This approach, which is at the heart of the entire medical profession, is a very bad way to go. We rely on the idea that diseases are predestined, but that is not true. We don't get diseases because of our genes. It is a matter of expression."
"Proper nutrition is required for healthy regeneration of our cells," emphasizes Campbell. "We are doing it every second of our lives."
Diagnostic Tools for Breast Health and What They Tell Us
Breast cancer survivor, Meg Wolff, first felt a lump in her breast when she was 40 years old. "The minute I felt a lump in my breast, I immediately took action. At that point, my doctor wasn't concerned. I'd had mammograms the prior five years. I was concerned and asked my doctor to refer me to a specialist."
"The specialist did a mammogram and an ultrasound and still wasn't concerned. He didn't think what I had found was anything. I would shower and I could feel it. I'd get a gut reaction of fear: this isn't right and doesn't belong there. So, I kept pursuing it."
At age 41, Wolff finally found a doctor who could hear her concern. She had another ultrasound, and this time, the person doing the test was concerned. "You need a biopsy," he said. They did a biopsy and immediately detected advanced cancer.
"I wondered why they didn't just do the biopsy before," reflects Wolff. "Better an unnecessary biopsy than an unnecessary mastectomy. If I wasn't aware of what was normal and what wasn't normal, I would have never detected my cancer. Never give your power away to people who think they know or don't know."
While many women know about mammograms and breast self-exams, information about exactly what diagnostic tests are available and what they can and cannot tell you is not readily enough provided. When I had my winter scare, I learned that primary care physicians often can't read mammograms, and therefore, can't provide insight on what is going on when a woman is told something is abnormal. Radiologists are the ones who truly diagnose what is going on when a woman has anything labeled abnormal, and speaking to one's radiologist is essential to get questions answered and sufficient information to understand what is going on.
There are many different findings that can cause a mammogram to be labeled abnormal. 15% of mammograms are labeled abnormal and 80% of the women in these cases turn out to be okay. What this means is that if you receive news your mammogram test is abnormal, there is only a 3% chance you may need treatment of any kind.
The only way to truly diagnose whether breast tissue malignant or not is to conduct a biopsy, where a sample of the tissue in question is removed for analysis. If there is nothing to biopsy, such as an "area of density," then there is nothing specific to evaluate as malignant or benign. Areas of density themselves are not linked to cancer; it just means you cannot see the underlying breast tissue in enough detail to know if things are okay or abnormal.
Breast Diagnostic Tools
SELF EXAM Beginning in their 20's, women should learn about breast self-exams. By learning how your breasts normally feel, and examining them regularly at the same time each month, you will be able to spot any changes. All changes do not mean there is cancer. However, consulting a doctor is wise if you do experience any change to determine what is going on.
EXAMINATION BY DOCTOR IN ANNUAL PHYSICAL As part of your annual physical, a doctor usually performs a manual breast exam. S/he would cover the same territory you might do in your monthly self-exams. The doctor may or may not pick up something worth exploring further.
MAMMOGRAM A mammogram uses low dose X-rays to examine breast tissue and see if there is anything abnormal or worth further study. Screening mammograms are used to check for breast cancer in women who have no signs or symptoms of the disease. Diagnostic mammograms are used to check for breast cancer after a lump or any other sign or symptom has been found.2 The frequency of mammograms and age at which women should begin to have regular mammograms is currently under debate. Historically, annual mammograms were recommended for women 40 and older, yet new evidence suggests that overuse of mammograms may actually be responsible for triggering cancer through toxic radiation and tissue trauma, as well as over diagnosis and unnecessary treatment in thousands of cases annually.3,4
THERMOGRAPHY Breast thermography uses digital infrared imaging to produce high-resolution images of temperature variations within the breast. Metabolic activity and vascular circulation in both pre-cancerous tissue and the area surrounding a developing breast cancer is almost always higher than in normal breast tissue, causing increases in regional surface temperatures of the affected area. Thermography may provide useful information when women have dense, large, enhanced, fibrocystic or nursing breasts. It involves no radiation or breast compression. Patients can have multiple screenings per year to track changes with no side effects. Currently, thermography is not covered by insurance and patients must pay out of pocket for this test.
ULTRASOUND A breast ultrasound is usually done if a mammogram or clinical exam determines an area of concern that isn't easily distinguishable. Ultrasounds use high-frequency sound waves, so there is no radiation. The ultrasound can provide clear imaging of dense breast tissue and excellent contrast resolution, but cannot provide as much detail as a mammogram image in many instances.
MRI Magnetic resonance imaging can be used to detect breast cancer or any other abnormality in the breast. The MRI technology allows for multiple images of breast tissue to be captured, and uses computers to generate detailed pictures. A dye is often injected into the patient for greater contrast of breast tissue in the images. An MRI is a costly procedure that may be ordered when insufficient data results from an abnormal mammogram, but is always read in addition to a mammogram, not instead of one. Because an MRI is so sensitive, it also results in a higher percentage of "false positive" findings, resulting in additional possibly unnecessary testing, stress and anxiety for patients.
BIOPSY A breast biopsy removes a small amount of breast tissue for laboratory analysis. This is the only way to determine whether tissue is benign or malignant. The results of a breast biopsy inform the need for further treatment when necessary.
Breast Care Resources for Daily Life
While there is no guarantee that we will completely avoid breast disease even if we take care of ourselves and "do everything right," we can increase our chances of remaining healthy by knowing about and choosing good breast health practices.
Eating Whole Foods
Meg Wolff attributes a change in diet to her cancer-free health. Meg recognized that when she tried alternative modalities prior to changing her diet, nothing seemed to work. Once she built a diet based on healthy, plant-based whole foods, her system responded to other healing methods.
"I think my body was so toxified before changing my diet that those gentle modalities didn't move anything. Now they work. When you eat a diet based on whole grains and vegetables, all the fiber keeps cholesterol and estrogen levels low by giving the estrogens something to bind on to. With no fiber, like in a meat and dairy diet, the estrogens keep circulating in the body. The plant-based foods also have immune system-enhancing and cancer-fighting compounds."
Caring For The Lymph System
We are all familiar with blood as a fluid system in the body. "Lymph is a second fluid system in the body," comments Brighton, MA lymphatic drainage practitioner Mimi Rhys. "It mirrors the circulatory system, but has no heart to move it."
The lymph is moved by muscles and by our activity. Because breasts don't have muscle, the lymph has a tendency to pool in the breasts. If women wear tight bras, the bras provide a barrier to lymph circulation.
"There are muscles behind the breasts, but not in the breasts," continues Rhys. "It's like a chest wall with breasts on top of it. Lymph collects behind the breasts. Exercise will move it, but a restrictive bra, which many women wear when they exercise, will counteract that movement."
Lymphatic drainage work, which is very light, using about a nickel's amount of weight on the breast in a specific pattern, can help the lymph move, helping the body detoxify. "The lymph carries the waste products of cellular degeneration," adds Rhys. "It also removes toxins from the body so it is important to move it out of the breasts. Fat has a tendency to collect toxins. By moving the lymph, you help detoxify the fat tissue and the lymph itself."
Eileen Beasley, a healer from Falmouth, ME, who also works with the lymphatic system, acknowledges, "There are specific areas within the breast that can be massaged following the travel route of lymph that will stimulate the lymph to work properly. Like working out at the gym, the daily practice of clearing out your lymph system will clear out anything that might cause disease."
Beasley studied at the Upledger Institute and notes that the protocol for self-care lymphatic work is available online. There are a number of areas to work with, including under the arms – the axilla area, and down along the side of the breast where it hits the ribcage. "You can rub your hand in an upwards motion. That will clean out the bronchial nodes, which are being used for the breasts. This is a good way to start self-care."
Learn how to add breast self-massage to your care routine. Regular massage increases fluid and lymph circulation in the breasts.
Acupuncture and Other Forms of Healing
If our bodies are in a state of imbalance, we are more likely to become I'll. An acupuncturist can identify which of our body's energy meridians are out of balance and help bring them into balance through treatment. Because an acupuncturist can tailor treatment to whatever ails us or what we are concerned might ail us down the line, acupuncture can help us do preventative care as well as address current health issues.
Qigong, another form of Chinese energy medicine, has many exercises to move our energy into balance. A lymphatic exercise can help move the lymph in the body, especially under the arms and in the breast area. Moving your body in figure 8 patterns is another qigong exercise that is good for working to balance your energy field. You can trace your finger in a figure 8 pattern over your breast area, or move your arms or whole body in a figure 8 pattern to balance your energy field. Other forms of energy work, such as body psychotherapy methods, can help work at the emotion-body interface. Vitamin D3 has recently gained notice for its remarkable research results in slashing cancer rates among patients and in preventing breast cancer.5
Underwire bras both block lymphatic flow and can cause soreness or blockages in the breast area. Wearing a wire-free, non-constrictive bra or camisole can help with breast health by allowing breast tissue and lymph to move more freely.
Avoiding Products With Toxic Chemicals
Microwave popcorn, plastics, soaps and detergents and personal care products that contain some of the toxic chemicals described in this article can be avoided by choosing healthier, chemical-free alternatives. Homemade popcorn may not be quite as convenient as microwave popcorn, but it is healthier.
Asking Questions and Seeking Information
If you have any questions about your breast health, it is always good to ask questions and seek information. Your Shoes at http://www.networkofstrength.org is a network of breast cancer survivors who are available to answer any question you might have about breast health, as well as http://www.knowbreastcancer.net
"Toxic Bust," a documentary film looking at chemicals and breast cancer by Megan Siler. http://toxicbust.org
"Network of Strength" and "Your Shoes." Cancer information and support from cancer survivors. http://www.networkofstrength.org
The China Study by T. Colin Campbell. BenBella Books, 2009. http://www.thechinastudy.com
Meg Wolff publishes a newsletter and has many breast health resources on her website. http://www.megwolff.com
Emotional Kinesthetic Psychotherapy (EKP) can work at the emotion-body interface to release deeply held emotion in the body. http://www.healingheartpower.com
Know Breast Cancer. A national breast cancer prevention project promotes real breast cancer prevention through 7 Easy Ways to Stop Breast Cancer. http://www.knowbreastcancer.net
Physicians Committee for Responsible Medicine. Has researched the relationship of nutrition and breast cancer extensively. http://www.pcrm.org
Campaign for Safe Cosmetics. Non-profit launched in 2004 to help protect the health of consumers. http://www.safecosmetics.org
Massachusetts Breast Cancer Coalition. Non-profit compiling the compelling research linking environmental toxins to breast cancer. http://www.mbcc.org
Silent Spring Institute. A unique partnership of scientists, physicians, activists and public health advocates identifying the links between the environment and women’s health. http://www.silentspring.org
1. "Toxic Bust", documentary film by Megan Siler. http://toxicbust.org.
2. National Cancer Institute Facts Sheet. http://www.cancer.gov/cancertopics/factsheet/Detection/mammograms
3. "Know About Mammograms; Know Safer Alternatives." http://www.knowbreastcancer.net/mammograms.html
4. "Early Mammograms May Trigger Genetic Breast Cancer" . NaturalNews.com. February 8, 2009. http://www.naturalnews.com/025560_cancer_brst_cancer_mammograms.html
5. "Breast Cancer, Integrative Medicine and Vitamin D" by Dr. Soram Khalsa. Huffington Post, October 20, 2009.
Linda Marks, MSM, has practiced heart-centered body psychotherapy for 25 years with individuals, couples, families and groups. She holds degrees from Yale and MIT, is the author of 3 books and the founder of the Institute for Emotional-Kinesthetic Psychotherapy in Newton, MA. She runs the Boston Area Mind-Body Therapies Meet-up group. You can learn more about Linda's work at http://www.healingheartpower.com, or contact her at LSMHEART@aol.com or (617) 965-7846.