RISK FACTORS AND NUTRITION

  • ~66% ~ with breast cancer have no known risk factors. [Harris JR, N Engl] Med 327(5): 319-328, 1992]
  • FACTORS THAT INCREASE RISK

(Bilimoria MM,CA Cancer J Clin 45: 263 – 278, 1995)

Gender

The primary risk factor.

  • M : F = ~135:1.

Age

  • As age progresses from 35 to 65 years, there is 6 X ↑ in breast cancer.
  • At age 60 years, ~ 17 in every 1,000 females ~ are expected to develop breast cancer within 5 years.

Hormonal factors

[Brinton LA, Cancer Invest 6: 245-254, 1988]

  • Estrogen levels in the breast are the same for pre- and post­menopausal females
  • General rule:

uninterrupted menstrual cycling for long periods of time ↑ risk.

  • Menstrual history

Early menarche:

in China the average age of menarche is 17 years

in the USA the average age of menarche is 12.8 years.

Regular menses:

[Henderson BE, Cancer 56: 1206-1208, 1985]

establishing regular menstrual cycles within 1 year of the first menstrual period.

Late menopause:

[Trichopoulos D,] Natl Cancer Imt 48: 605-613, 1972]

females who experienced menopause before the age of 45 years are esti­mated to have one-half the lifetime breast cancer risk of females who experience menopause after the age of 55 years.

Irregularity of menstrual cycles:

↓ in the total number of ovulatory cycles may be protective.

[Parazzini F, Oncology 50: 222-225, 1993].

  • Reproductive history

Nulliparity ↑ risk by 30%.

 

Females who delay childbirth until the age of 30 years have a 2 X ↑ risk of developing breast cancer compared with females who have a first child at < 20 years of age.

[Brewster A, Curr Opin Oncol13: 420-425, 2001]

Risk can be further reduced with earlier age of subsequent births.

[Chie WC, Am] Epidemiol151: 715-722, 2000]

There appears to be a transient ↑ risk of breast cancer after giving birth.

[Lambe M, N Engl] Med 331: 5-9, 1994]

This risk is more pronounced for females who have their first child after the age of 35 years.

Diethylstilbestrol (DES) use in pregnancy.

Oral contraceptives

Women’s CARE (Contraceptive and Reproductive Experiences) Study

[Marchbanks P, N Engl] Med 346: 2025-2032, 2002]

Population-based, case-control study of former and current users of oral contraceptives aged 35-64 years. – 4,575 females with breast cancer and 4,682 controls.

> 75% of ~ in the study had used oral contraceptives.

RESULTS:- Relative risk 1.0 (95% Cl, 0.8-1.3) for females who were currently usingl contraceptives.

Alcohol

 

[Smith-Warner SA,]AMA 279: 535-540, 1998]

[Longnecker Mp, Cancer Causes Control 5: 73-82,’1994]

[Longnecker Mp,]AMA 260: 652-656, 1988]

[Willett WC, N Engl] Med 316: 1174-1180, 1987]

[Tannenbaum A, Cancer Res 2: 468-475, 1942.]

 

Two drinks/day, ↑ risk (lA-1.7x)

The source of alcohol seems to influence the breast cancer risk.

The effect of alcohol consumption may be more noted in females with a family history of breast cancer.

[Vachon C, Cancer 92: 240-248, 2001]

The effect of alcohol on breast cancer may be enhanced by other factors, such as a low dietary intake of folate, HRT, or hormonereceptor status.

Singletary K,]AMA 286: 2143-2151, 2001]

Recent data suggest that dietary folate can counteract the effect of alcohol.

 

Family history

 

  • 85% of cases do not have a family history of breast cancer.

 

  • If a mother, sister, or daughter has a (+) history of breast cancer, the patient’s risk is ↑ 2x (sister> mother).

 

  • If two first-degree relatives have breast cancer, the patient’s risk is 25% ± 11%, or ↑ 4-6 x, and even as high as 50%, if one of the two relatives had bilateral disease before 50 years of age.

 

Hereditary breast cancer

 

[Garber JE,] Clin Oncol 23: 276-292, 2005]

[Greene MH, Mayo Clin Proc 72: 54-65, 1997]

 

~ 5-10% of all breast cancers have an inherited basis.

All are autosomal dominant, tend to be highly penetrant, and most are bilateral:

gene penetrance → associated cancer risk.

 

50% of hereditary breast cancer is inherited from the father’s side.

 

Carriers of a germ-line mutation have a 1.5–4% per year risk of develo­ping breast cancer.

 

The best characterized genetic risk factors are represented by germ­line mutations in BRCA1 and BRCA2.

 

BRCA1 and BRCA2 are tumour-suppressor genes that, when mutated, are associated with a much higher risk of

developing breast and ovarian cancer.

 

BRCA1 and BRCA2 encode for proteins the fundamental role of which is DNA repair.

 

There are> 500 mutations in BRCA1 and a similar number in BRCA2.

 

Females who inherit a single mutated copy of either BRCA1 or BRCA2 have a significantly ↑ lifetime risk of breast

cancer.

[Ford D, Lancet 343: 692-695, 1994]

 

In the USA> 500,000 females are carriers.

1/40 (2.5%) of Ashkenazi Jews in the USA carry a BRCA1 or BRCA2 mutation.

 

Three “founder” mutations comprise the majority of mutations found in Ashkenazi (Eastern European) Jews, with a total frequency of ~2.4%:

[Struewing JP, N Engl] Med 336: 1401-1408, 1997]

185delAG (in BRCA1) —+ frequency ~ 1 %

5382insC (in BRCA1) —+ frequency 0.1-0.3%

6174delT (in BRCA2) —+ frequency ~ 1.2%.

 

 

Loss of the p53 tumour-suppressor gene seems critical in the develop­ment of these breast cancers.

 

 

In in vitro and animal models BRCA1 or BRCA2 tumours have been shown to be radiosensitive.

 

 

45 years is the median age for development of inherited breast cancer (BRCA1/BRCA2).

 

 

Breast cancer

[Antoniou A, Am] Hum Genet 72: 1117-1130, 2003]

Lifetime risk associated with BRCA1 —+ 50-80%.

Lifetime risk associated with BRCA2 —+ 40-70%.

 

Good Breast Nutrition

The American Cancer Society states that about 1/3 of the ½ a million cancer deaths in the US each year can be attributed to dietary factors. Their two top recommendations are:

Choose most of the foods you eat from plant sources.

Limit your intake of animal protein.

Recent identified risk factors for Breast Cancer.

  •    Limit or avoid alcohol

Studies in France show that regular intake of alcohol amongst women (4 litres or more of red wine in 1 month) or ½ a glass per day is associated with a substantial increase in the risk of Breast Cancer amongst premenopausal women .Eurpean Journal of Epidemiology Sept.1997

A pooled analysis of  studies (USA, Cananda, Sweden, Netherlands) involving 32 2647 women over 11 years supports the hypothesis that alcohol intake is associated with an increased risk of Breast Cancer.

JAMA Feb 18/1988

Cut out smoking. There is a three-fold increase in Breast Cancer risk amongst women who engage in active smoking.

Maintain a healthy weight.

Obesity is a contributing factor to many health risks today. Obesity can be defined as a BMI of over 30. Your BMI should be 25 or less. Between 1978 and 2003, 2010 women with stage 1 and stage 2 Breast Cancer who were treated with lumpectomy, axillary dissection and radiotherapy were studied. The findings were- Obesity impairs survival in early Breast Cancer. Dr. P.R Anderson. Fox Chase

Cancer Center, Philadelphia.

Two out of  three Americans today are overweight & 73 million Americans have pre- diabetes & diabetes. Elevated insulin levels and leptin levels are the major contributing factors.

Control your insulin levels

An article in Medical Review July 1910 entitled ‘Diseases due to sugar poisoning’ by George M. Gould MD warned of the hidden dangers of refined sugar. Almost a century later Keith Block MD. Assist. Professor at University. Of Illinois warns about the consumption of refined carbs and sugar which stimulate insulin production.

Cancer’s preferred fuel is glucose. Otto Warburg MD the German physician was awarded a Nobel Prize over 75 years ago for first   uncovering cancer cells massive dependance on sugar as a fuel source. He also discovered that by depriving tissues of oxygen (35% less than normal) he could induce cancer in tissues. Now researchers at   Harvard Medical School have found that blocking one of the glycolytic pathways enzymes LDHA may be an effective anti-cancer therapy. Cancer Cell June 2006. Vol. 9 No. 6. 425 – 434.

Cut out all refined carbs & sugar. Stevia, fructose, xylitol and raw unpasteurised honey are better alternatives to sugar.

Maintain an alkaline  pH.

Cancer cells thrive in an acid pH. The large amount of lactic acid produced by the fermentation of glucose from cancer cells generates a lower more acidic pH in cancerous tumors. Hence physical fatigue from lactic acid buildup. The ideal pH would be one which promotes healing and building in the body. A very acidic environment below 5.8   can contribute to toxins accumulating in the body.

Avoid excessive use of antibiotics.

In 2004 the American Academy of Dermatology encouraged its members to carefully select patients for chronic antibiotic therapy and limit long-term use.

A study published that year found an association of increased risk of Breast Cancer with long term antibiotic use. The trial showed antibiotic use for more than 500 days or more than 25 perscriptions over an average period of 17 years had twice the risk of Breast Cancer.

Maintain healthy intestinal flora.

A most recent study published this month in ‘ Enviromental Health’ 08/2006 showed that employees who take probiotics on a daily basis will miss less work from common illnesses.

There are 100 trillion (1 ½ kg) of bacteria  which line our intestinal tract. Good bacteria help neutralize carcinogens and protect us from environmental toxins such as pesticides and pollutants. They control candida. They are a very important supplement for patients who are undergoing radiation & chemo, and for anyone taking antibiotics and cortisone.

Consume sufficient fiber. (20 – 30 grams a day)

Soluble fiber has been shown to improve glucose tolerance and serum lipid profiles.

Fiber reduces fecal transit time and helps absorb conjugated estrogens. It may directly reduce the amount of bioavailability oestradiol. Both soluble & insoluble fibre are crucial for good intestinal health.

Consume the right kind of fat.

The essential fatty acids are crucial to our wellbeing.

Omega 3  – Oily fish – Tuna, Salmon, Sardines, Trout and  Mackerel

 

Omega 6 – Avo, nuts, seeds, sweet corn, cold pressed oils

Omega 9 – Olives, cold pressed olive oil

 

Researchers  evaluated over 250 patients with Breast Cancer. They found a protective effect of Omega 3  on Breast Cancer risks and support the imperative balance of Omega 3 to Omega 6 ratio as being crucial in the development of Breast Cancer.Int Journal Cancer. March 2002 1; 98(1): 78-83

Vegetable oil fats can excelerate cancer growth.

A study on Omega 6 fatty acids showed accelerated growth of human prostate tumors. The omega 6 ratio was 25 x higher than Omega 3.

Cancer Research Feb 1 2006; 66: 1427 – 1433

Heat, hydrogenation, light and oxygen produce chemically altered fat products that  are cytotoxic. Cold pressed, virgin oils, especially flax helps slow tumor growth, decrease tumor formation, decrease metastasis, enhance oxygen in cells and extend patient survival time. UDO ERASMUS, Fats that heal, Fats that kill.

A randomized, double-blind, placebo- controlled clinical trial, showed the dietary effects of flaxeed on tumor biological markers and urinary lignon excretion in postmenopausal women with newly diagnosed Breast Cancer. Dietary flaxeed had the potential to reduce tumor growth in patients with Breast Cancer. Clinical Cancer Research. 2005 May 15; 11(10): 3828-3825

Reduce intake of animal and dairy

What’s that hormone in your milk?

An estimated 2 million doses of rBGH are injected into SA dairy cows annually. Main concern IGF – 1 ( Insulin- like growth factor) the molecule that transmits the effect of rBST is linked to Breast Cancer and Prostate Cancer and elevated levels of IGF- 1.

Researchers at Stanford University & National Institute of Health found high concentrations of  the IGF-1 hormone stimulated cancer cell growth. This hormone occurs naturally in humans and cows and all milk, especially milk treated with rBST.  Samuel Epstein MD, Illinois Scientist warns against the consumption of milk and potential risk factor of Breast Cancer.

Increased intake of animal fat and protein showed a corresponding increase in Breast Cancer. Asia Pacific Journal Public Health. 1994.

High intake of red meat associated with a significant increase of Breast Cancer. Int. Journal Cancer. Vol. 65 – 26 Jan. 96EU nations have banned the import of beef with hormones since 1989.

Consider other options to HR T and the Pill.

Current Pill users can be at risk of Breast Cancer. Lancet. 1996; 347:1713

Cumulative exposure to estrogens underlies most of the known risk factors for      Breast Cancer. The earlier in life the menses begin, the longer monthly cycles extend, the earlier and longer birth control pills and HRT are used, the greater a women’s total exposure to circulating estrogens, the greater her risk of Breast Cancer.

 

The China Study – Dr. Colin Campbell

Chart 10.1: BREAST CANCER RISK FACTORS AND NUTRITIONAL INFLUENCE

Risk of breast cancer increases when a woman has… A diet high in animal food and refined carbohydrates…
…early age of menarche (first menstruation) .. lowers the age of menarche
…late age of menopause …raises the age of menopause
…high levels of female hormones in the blood …increases female hormone levels
…high blood cholesterol …increases blood cholesterol levels

1997 – 2003. Scandinavian Researchers studied 345 post menopausal women who had completed treatment for Breast Cancer. Conclusion – HRT after diagnosis significantly increases risk of recurrence, metastasis or a new Breast Cancer. Estrogen resists stomach acid to remain effective. 3 Million women who live near Thames River in London use Birth Control Pills. Residue from 900 million pills a year pass in sewage & seep into ground water nearby. Large British study on 1 million post-menopausal women without personal history of Breast Cancer. Monitored for 4 years. Conclusion – HRT for 5 years or longer significantly increases women’s risk

  1. Beral et, at The Lancet, August 8/03New Nurses Health Study. Exactly how testosterone may increase Breast Cancer not yet fully understood. Speculation that enzymes in breast tissue may convert testosterone into estrogen – like hormones.Archives of Internal Medicine. July 24.2006 Dr. Ben Formby molecular biologist from Denmark and Dr. T.S Wiley from Santa Barbara cultured and grew cells from breast, endometrium, ovary and prostate.

Results:   Estradiol upregulates BCL2

Progesterone upregulates PS3

Avoid unnecessary exposure to petrochemicals and pesticides. Petrochemicals can indirectly modify DNA structure and function and are known as endocrine disruptors (EO) or ‘xeno oestrogens’.

They are ‘fat-loving’ and tend to reside in adipose tissue which can manufacture oestrogen. Chemicals are compounds used in agriculture, industry, insecticides etc.

Oak Ridge Nat. Lab reported that DOT and Red Dye. no. 3 markedly increases proliferation in human breast cancer cells that are estrogen receptor positive.

England done research since 1976 – ‘Steroids as water pollutants’ – all sewage was oestrogenic to fish.

Recent article indicates that parabens have been found 111 Breast Cancer tumours.

Journal Applied Toxicology. 2004; 24: 5-13

Aluminium salts used in deodorants concentration is highest in breast tissue.

Journal Applied Toxicology. Feb 17. 2006Pilot study down at Rietvlei Nature Reserve culling of buck. Chemical P-NP (Found in packaging material) found in the testicles of Eland and other buck. DDT causes reproductive problems in animalsPaint used on ships – starfish sterile

Fuel your body with the right nutrition

Antioxidents – Most potent ones found in fruit and veggies (Phytochemicals) Plant pigments have an effect on our genes. Healthy eating may lead to favourable gene expression.

To date evidence from animal and human studies support the idea that antioxidants may diminish toxicity and even enhance the effectiveness of cancer therapies.

Carotenoids and flavonoids are compounds that appear to be able to do such things as stop cell division, boost antioxidant activity, block carcinogens, inhibit the initiation and promotion of cancer cells, boost anti-inflammatory properties and enhance the body’s own detox mechanisms.

They may also help the body eliminate toxic compounds that are left over from conventional therapies that in their own right can create problems.

  1. Block MD and Ass. Prof. College of Medicine Unv. of Illinois.

Scientists recent research – benefits of cruciferous veggies on human breast cells. Shows indole – 3 – carbinol (a phytochemical) lowers the type of oestrogen that promotes Breast Cancer. Unv of Urbino. Italy.

A study on 1551 women March ’95-Nov 2000. Relationship between plasma carotenoid concentrations (a biomarker for fruit and veggie intake) and recurrent Breast Cancer. Results – May definitely be beneficial.

Journal Clinical Oncology.200S; 23: 6631- 6638

 Juicing from young green barley plants. High in living enzymes, SOD, alkalinity. Protects against carcinogens, plays a significant role in preventing cancer.

Robert Pickett MD, Director, Nutritional Medicine California.

Stay physically active, normalize Vitamin D levels and get enough sunshine

There is an association of Breast Cancer and latitude suggesting higher UV – B exposure as being protective. The manufacture of Vit D (a steroid hormone precursor) is currently under investigation for its benefits.

Cancer. January 1,2002: 94: 272 – 281

 

Wired for Cancer, Electric Magnetic Fields (EMF)

More Breast Cancer amongst electric power workers, at increased risk – 40% higher death rate.

The Lancet. 1992; 339: 1482 – 3

Suppression of melatonin production is the most important link between EMF’s and all cancer.

  1. Pineal Research, 1995; 18: 1- 11

75% of cancer shows oxidated DNA damage. Melatonin rivals all counterparts in its antioxidant ability and counteracts the oxidating effects of oestrogen and radiation.