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Cancer, Breast

Breast cancer occurs when there is a malignant tumor inside the breast. Each year more than 185,000 women are diagnosed with breast cancer, and the incidence of this disease is rising in developed countries. There are approximately 43,500 deaths from breast cancer annually, making this disease second to lung cancer as the leading cause of death by cancer among women. Ninety percent of breast cancer is detected by women themselves, often through breast self-examination (BSE).

Signs and Symptoms

According to the National Cancer Institute, breast cancer is often accompanied by the following signs and symptoms.

bulletA lump or thickening in or near the breast or in the underarm area
bulletA change in the size or shape of the breast
bulletNipple discharge or tenderness, or the nipple pulled back (inverted) into the breast
bulletRidges or pitting of the breast (the skin looks like the skin of an orange)
bulletA change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly)

What Causes It?

While the cause of breast cancer is not known, it is clear that the disease is hormone-dependent. Women whose ovaries do not function and who never receive hormone replacement therapy do not develop breast cancer.

Who's Most At Risk?

People with the following conditions or characteristics are at a higher-than-average risk for developing breast cancer.

bulletWomen (comprise over 99 percent of cases; men comprise under one percent)
bulletIncreasing age
bulletHistory of cancer in one breast
bulletHistory of benign breast disease
bulletNever giving birth or first pregnancy after 30
bulletFamily history (first-degree relative) of breast cancer (significant for premenopausal women)
bulletEarly onset of menstruation and late menopause
bulletPossibly, long-term oral contraceptive use (although this is controversial)
bulletHigh doses of ionizing radiation before age 35
bulletHistory of cancer of the colon, thyroid, endometrium, or ovary
bulletDiet high in animal fat, excessive alcohol consumption, and, possibly, obesity
bulletAlterations in certain genes
bulletBreast implants

Despite the relevance of risk factors, 70 to 80 percent of women with breast cancer have none of the known risk factors.

What to Expect at Your Provider's Office

If you are experiencing symptoms associated with breast cancer, see your health care provider immediately. He or she can help make a diagnosis and guide you in determining which treatment or combination of therapies will work best for you.

Your provider will do a breast exam and run some laboratory tests, including a study of breast tissue and genetic studies. Imaging techniques may include mammography, ultrasound, magnetic resonance imaging (MRI), and other methods that help distinguish a cyst from a solid mass or make a distinction between cancerous and noncancerous disease.

Treatment Options

Prevention

Early detection is important. Monthly breast self-examination and annual gynecologic examinations play a large role in early detection. Nutrition may play a role in prevention.

Treatment Plan

Treatment options depend on the size and location of the tumor, results of lab tests, and the stage, or extent, of the disease, along with the patient's age and menopausal status, general health, and breast size.

Drug Therapies

Your provider may prescribe one or more of the following therapies.

bulletRadiation therapy— the use of high energy rays to kill cancer cells and prevent them from growing
bulletChemotherapy—the use of drugs to kill cancer cells
bulletHormonal therapy, which keeps cancer cells from getting the hormones they need to grow
bulletAntitumor antibiotics
bulletAntiestrogens, such as tamoxifen, which block the action of estrogen on breast tissue
bulletMonoclonal antibodies to block the protein receptor that is produced in large numbers in women with breast cancer
bulletHigh-dose progestogens (steroid hormones)

Surgical and Other Procedures

Surgery is the most common treatment for breast cancer. The choice of surgeries includes the following.

bulletMastectomy—removal of the breast or as much of the breast tissue as possible; can be followed by breast reconstruction
bulletLumpectomy—removal of the tumor and a small amount of tissue around it, usually followed by radiation therapy
bulletSegmental, or partial, mastectomy—removal of the tumor and a small amount of tissue around it, as well as the lining of the chest muscles below the tumor and some of the lymph nodes under the arm. It is usually followed by radiation therapy.

Complementary and Alternative Therapies

A comprehensive treatment plan for breast cancer may include a range of complementary and alternative therapies. Psychotherapy and support groups may help improve quality of life and survival.

Nutrition

Nutritional tips include the following.

bulletEliminate non-organic poultry, dairy, red meat, sugar, white flour and refined foods, coffee, tea, chocolate, and colas.
bulletEat cruciferous vegetables (broccoli, cabbage, cauliflower).
bulletEat only organically raised foods.
bulletInclude liver foods such as beets, carrots, yams, garlic, dark leafy greens, lemons, and apples.
bulletFollow a high-fiber diet.
bulletUse soy.

Potentially beneficial nutrient supplements include the following.

bulletCoenzyme Q10 (120 mg three times a day)
bulletCalcium d-glucarate (500 to 1,000 mg three times a day)
bulletVitamin A (25,000 IU a day), vitamin E (800 IU a day), and vitamin C (3 to 6 g a day) to decrease side effects of chemotherapy and radiation
bulletSelenium (200 to 400 mcg a day) to decrease side effects of chemotherapy and radiation
bulletBromelain (500 mg two times a day between meals)
bulletMelatonin (10 to 50 mg a day)

Herbs

The use of certain herbal remedies may offer relief from symptoms. Try the following: a combination of black cohosh (Cimicifuga racemosa), red clover (Trifolium pratense), and alfalfa (Medicago sativa) as a base (1 to 3 g); add two to three of the following in equal parts, 30 to 60 drops two to three times daily:

bulletWith anxiety: passionflower (Passiflora incarnata), kava kava (Piper methysticum)
bulletWith lymph node involvement: poke root (Phytolacca americana), red root (Ceanothus americanus); maximum dose of poke root is 0.4 ml a day.
bulletWith nausea: ginger root (Zingiber officinale), fennel seed (Foeniculum vulgare)
bulletWith exhaustion: oatstraw (Avena sativa), skullcap (Scutellaria lateriflora)

Herbs are generally available as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp./cup water steeped for 10 minutes (roots need 20 minutes).

Homeopathy

An experienced homeopath can prescribe a regimen for treating breast cancer that is designed especially for you. Some of the most common acute remedies are listed below.

bulletArsenicum for anxiety and nausea, with restlessness and burning pains
bulletIpecac for nausea unrelieved by vomiting
bulletNux vomica for sharp abdominal pains with anger and collapse

Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms are relieved.

Prognosis/Possible Complications

Most complications result from surgery, radiation, chemotherapy, or use of the drug tamoxifen, which is effective in preventing recurrence but increases a woman's risk of endometrial cancer and thrombo-embolic disease. These include:

bulletRestricted shoulder movement
bulletIncrease in size of operative scar
bulletInflammation of connective tissue in the affected arm
bulletMalignant tumor of the lymphatic vessels in the affected arm
bulletAccumulation of fluid in the breast; swelling of tissue in the arm
bulletDiscoloration of the skin from radiation, or a red spot
bulletInflammation of the lung from radiation
bulletDeath of the fat cells underlying the breast tissue
bulletRecurrence of the disease

The prognosis for breast cancer patients depends primarily on the stage, or extent, of the disease at the time of the initial diagnosis.

Following Up

Breast cancer patients should be followed every three months for eighteen months to four years, then every six months.

Supporting Research

Ariel IM, Cleary JB. Breast Cancer: Diagnosis and Treatment. New York, NY: McGraw-Hill; 1987:35- 43, 172-180, 475-484.

Austin S, Hitchcock C. Breast Cancer: What You Should Know (But May Not Be Told) About Prevention, Diagnosis, and Treatment. Rocklin, Calif: Prima Publishing; 1994:194.

Balch JF, Balch PA. Prescription for Nutritional Healing. 2nd ed. Garden City Park, NY: Avery Publishing; 1997:160-164.

Birdsall TC. Effects and clinical uses of the pineal hormone melatonin. Altern Med Rev. 1996;1(2):94-102.

Bland KI, Copeland EM III. The Breast: Comprehensive Management of Benign and Malignant Diseases. Philadelphia, Pa: W.B. Saunders; 1991:731-747, 877-894.

Blumenthal M, ed. The Complete German Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 1998:462,464, 466.

Boik J. Cancer and Natural Medicine. Princeton, Minn: Oregon Medical Press; 1995:138, 149, 166.

Cummings SR, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women. JAMA. 1999;281:2189-2197, 1999.

Cunningham FG, et al. Williams Obstetrics. 19th ed. Norwalk, Conn: Appleton & Lange; 1993:1269-1270.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:562-568.

Holleb AI, et al. American Cancer Society Textbook of Clinical Oncology. Atlanta, Ga: American Cancer Society; 1991: 177-193.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:40,42,192,274.

Pawlowicz Z, Zachara BA, Trafikowska U, et al. Blood selenium concentrations and glutathione peroxidase activities in patients with breast cancer and with advanced gastrointestinal cancer. J Trace ElemElectrolytes Health Dis. 1991;4:275-277.

Thomson JD, Rock JA. Te Linde's Operative Gynecology. Philadelphia, Pa: J.B. Lippincott's; 1992:979-907.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1987:98-106.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor, pharmacist, nurse, or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.