Diet has a role to play in breast cancer survival. Breast cancer survivors who stay lean are less likely to die from breast cancer than those who gain weight. Women with breast cancer and elevated insulin levels have a significantly higher risk of death than their counterparts with lower insulin levels. Breast cancer patients can lower their blood insulin levels by being physically active, eating a diet rich in fruits and vegetables, whole grains, and low in junk foods, sugar and simple carbohydrates.

Subscribe to a FREE Supplement Research Update newsletter. Twice a month we email a brief abstract of several studies on various supplements and natural medicine topics, including breast cancer treatment and prevention, and their practical interpretation by Ray Sahelian, M.D.

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Natural Supplements for Breast Cancer
The field of prevention or treatment of breast cancer with supplements or alternative methods is very early and no firm answers can be given at this time, however I wanted to mention a few compounds that have been studied in relation to breast cancer. These supplements have not been extensively tested in humans in the treatment of breast cancer, and at this point it is best to use conventional breast cancer treatment and use these herbs only as a supplement, not as an alternative to breast cancer treatment. Also, discuss with your doctor the use of these supplements. Click each link for more information.

Curcumin is extracted from the spice turmeric
Mangosteen fruit and rind
Green Tea or green tea extract
Resveratrol has been found helpful in mouse studies.
Reishi is a mushroom that may be helpful in breast cancer.
Genistein, which has weak estrogenic and antiestrogenic properties, may be one of the the components in the soy-based Asian diet that helps prevent breast cancer by its effects on biochemistry early in life. Reduced caloric consumption by Asians may be another reason for the lower rate of breast cancer.
CoQ10 may be helpful in breast cancer patients undergoing tamoxifen therapy.
Ginseng has been associated with longer survival in women with breast cancer.
Indole-3-Carbinol has been studied as a possible treatment for breast cancer.
Black Cohosh herb
Cat's Claw herb
Melatonin is a hormone supplement used for sleep
Saw palmetto One test tube study indicates it slows the growth of breast cancer cells.
IP6 has in vivo and in vitro anti- cancer activity
Resveratrol is an interesting molecule

Post Breast Cancer nutritional treatment
Ameliorating effect of coenzyme Q10, riboflavin and niacin in tamoxifen-treated postmenopausal breast cancer patients with special reference to lipids and lipoproteins.
Clin Biochem. 2007 Jun;40(9-10):623-8. Epub 2007 Mar 19. Department of Medical Biochemistry, University of Madras, Taramani Campus, Chennai - 600 113, Tamil Nadu, India.
Tamoxifen, a non-steroidal anti-estrogen that is widely used in adjuvant therapy for all stages of breast carcinomas and in chemoprevention of high-risk group. Coenzyme Q10 (Co Q10), riboflavin and niacin are proved to be potent antioxidant and protective agents against many diseases including cancer and cardiovascular diseases. In this context, the objective of the study is to find the effect of the combined modality of Co Q10 (100 mg), riboflavin (10 mg) and niacin (50 mg) with TAM (10 mg twice a day) on serum lipids and lipoprotein levels in postmenopausal women with breast cancer. CONCLUSION: The study figures the altered lipid and lipoprotein levels in the untreated and tamozifen-treated breast cancer patients. On combination therapy with Co Q10, riboflavin and niacin, it counteracts the tamoxifen-induced hyperlipidemia to normal levels.

Effect of coenzyme Q10, riboflavin and niacin on serum CEA and CA 15-3 levels in breast cancer patients undergoing tamoxifen therapy.
Biol Pharm Bull. 2007 Feb;30(2):367-70. Department of Medical Biochemistry, Dr. ALMP-GIBMS, University of Madras, Taramani Campus, and Department of Medical Oncology, Government Royapettah Hospital, Tamilnadu, India.
Circulating breast cancer tumour markers such as carcinoembryonic antigen (CEA) and carbohydrate antigen 15-3 (CA 15-3) are reliable indicators of impending relapse, in which an increasing tumour marker level is associated with a very likelihood of developing recurrence. In the present study, 84 breast cancer patients were randomized to receive a daily supplement of 100 mg coenzyme Q10 (CoQ10), 10 mg riboflavin and 50 mg niacin (CoRN) one dosage per day along with 10 mg tamoxifen (TAM) twice a day. Serum CEA and CA 15-3 levels were elevated in untreated breast cancer patients (group II) and their tumour marker levels significantly reduced upon tamoxifen therapy for more than 1 year (group III). Group III patients supplemented with CoRN for 45 d (group IV) and 90 d (group V) along with tamoxifen significantly reduced CEA and CA 15-3 levels.
   My comments: "I am not sure why the scientists chose these three particular supplements to add to the tamoxifen regimen. There are countless nutrients and vitamins that have health benefits. But the important point is that there appears to be nutritional factors that could reduce the risk for recurrence.

Diet and Breast Cancer
A high-fiber low-fat diet reduces blood levels of estrogen in women with breast cancer. This may help keep the disease in check, as breast cancer is sometimes driven by female hormones. Premenopausal women who eat large amounts of red meat appear to have an increased risk of developing breast cancer with receptors that are positive for estrogen and progesterone. Eating soy regularly as a young girl may help protect against the development of breast cancer later on in life. Contrary to some earlier research, a large U.S. study in 2006 found no evidence that a high-fat diet raises older women's risk of breast cancer. In a study that followed more than 80,000 women for 20 years, Harvard University researchers found that fat intake during middle age or later was largely unrelated to breast cancer risk after menopause. Nor was there evidence that any specific type of fat, such as saturated fat from animal products, altered a woman's odds of developing breast cancer. High-carb diets (with a high intake of simple carbohydrates) may increase more than just waistlines. They might raise the risk of breast cancer.
    Eating beans or lentils at least twice a week may reduce a woman's risk of developing breast cancer. Eating mushrooms may also lower the risk for breast cancer.
    The breast cancer rate is rising among women in Singapore and appears to be approaching that seen in Europe. The introduction of a Westernized lifestyle, diet, and child-bearing pattern may underlie this trend.
    Breast cancer patients who are overweight may have somewhat poorer survival odds than leaner women with the disease.
    Interestingly, the diet of preschoolers may influence the risk of breast cancer during adulthood. this indicates that cancer, at least breast cancer, is influenced by diet decades before it becomes clinically apparent.
   Post-menopausal Chinese women who eat a Western-style diet heavy in meat and sweets face a higher risk of breast cancer than their counterparts who stick to a typical Chinese diet loaded with vegetables and soy.
   The type of fat consumed influences breast cancer risk.

Phytoestrogens and Breast Cancer
The role of phytoestrogens and consumption of phytoestrogen -rich foods such as soy containing isoflavones and whole grain products with lignans for the prevention of breast cancer is reviewed. It is concluded that soy-containing diet in adult women is not or only slightly protective with regard to breast cancer, but that it may be beneficial if consumed in early life before puberty or during adolescence supporting results of immigrant and epidemiological studies. No negative effects of soy on breast cancer have been observed. On the other hand, a diet low in lignans, resulting in a low plasma enterolactone concentration, increases risk.

Ginseng and Breast Cancer
Women who use ginseng may be more likely to survive breast cancer, and have a better quality of life after treatment. The study included 1,455 Chinese women who were treated for breast cancer and then followed for up to 6 years. It found that women who had been using ginseng before their diagnosis were 30 percent less likely to die during follow-up than women who had never used the herb. In addition, breast cancer survivors who had started using ginseng after their diagnosis reported greater emotional well-being and a more active social life than those who never tried the herb. Most ginseng users in the current study took an American ginseng product or unprocessed "white" ginseng root; all also received mainstream cancer therapy -- surgery, chemotherapy or radiation. Lab research has found that constituents of ginseng can inhibit tumor cell growth. American Journal of Epidemiology, April 1, 2006.
     Dr. Sahelian says: Like any drug, high doses of stimulating herbs such as ginseng can have side effects or interact with other medications. If you plan to use ginseng, take less than a full capsule, and reduce this dose further if you notice insomnia.

Exercise and Breast Cancer
Physical activity increases a woman's chances of surviving breast cancer -- regardless of her level of physical activity before the diagnosis.

Smoking and Breast Cancer
Long-term smoking increases the risk of breast cancer in older postmenopausal women by up to 40 percent, according to a report in the October, 2005 issue of Cancer Causes and Control.

Breast Cancer and Coffee
Women with BRCA1 gene mutations, which confer a high risk of developing breast cancer, might decrease their risk by coffee, which may be due to antioxidants present in coffee. It is likely that certain teas would also be helpful in reducing the risk for breast cancer.

Breast cancer and alcohol
Moderate or heavy alcohol consumption raises the risk of breast cancer among postmenopausal women on hormone replacement therapy. International Journal of Cancer, March 2008.

Breast Cancer Basic Facts
Breast cancer is the most common non-skin malignancy in women in the United States and is second only to lung cancer as a cause of cancer -related deaths. Nearly 9 out of 10 women overestimate how likely they are to develop breast cancer in their lifetimes. In one study, a group of 175 women estimated that the chance of developing breast cancer was, on average, 46 percent -- much higher than the actual average risk of 13 percent. Oral contraceptive use is a risk factor for premenopausal breast cancer. There is no proof at this time that screening for breast cancer with a mammogram in women below age 50 saves lives.

Mammogram benefit versus risks
Mammograms may not be necessary for women in the forties unless there is a very high suspicion or family history. The American College of Physicians, which represents 120,000 internists, issued new guidelines that instead urge women in their 40s to consult with their doctors about whether to have the breast X-rays. The American College of Physicians based its recommendations on a comprehensive review of mammography research that concluded that the benefit is less clear for women in their 40s than for those 50 and older, and that screening carries significant risks, including exposure to radiation and unnecessary biopsies, surgery and chemotherapy.

Estrogen and Breast Cancer
Following reports that the use of estrogen hormone replacement after menopause could perhaps increase the incidence of breast cancer, the reduction in the use of estrogen hormone (such as Premarin)  by post menopausal women will lead to fewer cases of breast cancer being diagnosed.
   Women who take birth control pills could increase their risk of cervical and breast cancer.
   As little as 3 years of using combined estrogen and progestin menopausal hormone therapy substantially increases the risk of developing lobular breast carcinoma.
   Detecting breast cancer with mammography and biopsy is more difficult in women who use estrogen and progestin hormone therapy. Breast cancer diagnosis is more difficult in women using combined hormone therapy.

Androgens and Breast Cancer
High levels of 'male' hormones, or androgens, in young women apparently raise their risk of developing breast cancer. Androgens are normally present in women, albeit at much lower levels than in men. Elevated androgen levels have been linked with breast cancer in studies of postmenopausal women, but it was unclear if this also applied to premenopausal women. In the Journal of the National Cancer Institute, Dr. Rudolf Kaaks, from the International Agency for Research on Cancer in Lyon, France, and colleagues compared androgen levels in 370 premenopausal women who were later diagnosed with breast cancer with levels found in 726 similar women without breast cancer. The likelihood of developing of breast increased significantly as levels of testosterone and androstenedione rose. The absolute risks of women younger than 40 years developing breast cancer over a 10-year period ranged from 2.6 percent for those with the highest testosterone levels to 1.5 percent among those with the lowest levels. The study "provides strong evidence that the risk of breast cancer among premenopausal women is directly related to circulating levels of testosterone and androstenedione," Kaaks' team concludes.
     Dr. Sahelian says: It would be prudent for women who have a family history of breast cancer or other risk factors to avoid the use of androgens, including DHEA, or to use them for only brief periods.

Underarm Antiperspirants and Breast Cancer
Underarm antiperspirants may contribute to the risk of breast cancer because they contain aluminum salts with metal ions that mimic the effect of estrogen. Until recently, it was thought that such estrogen-mimicking substances were uniformly organic -- either phenolic or carbon ring structures -- but evidence is mounting that some metals can also binding to estrogen receptors.
     Aluminum salts contained in many underarm deodorants could increase a woman's breast cancer risk. Metals including aluminum salts and cadmium have been shown to exert estrogen-like effects, while some also promote the growth of breast cancer cells in the laboratory,. Aluminum salts increase estrogen-related gene expression in human breast cancer cells grown in the laboratory. Given the wide variety of other substances that can mimic estrogen, including certain pesticides, cosmetics and detergents, it is possible that aluminum salts and other inorganic estrogen-related compounds called "metalloestrogens" can further disrupt normal hormonal signaling within the breast.  What is particularly concerning about aluminium is the fact that it is applied to the underarm, close to the breast, and left on the skin. Deodorants also are frequently used after shaving, making it easier for aluminium salts to enter the blood stream. Studies also have demonstrated that aluminium salts can penetrate human underarm skin even if it is unbroken. People can reduce their exposure to cadmium by quitting smoking. Journal of Applied Toxicology, March, 2006.

Risk factors for breast cancer
Many risk factors for breast cancer cannot be controlled -- such as genetic mutations, age, and family history -- others are associated with lifestyle choices. The following lifestyle factors may increase a woman's risk of breast cancer:
Having no children, using oral contraceptives, depending on at what age and for how long they were taken, using post-menopausal hormone replacement therapy (HRT), overuse of alcohol, being obese and eating an unhealthy diet, getting inadequate physical activity.

Breast cancer and exposure to n-butyl benzyl phthalate
According to a study done in rats, BBP (n-butyl benzyl phthalate), a chemical additive used in pipes, vinyl floor tiles, carpet-backing, and other household items, may affect mammary gland development and perhaps increase the susceptibility to breast cancer. BBP is a "plasticizer," which is added to substances such as cement, concrete and clay to increase fluidity. BMC Genomics, December 5, 2007.

Mammograms to detect early Breast Cancer - Research is not conclusive
Women who are aged 50 to 69 years, and who are concerned about breast cancer, should probably have a mammogram every two years along with a medical exam.  Eighty five percent of breast cancer cases occur after age 50. The most common type is infiltrating ductal carcinoma, but the more aggressive types are medullary and inflammatory. However, there are risks to mammography, including overdiagnosis, and one has to measure the potential benefit versus potential harm of mammography.
     Women aged 40 to 50 may choose to have regular mammograms only if there is a very strong family history of breast cancer, particularly if the breast cancer was diagnosed before menopause. There is a debate in the medical community as to the benefit of screening women before age 50 (see below). Screening women under 50 years old for breast cancer does not significantly reduce deaths from the disease, according to British researcher of the Institute of Cancer Research in London. They estimated giving women annual mammograms beginning at the age of 40 could save about four lives for every 1,000 women screened. But they added the benefit must be weighted against increased radiation exposure, which could raise breast cancer risk, anxiety caused by false positive results and higher costs for the screening programs. More than  twenty percent of women who had regular mammograms from age 40 had at least one false positive result. Professor John Toy, of the charity Cancer Research UK which funded the trial, said mammograms in women below age 50 showed no definitive evidence for benefit. "We encourage women of all ages, and particularly older women in whom breast cancer is more common ... to see their doctor straight away if they notice any changes in their breasts," he said in a statement.
     In the "real-world" setting of a community-based case-control study, a small reduction in mortality associated with breast cancer screening is statistically nonsignificant, researchers report in the July 20th, 2005 issue of the Journal of the National Cancer Institute. Therefore, at this time, a doctor cannot emphatically say that breast cancer screening reduces mortality to any significant extent.

Update - Mammograms may not be necessary in women in their forties
April 2007 - Mammograms may not be necessary for women in the forties. The American College of Physicians, which represents 120,000 internists, issued new guidelines that instead urge women in their 40s to consult with their doctors about whether to have the breast X-rays. The American College of Physicians based its recommendations on a comprehensive review of mammography research that concluded that the benefit is less clear for women in their 40s than for those 50 and older, and that screening carries significant risks, including exposure to radiation and unnecessary biopsies, surgery and chemotherapy.
   My comments: I tend to agree that mammograms should be reserved to women over 50. However, there are always cases where a few individuals are alive today because they had a routine mammogram done in their 40s and a cancer was picked up early. However, we cannot let such infrequent cases mar our judgment regarding the overall benefit versus risk of millions of American women in their 40s subjected to mammograms that may lead to unnecessary worry, biopsies, and false positives, and perhaps not extend life span even if diagnosed earlier than usual.

Screening mammography in women 40 to 49 years of age: a systematic review for the American College of Physicians.
Ann Intern Med. 2007 Apr 3;146(7):516-26. Armstrong K, Moye E, Williams S, Berlin JA, Reynolds EE. University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
The risks and benefits of mammography screening among women 40 to 49 years of age remain an important issue for clinical practice. Although few women 50 years of age or older have risks from mammography that outweigh the benefits, the evidence suggests that more women 40 to 49 years of age have such risks.

At what age should you not have mammograms?
Breast cancer screening in the US is common among women 80 years of age or older, but it is of little benefit to the majority of them. Breast cancer screening is not worthwhile when life expectancy is less than 10 years, and most women 80 or older have a life expectancy of less than 10 years.

Routine Breast Examinations by your doctor
Having a doctor examine the breasts for potential signs of cancer may add little to the benefits of mammography screening. Researchers found that among nearly 62,000 women age 40 or older, the combination of mammography and a clinical breast exam detected only a small number of additional breast cancers compared with mammography alone. Although the clinical exam did help catch cancers in women with dense breast tissue, in particular, it also put these women at greater risk of being told they might have cancer when they did not. However, the findings should not be interpreted as a recommendation against clinical breast exams, according to the study's lead author. "We're just trying to lay out the information for women," said Dr. Nina Oestreicher, a researcher at Kaiser Permanente in Oakland, California. "It's really up to women and their doctors to make the decision," noting that many factors, including a woman's personal risk of breast cancer and her degree of concern about the disease, could influence the choice to have regular clinical breast exams in addition to mammography.

Breast Self-Exam -- is it worth the trouble?
Breast self-exams have not been found to be definitively helpful. Breast self exam increases the number of false positive results. These may result in follow-up testing or invasive procedures such as breast biopsies, leading to anxiety, inconvenience, discomfort, and additional medical expenses.

Risk factors for Breast Cancer
There is a higher risk of breast cancer with early menarche and late menopause. The more a woman breast feeds, the more she is protected against breast cancer. There is also a higher risk with oral contraceptives and hormone replacement therapy, including several forms of estrogen, and probably with the long term use of androstenedione, dihydroepiandrosterone (DHEA) and testosterone. Women who already have breast cancer should not take additional hormone replacement, particularly estrogens.
    Women who work night shifts have a higher rate of breast cancer.
    Having an abortion or miscarriage does not increase a woman's risk of suffering from breast cancer later in life.
    Exposure to the environmental estrogen 4-nonylphenol increases the risk of breast cancer in mice. Estrogen-like chemicals in the environment have the ability to cause cancer. Breast cancer is the most commonly diagnosed cancer in women and environmental factors appear to cause many of these cases. Many of the environmental factors increase a woman's level of the female hormone estrogen, which is thought to be a major contributing factor to the disease. 4-nonylphenol is released from cleaning agents, textiles, paper, plastic, personal care products and agricultural chemicals.

Genetic Mutation and Breast Cancer Risk
Mutations in BRCA1, BRCA2, and TP53 raise the risk of breast cancer by 10- to 20-fold by age 60. Mutations in genes called BRIP1, CHEK2 and ATM roughly double the risk. BRIP1, helps to repair damaged DNA -- like some of the other known breast cancer genes. And, as with the BRCA2 breast cancer gene, certain mutations in BRIP1 may cause a blood disease called Fanconi anemia. Breast cancer is approximately twice as common in sisters and mothers of affected individuals as in the general population. BRIP1 is also known as BACH1.

Exercise and Breast Cancer
Risk of breast cancer decreases in women who are physically active. Even moderate physical activity -- for example brisk walking for at least 2 miles three times a week -- over the course of a lifetime can reduce a young woman's risk of developing cancer by 33%, and the risk of breast cancer after menopause by 26%.
     Pumping iron may help breast cancer survivors improve the quality of their lives, as well as strengthen their bodies. Women who lift weights report feeling more self-confident and stronger, sleeping better and have more energy.

Needle biopsy and Breast Cancer
Having breast cancer tissue sampled with a needle seems to increase the odds that the disease will also be found in an armpit lymph node called the sentinel node. The spread of breast cancer to the sentinel node adversely affects a woman's survival and influences the treatment received. As reported in the Archives of Surgery, Dr. Nora M. Hansen of the John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California hypothesized that the method used to obtain specimens from the breast tumor might influence the spread of cancer to the sentinel node. To investigate, the researchers studied 663 women with proven breast cancer. Of the cancers, about half were biopsied with a needle, while the remainder involved actual removal of the tumor. Women who had a needle biopsy were about 50 percent more likely to have cancer in the sentinel node than women who underwent tumor removal. The researchers suggest that the increased risk of sentinel node disease may be "due in part to the mechanical disruption of the tumor by the needle," and they call for further studies to confirm these findings. SOURCE: Archives of Surgery, June 2004.

Breast Cancer Post Surgical survival
Younger breast cancer patients seem to suffer more serious side effects from chemotherapy than previously thought. Roughly one in six of those women wind up at the emergency room or hospitalized because of such side effects as infection, low blood counts, dehydration or nausea. Some of the breast cancer treatment side effects occur at rates three to four times higher than earlier research has predicted.
   Treatments such as chemotherapy and hormonal therapy have improved the survival of women diagnosed with early breast cancer. After surgery for advanced breast cancer, survival rates are no better with high-dose chemotherapy than with conventional chemotherapy.
   Surgical removal of the breast tumor without mastectomy, plus treatment with tamoxifen, may be sufficient for elderly women with early-stage breast cancer. Tamoxifen should only be used in women who are at very high risk for recurrence of the breast cancer. The risk of tamoxifen therapy outweigh the benefits in women who do not have a high risk for breast cancer recurrence. Raloxifene (Evista) has been proposed to be a better choice than tamoxifen (Nolvadex, and others) for prevention of breast cancer in high-risk postmenopausal women. However, new research indicates that the cardiovascular side effects of raloxifene may outweigh its potential benefits in breast cancer prevention.
   Postmenopausal women who have survived early breast cancer face a higher than average risk of osteoporosis. Aromatase inhibitors -- Arimidex (anastrozole), Femara (letrozole), and (Aromasin) exemestane, which are used to suppress estrogen in women whose tumors are hormone driven -- have been associated with changes in bone mineral density.
   Women with early breast cancer who receive higher-than-standard doses of two chemotherapy drugs (epirubicin and cyclophosphamide) as "add-on" therapy are at increased risk of subsequently developing cancer of the blood. Although add-on therapy with these drugs for early breast cancer has increased the number of long-term survivors, a small risk of secondary acute myeloid leukemia (AML), with or without a pre-leukemia known as myelodysplastic syndrome (MDS), has been identified.
   Women who survive a bout with breast cancer are at increased risk of developing cancers of the lung, stomach, and colon, among several others. The elevated risk of other cancers could be due to the treatment given to fight the breast cancer, or perhaps to a genetic predisposition to develop cancer.
   As a treatment for breast cancer, radiation, even modern regimens, appears to increase the risk of cardiovascular disease.

Breast Cancer and Tamoxifen
In a study involving 88 women at high risk of eventually developing breast cancer, only 1 agreed to take tamoxifen. Furthermore, only about half of women discussed tamoxifen with their doctors -- and in most cases their doctors advised against taking the drug. Nearly all the women said they chose not to take tamoxifen because of a fear of side effects, which can include hot flashes and other symptoms of menopause, blood clots in the legs or lungs, stroke, and uterine cancer. Many of these women who are at low or moderate risk for breast cancer made the right decision in terms of avoiding the tamoxifen.

Breast Cancer and Aromatase Inhibitors
The widespread use of tamoxifen has led to improvements in survival for postmenopausal women with early-stage hormone receptor-positive breast cancer; however, approximately 30% of patients die despite receiving tamoxifen as adjuvant treatment. In addition, concerns exist regarding tamoxifen-associated side effects, including endometrial cancer and thromboembolic disease. The development of the third-generation aromatase inhibitors (AIs; anastrozole, exemestane, and letrozole) therefore represented a welcome potential alternative to tamoxifen. Tamoxifen use may be counterproductive in women who have a low or moderate risk for breast cancer.

Testosterone replacement and Breast Cancer
Women seeking help from menopausal symptoms and diminished sex drive by taking testosterone as well as estrogen face a higher risk of breast cancer than with estrogen alone. Analyzing data on more than 120,000 women in the Nurses’ Health Study, researchers from Boston’s Brigham and Women’s Hospital and Harvard Medical School found the more than 800 women who had taken estrogen with testosterone faced an even higher risk of breast cancer.

Breast Cancer symptom
The early detection of a breast cancer symptom is key. Detecting a breast cancer symptom while still in the early stages provides the greatest chance of recovery. If you feel that you may be experiencing a possible breast cancer symptom, don't hesitate. See your doctor as soon as possible to determine if your possible breast cancer symptom is the result of breast cancer. A common breast cancer symptom is a change in the size or shape of one of your breasts. Another breast cancer symptom is a thickening or lump in or near the breast or in the underarm. A third breast cancer symptom is ridges or pitting of the breast. Just because you experience a breast cancer symptom does not necessarily indicate the presence of breast cancer.

Breast Cancer Treatment
Different types of treatment are available for patients with breast cancer. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. Four types of standard treatment are used:
Surgery - Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells. Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes the following:
* Lumpectomy: A surgical procedure to remove a tumor (lump) and a small amount of normal tissue around it.
* Partial mastectomy: A surgical procedure to remove the part of the breast that contains cancer and some normal tissue around it. This procedure is also called a segmental mastectomy. Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after. Lymph node dissection is done through a separate incision.
* Total mastectomy: A surgical procedure to remove the whole breast that contains cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after. This is done through a separate incision.
* Modified radical mastectomy: A surgical procedure to remove the whole breast that contains cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

Radiation therapy for breast cancer
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types of radiation therapy. External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. The way the radiation therapy is given depends on the type and stage of the cancer being treated.
     Fewer but more concentrated doses of radiotherapy could be as safe and effective as a longer-course treatment for breast cancer patients. Women having radiotherapy, which is given to reduce the risk of the cancer returning after surgery, normally receive 25 doses over five weeks. A 10-year trial of a shorter course of 13 larger doses showed it worked just as well as the standard treatment and without an increase in side effects. This study was done by Professor John Yarnold of the Institute of Cancer Research and the Royal Marsden NHS Foundation Trust in London.

Chemotherapy for breast cancer
Chemotherapy is a cancer treatment that uses drugs to stop the growth of cancer cells, either by killing the cells or by stopping the cells from dividing. When chemotherapy is taken by mouth or injected into a vein or muscle, the drugs enter the bloodstream and can reach cancer cells throughout the body (systemic chemotherapy). When chemotherapy is placed directly into the spinal column, an organ, or a body cavity such as the abdomen, the drugs mainly affect cancer cells in those areas (regional chemotherapy). The way the chemotherapy is given depends on the type and stage of the cancer being treated.

Hormone therapy for breast cancer
Hormone therapy is a cancer treatment that removes hormones or blocks their action and stops cancer cells from growing. Hormones are substances produced by glands in the body and circulated in the bloodstream. The presence of some hormones can cause certain cancers to grow. If tests show that the cancer cells have places where hormones can attach (receptors), drugs, surgery, or radiation therapy are used to reduce the production of hormones or block them from working. Hormone therapy with tamoxifen is often given to patients with early stages of breast cancer and those with metastatic breast cancer (cancer that has spread to other parts of the body). Hormone therapy with tamoxifen or estrogens can act on cells all over the body and may increase the chance of developing endometrial cancer. Women taking tamoxifen should have a pelvic examination every year to look for any signs of cancer. Any vaginal bleeding, other than menstrual bleeding, should be reported to a doctor as soon as possible.

Breast Cancer and Benign Breast Disease
In women with benign breast disease, atypical hyperplasia is associated with a four-fold increased risk of malignancy during 15 years of follow-up. In contrast, women with nonproliferative disease in the absence of a family history of breast cancer appear not to be at increased risk.

Statins and Breast Cancer
Contrary to experimental evidence, the class of cholesterol-lowering drugs known as statins does not appear to reduce the risk of breast cancer. Lab studies have suggested that statins such as Lipitor or Zocor can halt breast cancer by disrupting the cells' cycle and promoting cell death. The findings from human studies, however, have not confirmed the lab studies.

Breast Cancer and Lifestyle in Korea
In a paper published in the February, 2006 issue of the Archives of Surgery, a Journal of the American Medical Association publication, South Korean scientists found that South Korean women have increased risk factors for breast cancer in recent years. Medical researchers at South Korea's University of Ulsan and Asan Medical Center, based in Seoul, analyzed data from a group of 5,001 women who underwent surgery for breast cancer at the hospital from between July 1989 and March 2004. Apart from diet, the authors did not mention any specifics about how South Korean lifestyles have become more Westernized. However, other studies have shown that in recent years, South Korean women are having babies later in life and fewer of them than previous generations. The study found that the proportion of patients with risk factors such as late menopause, high-fat diets and obesity had increased dramatically between 1996 and 2000. The study found that while the rate of breast cancer in South Korea was still much lower than in Western countries, the incidence of breast cancer in South Korea was increasing at a rate that was more rapid than the world average.

Breast Cancer and fatigue
Approximately one third of women treated for breast cancer experience fatigue for the first five years after treatment, and for about two thirds of those, the fatigue will persist.

Breast Cancer and Breast Implants - Is there a connection?
Results of a study that followed women up to 30 years adds to evidence that silicone breast implants do not boost cancer risk. The study, of nearly 2,800 Danish women who got breast implants between 1973 and 1995, found that these women actually had a lower risk of breast cancer than a group of similar but implant-free women. Also, the implants were not tied to other types of cancer. Past research had indicated that, despite fears about the cancer-causing potential of silicone found in animal studies, silicone breast implants do not lead to cancer in some women. But few studies had looked at breast cancer risk beyond the 15-year mark, or at the risk of tumors in sites other than the breast. Women in the current study were followed for up to 30 years after receiving breast implants, and overall, their risk of developing breast cancer was 30 percent lower than that of the 1,736 women in the comparison group. The reason for the lower risk is unclear, but could it be that some women who got implants were likely to be thinner or have smaller breasts and less fatty tissue? Source: International Journal of Cancer, February 15, 2006.

Breast Cancer and Natural Supplements and Natural Treatment Research Update
Nutrition and primary prevention of breast cancer: foods, nutrients and breast cancer risk.
Eur J Obstet Gynecol Reprod Biol. 2005 Dec 1;123(2):139-49. Hanf V, Gonder U.
Department of Obstetrics and Gynecology, University of Gottingen, Robert-Koch-Street 40, Gottingen, Germany.
Worldwide, each year approximately one million women are newly diagnosed with breast cancer. The fact that incidence has been rising in parallel with economic development indicates that environmental factors might play a role in the causation of breast cancer. Migrational data have pointed to nutrition as one of the more relevant external factors involved. Preventive dietary advice often includes a reduction of alcohol, red meat and animal fat and increasing the intake of vegetables, fruit and fibre and lately, phytoestrogens from various sources. The available prospective data from epidemiological studies and interventional trials do not support the overall hypothesis that higher fat-intakes are a relevant risk factor for breast cancer development, more important seems the relative distribution of various fatty acids. A non- vegetarian eating habit (consumption of animal products) per se does not elevate breast cancer risk, while consumption of broiled or deep fried meats cannot be ruled out as a risk factor in genetically susceptible individuals. It appears prudent to abstain from regular and increased alcohol consumption. In general, if alcohol is consumed on a regular basis, a sufficient supply of fresh vegetables and fruit is essential. While there is no overall protective effect of a high fruit and vegetable consumption speculation remains over possible beneficial effects of certain subcategories, especially brassica vegetables like broccoli, cauliflower and cabbage. Lignans from traditionally made sourdough rye bread, linseed / flaxseed and berries are local sources of potentially canceroprotective phyto-estrogens. Furthermore, indole-3-carbinol rich cabbage species might contribute to breast cancer protection by diet. Nevertheless, clear cut recommendations for or against single nutrients or secondary plant metabolites are not yet possible, lacking sufficient data on individual bioavailability, safety and long term outcome. Breast cancer prevention by dietary means therefore relies on an individually tailored mixed diet, rich in basic foods and traditional manufacturing and cooking methods.

Plasma sex hormone concentrations and subsequent risk of breast cancer among women using postmenopausal hormones.
J Natl Cancer Inst. 2005 Apr 20;97(8):595-602.
Sex hormone concentrations are associated with breast cancer risk among women not using postmenopausal hormones. We conducted a prospective, nested case-control study within the Nurses' Health Study cohort to examine the association between plasma sex hormone concentrations and postmenopausal breast cancer among women using post menopausal hormones at blood collection. CONCLUSION: Although women using hormones have a different hormonal profile than those not using hormones, plasma sex hormone concentrations appear to be associated with breast cancer risk among post menopausal hormone users.

Preliminary findings suggest that the ancient art of reflexology may help women with breast cancer cope in part by relieving anxiety and depression.

Estrogen -like chemicals widely used in food packaging and dental materials may be contributing to the development of breast cancer in women. A study linked low levels of the chemicals to the development of vulnerable and hormone-sensitive breast tissue in mice. In the study, the mammary glands of pubescent female mice grew structurally in a way that made them more likely to develop breast cancer. They also became unusually sensitised to oestrogen, which fuels the vast majority of breast tumours in humans. The research focused on bisphenol-A (BPA), a compound used in large quantities in the manufacture of plastic food containers, dental sealants and resins that line food tins. Research has shown that the chemical leaches out of products and may be absorbed at low concentrations into the body. Scientists working with animals have already demonstrated that BPA is potentially damaging to health. But the new study is the first to suggest even extremely weak levels of exposure in the womb may be harmful.

Treatment with a shark cartilage product does not prolong life in patients with advanced breast cancer, nor does it improve quality of life. Shark cartilage has become a popular alternative medicine for people with advanced breast cancer. Its use is based on the belief that the reason sharks rarely develop cancer is because of their high cartilage content.

A test using two chemotherapy agents to treat breast cancer was halted after two women in the study died. The test involved a combination of doxorubicin and docetaxel and followed a line of research that has shown combinations of certain breast cancer drug types are better that one kind alone to combat advanced and spreading breast cancer

Antiproliferative activity of Thai medicinal plant extracts on human breast adenocarcinoma cell line.
Fitoterapia. 2004 Jun;75(3-4):375-7.
Ethanolic extracts of selected nine Thai medicinal plants were tested for antiproliferative activity against SKBR3 human breast adenocarcinoma cell line using MTT assay.  Mangosteen showed the most potent activity.

Antiproliferation, antioxidation and induction of apoptosis by Garcinia mangostana ( mangosteen ) on SKBR3 human breast cancer cell line.
J Ethnopharmacol. 2004 Jan;90(1):161-6.
This study was designed to determine the antiproliferative, apoptotic and antioxidative properties of crude methanolic extract from the pericarp of Garcinia mangostana (family Guttiferae) ( mangosteen ) using human breast cancer (SKBR3) cell line as a model system. These investigations suggested that the mangosteen extract had strong antiproliferation, potent antioxidation and induction of apoptosis. Thus, it indicates that mangosteen extract has potential for breast cancer chemoprevention which is dose dependent as well as exposure time dependent.

Green tea linked to reduced breast cancer risk
Compounds in green tea may help protect women against breast cancer. Rats who drank water containing green tea had reductions in the size and malignancy of breast tumors compared with rats that drank only water. Additionally, the tumors of tea-drinking rats developed later and were less invasive. The findings, coupled with observations of lower rates of breast cancer in countries where green tea is consumed daily, suggest that green tea may benefit women as part of an overall healthy diet. Polyphenols, compounds that are abundant in green tea, red wine and olive oil, may protect against various types of cancer. Polyphenols are potent antioxidants, compounds that help neutralize disease-causing free radicals. These cell-damaging molecules occur naturally in the body and are linked with heart disease, aging and a number of other disorders. Dry green tea leaves, which are about 40% polyphenols by weight, may also reduce the risk of cancer of the stomach, lung, colon, rectum, liver and pancreas.

In findings that could make broccoli and Brussels sprouts easier to swallow, early research suggests a chemical found in the vegetables may impede the spread of breast cancer cells. Scientists found that the compound, called sulforaphane, hindered the growth of human breast cancer cells in the lab. It did so by apparently disrupting the action of protein 'microtubules' within the cells, which are vital for the success of cell division. The findings are published in the Journal of Nutrition. Past research has suggested a role for sulforaphane in preventing cancer, possibly due to its effects on detoxification enzymes that can defend against cancer-promoting substances. A study in rats showed that oral sulforaphane blocked the formation of breast tumors, and scientists have found that the chemical can push colon cancer cells to commit suicide. This latest research suggests a new mechanism -- microtubule disruption -- by which sulforaphane may bestow anti-cancer benefits.

Soy isoflavones suppress invasiveness of breast cancer cells by the inhibition of NF-kappaB/AP-1-dependent and -independent pathways.
 Int J Oncol. 2004 Nov;25(5):1389-95.
High consumption of soy products in some Asian countries has been linked to the low incidence of breast cancer in women. The chemopreventive effect of the soy isoflavone, genistein, has been observed through the suppression of cell proliferation, inhibition of angiogenesis and stimulation of apoptosis in breast carcinoma cells. Cancer metastasis consists of interdependent processes, including cell adhesion, migration and invasion. In the present study, we compare the effect of soy isoflavones in the form of aglycones (genistein, daidzein and glycitein) and glucosides (genistin, daidzin and glycitin) on the behavior of highly invasive breast cancer cells. Here we demonstrate that genistein suppresses cell adhesion and migration by inhibiting the constitutively active transcription factors NF-kappaB and AP-1, resulting in the suppression of secretion of urokinase-type plasminogen activator (uPA) in breast cancer cells. In addition, we show that all tested soy isoflavone aglycones (genistein, daidzein, glycitein) and glucosides (genistin, daidzin, glycitin) markedly reduced motility of MDA-MB-231 cells. However, only genistein and daidzein inhibited constitutively active NF-kappaB and AP-1 and suppressed secretion of uPA from breast cancer cells. Taken together, our results suggest that dietary soy isoflavones inhibit adhesion and motility of highly invasive breast cancer cells by distinct signaling pathways.

Dietary phytoestrogen intake and premenopausal breast cancer risk in a German case-control study.
Int J Cancer. 2004 Jun 10;110(2):284-90.
A diet high in isoflavonoids (soy) is associated with lower breast cancer risk in Asian populations. Due to the low soy intake, dietary lignans may be the more important phytoestrogen class in Western populations. We used a population-based case-control study of breast cancer by age 50 in southern Germany to evaluate the association between dietary intake of different phytoestrogens and premenopausal breast cancer risk. Dietary information was collected from 278 premenopausal cases and 666 age-matched controls, using a validated FFQ. Using multivariate logistic regression, the highest vs. lowest intake quartiles of daidzein and genistein yielded significantly reduced ORs for breast cancer risk of 0.62 and 0.47, respectively. The protective effects of daidzein and genistein were found only for hormone receptor-positive tumors. High intake of other isoflavonoids, e.g., formononetin and biochanin A, as well as the sum of isoflavonoids were not associated with a decrease in risk. Breast cancer risk significantly decreased with a high intake of the plant lignan matairesinol but not secoisolariciresinol or the sum of plant lignans. However, both estimated mammalian lignans, enterodiol and enterolactone, were inversely associated with breast cancer risk, with ORs (95% CI) of 0.61and 0.57, respectively. No effect was found for total phytoestrogen intake. Our results suggest an important role of dietary intake of daidzein and genistein, despite low levels, as well as of matairesinol and mammalian lignans to reduce premenopausal breast cancer risk in this study population.

Cimicifuga racemosa (black cohosh) extract inhibits proliferation of estrogen receptor-positive and negative human breast carcinoma cell lines by induction of apoptosis.
Breast Cancer Res Treat. 2004 Mar;84(2):151-60.
Hormone replacement therapy is contraindicated in women with breast cancer. Extracts from the rhizomes of Cimicifuga racemosa (black cohosh), have gained acceptance as a natural alternative for the treatment of menopausal symptoms. In the present study we investigated the antiproliferative activity of black cohosh extracts (isopropanolic and ethanolic) on the estrogen receptor positive MCF-7 and estrogen receptor negative MDA-MB231 breast cancer cells. Down regulation of the proliferative activity and cell killing by isopropanolic and ethanolic extracts occurred in a clear dose-dependent response with a 50% growth inhibitory concentration. Further, the mode of cell death was identified as apoptosis. These results indicate that black cohosh extract exerts no proliferative activity, but kills the estrogen receptor positive MCF-7 as well as estrogen receptor negative MDA-MB231 cells by activation of caspases and induction of apoptosis.

Two studies published in The New England Journal of Medicine show that treatment with trastuzumab (Herceptin; Roche) can dramatically improve outcomes in women with breast cancers that are HER2-positive.
HER2 overexpression occurs in approximately 15 percent to 25 percent of breast cancers and is associated with a worse prognosis than HER2-negative tumors.

Breast Cancer symptom
Often, most breast cancers develop without a symptom. A sign of breast cancer is a lump under the arm or a hard mass in breast tissue. But a breast cancer sign depends of the state of the breast cancer.

Breast Cancer Emails
I read with interest your latest supplement research update newsletter - vol. 2, issue 7 - in which you voice your concerns about elevated androgens in women's breast cancer. I have done a lot of research on androgens and cancer, and have come to the initial conclusion that testosterone may not be the culprit it's often described as being. Rather, the research I've read would indicate that the parallel increase in estrogen, esp. estradiol, may be the "bad guy" here. Aromatase is a curse for many people, men and women. If this is the case - and I only go on what research I can find - then it would seem that a LOT more research needs to be done on the now age-old controversy: "which causes cancer, testosterone or estrogen?" As you well know, the tide of opinion is shifting re testosterone and prostate cancer. I hope that enough time, energy and money may be spent to determine the role of both androgens and the estrogen trio in the eternal quest for an answer to what causes breast cancer, and how to stop it. Concurrently, I hope that much more research continues into the lives of us "old geezers" (I'm 69) who fight the good fight against andropause! Very depressing, that. (I'm currently and happily taking point-5 mg of Arimidex three times a week - BIG improvement! smile serum estradiol levels have gone from 43 to 26 and free testosterone has risen from 102 to 169 after six weeks of use). I find on your web site and in your newsletters many interesting and mind-expanding (no, not that kind of mind expansion! grin) ideas, many of which lead me to even further study and thought. In other words, sir - Thank You!
     A. We appreciate the feedback. We suspect both estrogen and androgens have an influence on breast cancer.

Q. I have a very good friend who just found out her breast cancer has spread to her liver, lung, spine and brain. Is there anything natural she can take to help in keeping this from getting any worse, or better yet, shrinking some of these tumors? She has had radiation, and is now preparing to take an oral chemo that has minimal side effects. We realize there is no cure for this right now, but we are trying to look into alternative therapies that can compliment the chemo, or she can even take instead of the chemo.
   A. Not enough human studies are available to say anything with certainty. If her doctor approves she can try some of the herbs mentioned above.

Q. Do parabens increase breast cancer risk?
    A. See parabens for a full discussion.

Q. I would appreciate your helping us to select the best herbal extract to induce apoptosis in a breast cancer patient. My problem is weather any herbal extract that induce apoptosis may interfere with chemotherapy.
   A. We are not aware of any good studies with herbal extracts and breast cancer to have a strong opinion on this topic, all we can do is refer you to general research we have on breast cancer.

Q. I am having much difficulty finding a mind boosting product that have ingredients that are safe enough to be used by breast cancer survivors. I finished radiation treatments in March of 07. I was taking ginkgo biloba which worked so well for me and I also felt better. Then I discovered that it had estrogenic like effects on the body and I stopped taking them because my cancer was 80% ER positive, and 10% progesterone positive. It's also difficult to find soyless products. I have wasted more money on supplements that do work for me, only to find out once I do my research, they have estrogenic like properties. I am so frustrated. Its as if ER positive breast cancer survivors are overlooked when it comes to this. Also, it would be great if I could find something to help my libido that doesn't have estrogen like properties.
   A. We have not seen any research to indicate ginkgo biloba causes harm to those with breast cancer. One study concludes, "Ginkgo biloba extract can be considered as a potential alternative to HRT with chemopreventive effects on breast cancer. However, further studies on animals and humans will be required." J Steroid Biochem Mol Biol. 2006 Aug;100(4-5):167-76. Another study says, "In humans, Ginkgo extracts inhibit the formation of radiation-induced (chromosome-damaging) clastogenic factors and ultraviolet light-induced oxidative stress - effects that may also be associated with anticancer activity. Flavonoid and terpenoid constituents of Ginkgo extracts may act in a complementary manner to inhibit several carcinogenesis-related processes, and therefore the total extracts may be required for producing optimal effects." Fundam Clin Pharmacol. 2003 Aug;17(4):405-17.
   Since human studies regarding various herbs and breast cancer are in short supply, it is premature to jump to conclusions regarding the role of a particular herb in being beneficial or harmful for breast cancer survivors. There's much yet that is not known. There are many factors that influence cancer cell growth or inhibition and herbs have dozens or hundreds of compounds in them that influence various stages of cancer growth or inhibition. In most cases, herbs have anti-cancer benefits.

Q. I am on chemotherapy for small blue cell carcinoma of the breast. It is of the neuroendocrine type. It is considered rare since this type of cancer usually shows up as lung cancer. I was told this was not in my lung, but it did find it's way into my breast. I am wanting to survive this thing after my mastectomy and I am wanting to survive the radiation they desire to put me through after that. Right now I am receiving both Taxotere and Carboplatin. Carboplatin is somewhat damaging to the nervous system. Do you have a suggestion about formulas that might help me?
   A. We can only provide general research on natural herbs or supplements that influence breast cancer, and are not in a position to offer individual advice. We wish you optimal healing.

Additional herbs and compounds that could potentially be of benefit in breast cancer prevention or treatment:
Turmeric herb
Vanillin extract

Additional links of interest
Breast Enhancement web page
Ovarian Cancer information