Breast Cancer: Overview And Risk Factors

Avoiding Breast Cancer with Diet
Breast cancer is clearly a terrifying disease. Out of every nine women in America, at least one will fall victim to its toll. Despite massive research and immense funding, scientists are often at odds regarding its possible causes.

At the heart of the confusion and controversy is the role of a high-fat diet. On the one hand, extensive laboratory research and human epidemiological studies often link high-fat diets to higher rates of breast cancer. On the other hand, several prominent medical studies have shown little or no relationship between fat intake and breast cancer. Lacking conclusive evidence, most nutritional experts play it safe by suggesting that the most effective way to reduce breast cancer is to reduce overall fat intake.

What we have found from the China Project is that such advice is not sufficient. The fact that significantly lower breast cancer rates exist throughout China is not simply due to low-fat diets but also because these diets are largely plant-based.

Let’s look at the findings:

* Even though breast cancer is substantially lower in China, a broad 13-fold range can still be found between various areas of the country.
* Fat intake in rural China ranges between 6 and 24% of total calories. By contrast, this range soars to 25-45% of total calories in the U.S.
* Age at first menstruation (menarche) in China is typically 15–19 years, considerably later than the 10–14 years in the U.S.
* Blood levels of the female hormone estrogen are significantly lower among Chinese women than among U.S. women.
* As dietary fat declines from 24 to 6%, and these diets become richer in plant matter, breast cancer rates make a similar decline.

In our survey we found that girls who consumed diets that were limited in plant foods, yet were high in animal foods that increased growth rates, reached menarche at an early age. When girls are pushed early to menarche by what they eat, their blood levels of estrogen and certain other hormones reach unusually high levels. These levels will then remain high as long as no dietary change is made. What is the problem? Higher levels of female hormones are known to be associated with higher breast cancer risk.

More Than “Just Fat”

On the other side of the coin, low-fat, plant-rich diets retard the onset of menstruation and decrease circulating hormone levels. Fat and animal protein have each been shown to increase female hormone levels, while dietary fiber decreases these levels. The most important message from these studies is not that low fat intake alone reduces cancer risk, but that a large number of factors in plant-based diets combine to reduce the disease. And this is very likely the reason not only for the confusion about breast cancer but also why removing only small amounts of fat from an animal-based diet will not significantly reduce this serious disease.

A Point to Ponder

How about this for a side benefit of a plant-based diet? Later age at first menstruation could add up to substantially fewer teenage pregnancies, which are currently estimated at more than 1 million per year in the U.S., a figure equivalent to the entire population of San Diego, CA.

What Can You Do?

If we are going to reduce our nation’s breast cancer risk, we need a much more aggressive nutritional approach. In our advice about reducing dietary fat, we need to encourage a diet based on plant foods.

Start your children early in life on a diet rich in fruits, vegetables, and grain products. And begin the change yourself to a plant-based diet!


Marshall, J. R., Yinsheng, Q., Junshi, C., Parpia, B., Campbell, T. C., “Additional Ecological Evidence: Lipids and Breast Cancer Mortality Among Women Aged 55 and Over in China,” European Journal of Cancer, Vol. 28A, No. 10, pp 1720-1727, 1992.

Breast Cancer
Breast Cancer: Overview and Risk Factors
Breast cancer is the most common cancer of women and the second most common cause of cancer death in women. In the United States, one in nine women will be diagnosed with invasive breast cancer over a lifetime. The development of breast cancer has been associated with increased levels of estrogens–female sex hormones–in the body.  These states include long–term use of menopausal hormone “replacement” therapy and uninterrupted menstrual cycles, including early onset of menstrual periods or late onset of menopause. Food choices and body fat accumulation can also affect the amount of estrogen in a woman’s bloodstream. Symptoms may include a breast lump; thickening, dimpling, or redness of the skin of the breast; or bloody nipple discharge. Breast pain or tenderness is usually not associated with cancer. In many cases, the only sign of disease is an abnormal mammogram. Breast cancer does occur in men, although it is relatively rare. For men, the incidence is about 1 percent of the rate in women. There is an 85 percent five–year survival rate. Early diagnosis and treatment is important because breast cancers can become invasive and spread throughout the body. Risk Factors
Age: Incidence increases with age.
Family history: Having a first–degree relative with breast cancer increases the risk.
Genetics: Researchers have discovered two genes, named BRCA1 and BRCA2, which are related to breast cancer. Mutations of these genes significantly increase the risk of cancer.
Increased estrogen states: These include long–term use of menopausal hormone “replacement” therapy, uninterrupted menstrual cycles (including early onset of menstrual periods, late onset of menopause, older age at first birth, and nulliparity (having never given birth). In a clinical trial with 7,705 women, those with the highest blood estrogen levels had double the risk for invasive breast cancer.
The Women’s Health Initiative study showed a higher risk of breast cancer among women taking estrogen and progesterone hormone “replacement” therapy for approximately five years, in comparison with those who used a placebo.
Radiation exposure
Shorter duration of breast–feeding: Several studies show protective benefits of breast–feeding. A multinational study of nearly 150,000 women showed a decreased risk of 4.3 percent for each year of breast–feeding and 7 percent for each pregnancy.
History of ovarian cancer
Elevated blood glucose: The Nurses’ Health Study found that postmenopausal women with diabetes had a slightly greater risk for breast cancer. Other studies have found greater risk for breast cancer in nondiabetic women with higher levels of fasting glucose.
Race: Breast cancer incidence, aggressiveness, and mortality are higher in African–American women, compared with whites.
Other: Moderate sunlight exposure and physical activity are associated with a reduced risk. Despite common beliefs, most studies have not shown increased risk from silicone breast implants, electromagnetic fields, electric blankets, hair dyes, or organochlorines.
All women should have physical examinations, including careful breast exams. Mammograms in all women over 50 are an effective screening tool ???? that clearly decreases mortality from breast cancer. In women with increased risk, initial screenings may be started earlier.
All breast lumps that are found on examination should be evaluated with mammography or ultrasound. In some cases, an MRI scan may also be used.
If there is suspicion for cancer, a biopsy is necessary for definitive diagnosis.
Surgery to remove the breast cancer is the preferred therapy. The surgical options include lumpectomy plus radiation therapy, or mastectomy.
The choice of surgical therapy often presents difficulties for doctors and patients. Lumpectomy followed by radiation may be considered in the case of smaller tumors and/or in women with larger breasts where a good cosmetic result is anticipated. Mastectomy virtually eliminates the risk of local recurrence, but may result in poorer cosmetic results.
Chemotherapy is indicated for most patients in addition to surgery.
Breast cancers are also evaluated based on whether they contain estrogen or progesterone hormone receptors. Women with hormone–positive cancers are treated with long–term medications (e.g., tamoxifen) in addition to surgery and/or chemotherapy.
Further, in high–risk women without breast cancer, tamoxifen taken for five years decreases the risk of developing breast cancer by 50 percent or more.
Breast Cancer: Nutritional Considerations
A plant–based diet: Researchers have long noted a low incidence of breast cancer in countries where traditional diets are based on plant foods. In contrast, a striking increase in breast cancer incidence has been noted in migrants who abandon traditional diets (e.g., rice, vegetables, and soy foods) and adopt Western–type diets high in meat, dairy products, and fat.
Part of this risk may be related to eating fiber–depleted, fatty foods that increase blood levels of estrogen or to an increase in estrogen production from fat cells. High–fiber foods help to remove excess estrogens from the body in the same way that these foods remove cholesterol. Here are some tips for starting a plant-based diet >>
Maintenance of a healthy body weight: Large studies, including the Women’s Health Initiative, indicate that breast cancer risk increases significantly with overweight and obesity. Lower body weight also appears to improve the prognosis in patients with breast cancer. Overweight patients with breast cancer were shown to have a shortened life expectancy and greater risk of cancer recurrence after treatment.
The same low–fat, plant based diet that reduces fat intake and increases fiber will also help reduce body weight.
Reduced intake of saturated fat and meat: The high intake of saturated fat and meat may be a part of the reason that breast cancer is much more common in areas where Western diets prevail.
In the Nurses’ Health II Study, premenopausal women who ate the most fat had a slightly increased risk for breast cancer. This risk was attributed mainly to the intake of red meat and high–fat dairy products.
Lower fat diets may also improve survival in patients who are diagnosed with breast cancer. A Japanese study showed increased death rates when high–fat foods (particularly butter and margarine, cheese, ham, sausage, and dairy products) are consumed. Other studies have suggested that patients who eat the least fat when they are diagnosed have a better prognosis. Further, results from a large randomized clinical trial, the Women’s Intervention Nutrition Study, showed that postmenopausal women who ate a low–fat diet were less likely to develop a recurrence of breast cancer, compared with those who ate a standard diet.
Increased fiber intake: A large study of postmenopausal women found that women who ate the most fiber had the lowest risk. And the risk was even lower among women who ate the least fat. High–fiber, low–fat diets also reduce serum estrogen, which is known to be associated with breast cancer risk.
With the addition of exercise, this type of diet is known to help keep blood glucose levels within normal limits and to lower the risk for adult–onset diabetes, both of which have been related to increased breast cancer risk.
Fruits, vegetables, beans, and legumes (including soy products) are particularly good sources of fiber. Studies show that women who eat more fruits and vegetables may have greater long–term survival from breast cancer, possibly because of the combinations of carotenoids, folate, and phytochemicals present in these foods.
When the intake of these foods begins before or during adolescence, the healthy effects are especially prominent.
Reduced or eliminated alcohol intake: Alcohol intake is associated with an increase in the incidence of breast cancer. People who had two (approximately 30g of alcohol) or more drinks per day had a 40 percent increased risk compared with nondrinkers. Even one drink daily increases one’s risk by up to 10 percent.
Increased intake of folic acid: Eating foods high in folate may help lower the risk for breast cancer, especially in women who consume alcohol. Foods that contain folic acid (green leafy vegetables, legumes, and oranges) are likely to be preferable to folate supplements, due to their fiber, beta–carotene, vitamin C, and phytochemical content, all of which may have important roles in reduction of breast cancer and cancer risk in general.

Breast Cancer Recurrence
Lack of information and misinformation are rampant in the cancer field. Most people are unaware that most traditional cancer treatments don’t work and that there are alternatives.  When I make this statement many people  are quick to refer to a friend or relative who had cancer a couple of years ago and recovered.  However, the recovery may be temporary, as there is a very high recurrence rate for many types of cancer.

The Canadian Breast Cancer Network conducted a survey showing that only 1 in 10 breast cancer patients are aware that there is a risk of relapse five years after tamoxifen treatment. Yet, according to Dianna Schreuer, past president of the Canadian Breast Cancer Network, one third of survivors will experience a recurrence.

The survey showed that less than half of breast cancer patients recall receiving information from their doctors about support and/or recurrence, and only 8% of those surveyed believed they were at risk for a recurrence.  61% stated that they felt recurrence was unlikely.  75% stated that completing the tamoxifen regimen made them feel optimistic about the future, and 63% felt they had won the battle.

In other words, the impression and beliefs these women have about their health is significantly different than the reality of their situation.  Again, this is common in the cancer “industry.”

Here is the reality for breast cancer patients.  Most breast cancers are estrogen positive, and most women receive treatment for their cancer that an increasing number of doctors are starting to acknowledge is overkill. Tamoxifen is often prescribed as a follow-up treatment.  There are serious side effects from tamoxifen, and the drug confers little benefit in absolute terms.

Estrogen levels are easily lowered for most women by consuming a low-fat, high-fiber plant based diet, exercising, and by achieving and maintaining optimal weight and body composition. Women should be given this information both as a means of preventing breast cancer, and certainly as a primary means for preventing recurrence.  Dietary excellence and optimal habits are considerably more effective than tamoxifen without the negative side effects.

Hopefully, we can look forward to a time when the expectations and beliefs about disease prevention and reversal begin to line up with the reality of the science in these areas.

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