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Inflammatory breast cancer

Breast cancer is cancer of breast tissue. Worldwide,it is the most common form of cancer in females, affecting approximately 10% of all women at some stage of their life in the Western world. Although significant efforts are made to achieve early detection and effective treatment, about 20% of all women with breast cancer will die from the disease, and it is the second most common cause of cancer deaths in women. more...

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Epidemiology

Age

The risk of getting breast cancer increases with age. For a woman who lives to the age of 90 the chances of getting breast cancer her entire lifetime is about 12.5% or 1 in 8. Men can also develop breast cancer, but their risk is less than 1 in 1000 (see sex and illness). This risk is modified by many different factors. In a very small (~ 5%) proportion of breast cancer cases, there is a strong inherited familial risk. Some racial groups have a higher risk of developing breast cancer - notably, women of European and African descent have been noted to have a higher rate of breast cancer than women of Asian origin. (figures from breastcancer.org) However, these apparent racial differences diminish when geography is altered, as Asian women migrating to the western world, gradually acquire risk approaching that of western women.

The probability of breast cancer rises with age but breast cancer tends to be more aggressive when it occurs in younger women. One type of breast cancer that is especially aggressive and disproportionately occurs in younger women is inflammatory breast cancer. It is initially staged as Stage IIIb or Stage IV. It also is unique because it often does not present with a lump so that it often is not detected by mammography or ultrasound. It presents with the signs and symptoms of a breast infection like mastitis.

Genes

Two genes, BRCA1 and BRCA2, have been linked to the rare familial form of breast cancer. Women in families expressing mutations in these genes have a much higher risk of developing breast cancer than women who do not. Not all people who inherit mutations in these genes will develop breast cancer. Together with Li-Fraumeni syndrome (p53 mutations), these genetic aberrations determine around 5% of all breast cancer cases, suggesting that the remainder is sporadic. Genetic counseling and genetic testing should be considered for families who may carry a hereditary form of cancer.

Alcohol

Alcohol is another risk factor for the development of breast cancer. Women who drink half a glass of wine every day have 6% increased risk of developing breast cancer where as women who drink two drinks or more daily may have 37% increased chance of developing breast cancer. 1

Hormones

The International Agency for Research on Cancer (IARC) in Lyon, France invited 21 scientist from 8 countries in June 2005, to evaluate the risk of cancer for humans of combined estrogen-progestogen contraceptives and combined estrogen-progestogen menopausal therapy. The working group found that there is a small increase in the relative risk of breast cancer in current and recent users of combined oral contraceptives.

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The breast health handbook: how to reduce your risk of breast cancer, take control of the treatment process, and be there for your friends and family
From Natural Health, 10/1/05 by Angela Hynes

WOMEN LIVE IN A CONSTANT STATE OF "YELLOW ALERT" when it comes to breast cancer. In a recent worldwide survey, almost 50 percent of the women polled said they were afraid of developing breast cancer; according to the American Cancer Society, an estimated 211,000 women in the United States will get breast cancer this year.

The good news is that fewer women are dying from breast cancer, due to improved diagnostic techniques that catch tumors early, more effective treatments, and growing insight into lifestyle and environmental risk factors. This means that every woman has choices in how she approaches breast cancer, whether her concern is prevention, treatment, or coping with the disease in herself or in her loved ones.

prevention:

10 ways to reduce your risk

1 Drink green tea.

A number of studies have suggested that the antioxidant and anti-inflammatory powers of green tea may help prevent numerous cancers, including breast cancer. You'll need about five cups a day to get the effects.

2 Supplement.

Take Brevail: This all-natural capsule is high in lignans, which are phytochemicals found in grains, legumes, and produce that are known to be protective against breast cancer in over a dozen ways; find a retailer at brevail.com.

3 Choose organic meats and dairy.

Eating products from cows given bovine growth hormone may result in elevated levels of IGF-1 (insulin-like growth factor), which stimulates breast tumors in pre-menopausal women. Fatty red meats generally store the most toxins.

4 Step away from the smokers.

Researchers at the Public Health Agency of Canada found that pre-menopausal women who were nonsmokers but were exposed to smoke from co-workers or family members had a 68 percent greater risk of breast cancer.

5 Eat your broccoli.

And your cauliflower, Brussels sprouts, kale, and cabbage. These cruciferous veggies are rich in indole-3 carbinol, which offers a number of protections against breast cancer. Get at least four servings a week.

6 Taper off the alcohol.

Moderate imbibing, especially of red wine, can have many health benefits. Yet data from the Nurses' Health Study show that drinking small amounts of wine or beer daily elevates breast-cancer risk in postmenopausal women.

7 Block that estrogen.

Turmeric regulates estrogen receptors, and helps the body eliminate carcinogens. Add 1/4 to 1/3 teaspoon per person to dishes at the end of cooking, says Christine Hornet, M.D. This Indian spice also enhances soy's estrogen-blocking properties.

8 Get windblown.

Electromagnetic frequencies have been linked to breast cancer--and hair dryers are the No. 1 culprit. One brand, Angelite, emits reduced levels of EMFs; find it at lowemfs.com.

9 Scrounge up some seaweed.

In a recent animal study published in the Journal of Nutrition, researchers found that 35 to 70 milligrams of bladderwrack seaweed daily lowered estrogen levels up to 25 percent.

10 Sleep on it.

Night workers have more risk of breast cancer, possibly due to disrupted melatonin and cortisol cycles. Melatonin slows estrogen production, and cortisol regulates some anti-cancer cells. Sleeping from 10 p.m. to 6 a.m. is optimal."

the estrogen link

WHO IS MOST AT RISK to develop breast cancer?

"Women think it's genetic, and that's a misconception," declares Christine Horner, M.D., F.A.C.S., author of Waking the Warrior Goddess: Dr. Christine Horner's Program to Protect Against & Fight Breast Cancer. While DNA is the main risk for women with certain mutations (see "The Gene Test," page 61), 90 percent of breast cancers occur in women with no family history of the disease. Why them?

One reason is high, cumulative exposure to estrogen. Many breast tumors are estrogen-responsive, meaning the hormone makes cancer cells grow and divide. Of the three major types of estrogen--estriol, estrone, and estradiol--the latter fuels breast cancer the most. The body produces estradiol during every menstruation. So if a gift starts her periods at 10 rather than at 16 (increasingly the case in the U. S.), her risk for breast cancer is 50 percent higher for the rest of her life, says Horner. Not getting pregnant or not breastfeeding (times when minimal estradiol is produced); having short, more frequent cycles; and experiencing menopause past age 55 augment the risk. Also, hormone replacement therapy combining estrogen and progestin is associated with an elevated chance of first and recurrent breast cancers.

On top of that, there's the environmental factor. "We are exposed to a huge amount of chemicals and toxins that mimic the estrogen molecule," says Horner. Culprits include certain soft plastics and heavy metals, as well as pesticides like DDT that are banned in the U.S. but may be present on imported produce.

One answer to bodily pollution: Go organic. "You can't be 100 percent free from these toxins, because they are everywhere in our environment," says Horner. "But you can keep them at an absolute minimum by consuming only organic fruits and vegetables and whole grains." Also, switching to organic meats and dairy reduces your exposure to a potentially harmful growth hormone (see No. 3, opposite).

The "go organic" advice doesn't stop at foods but extends to household cleaners, paint and building materials, clothing, and bedding (cotton is the most pesticide-heavy crop in the world). "Assume everything is toxic unless it's labeled nontoxic," says Horner.

weight watch "Many environmental toxins are stored in body fat," says Horner, "so the less fat you have, the fewer toxins you will store." Body fat also leads to higher amounts of estrogen in the blood of post-menopausal women. Plus, being overweight boosts your risk of insulin resistance, which can start a chain reaction leading to the selective cell growth of malignant breast-cancer cells.

A recent study in Cancer Epidemiology, Biomarkers & Prevention concluded that overweight, sedentary women doubled their chances of getting breast cancer, compared with women who were lean and physically active. The CDC recommends moderate exercise such as brisk walking for at least 30 minutes five or more days a week.

prevention: detox, ayurveda-style

Since synthetic and cancer-causing chemicals tend to deposit in your fat cells, consider detoxing through panchakarma, an ayurvedic program for cleansing and rejuvenating.

internal oleation

This is the first step in panchakarma. Eating ghee (clarified butter) in increasing amounts for several days is believed to move toxins from your fat cells into your digestive tract, where they're eliminated.

organic foods

"People who underwent panchakarma twice a year and ate mostly organic foods had no detectable pesticides in their bodies," says Christine Horner, M.D., citing a report in Alternative Therapies in Health and Medicine.

seat therapy with herbs

Treatments include yoga, meditation and multiple heat therapies. During herbal steams, cool your face and head with a frozen cube of coconut oil, and take frequent sips of water.

body work

Comprehensive programs can be found at The Raj (theraj.com) in Iowa, the Ayurvedic Institute (ayurveda.com) in New Mexico and the Chopra Center (chopra.com) in California. You can also detox at home with herbal systems; Horner recommends Whole Body Cleanse from Enzymatic Therapy (enzy.com).

treatment: making choices

BRENDA MICHAELS WAS 39 when she was diagnosed with an aggressive breast cancer. She had a radical mastectomy and chose to follow up with the drug tamoxifen rather than with chemotherapy. One year later, a new cancer appeared in her other breast. After this mastectomy, her doctor insisted she needed adjuvant chemotherapy. "He gave me five years with it and a year without it," she says.

Despite having little previous interest in alternative medicine, Michaels instinctively felt that it made no sense to poison her body further with chemotherapy drugs and then try to get well. She was introduced to an M.D.--an immunologist--who took a holistic approach to cancer treatment. He put her on a program of organic foods, detoxification, supplements, and stress reduction.

Fifteen years later, she has had no recurrence of cancer and is thriving. Yet she does not advocate that others follow the path she chose. "I never recommend any treatment modality to anyone," says Michaels, who now owns and hosts Conscious Talk Radio. "I tell women that our bodies have an innate intelligence. If we tap into it, it will guide us along when we have to make these profound decisions."

Whether or not to follow surgery with preventive chemo is indeed a very personal choice. "We treat people who are at risk for recurrence but are without measurable disease, so we don't know that they need chemotherapy," says Jennifer Griggs, M.D., F.A.C.P., medical director of the Comprehensive Breast Cancer Program at the University of Rochester Medical Center in New York. "They can get chemotherapy and still have a recurrence, or not get it and survive. I've found that patients don't fear the toxicity of chemotherapy as much as they fear it not working."

There can be extenuating factors at every turn. For example, Griggs analyzed data on patients treated with adjuvant chemotherapy (which is based on weight) and found that some doctors hesitated to fully dose overweight patients. But there is no evidence of heavy women getting the appropriate dose being at additional risk, says Griggs. "Oncologists don't have a long-term relationship with the patient," she notes, "and we worry about hurting that new relationship."

So take the initiative to ask questions and make your wishes known. And be upfront about your own treatment plans, such as alleviating menopausal symptoms with black cohosh, which can interact with breast-cancer drugs.

At the same time, tune in to your innate wisdom. "It's a matter of asking difficult questions of yourself," declares Michaels, who meditated, prayed, and journaled. "I got what I call downloads of information--that's inner inspiration. I was willing to surrender to it, because I had nothing to lose and everything to gain."

THE GENE TEST

Genetic breast cancer is primarily caused by changes in the BRCA1 and BRCA2 genes. There is a blood test--covered by most health insurance companies--that identifies these irregularities. The National Cancer institute recommends the cancer patient first be tested, and if she has the genetic variation, her close relatives be checked. Myriad Genetic Laboratories, the company that analyzes the tests, supplies a risk-determination questionnaire at myriadtests.com/cancethistory.htm.

treatment: be your own advocate

1. Write it all down.

Processing information is difficult when you're reeling from the shock of diagnosis. Take notes or ask a friend to, or tell your doctor you want to record the consultation.

2. Hit the Net.

Useful Web sites are run by the National Breast Cancer Foundation (nationalbreastcancer.org), the Susan G. Komen Breast Cancer Foundation (komen.org), the American Cancer Society (cancer.org), and the National Center for Complementary and Alternative Medicine (nccum.nih.gov) Another resource is cancer.gov/clinicaltrials, which may help you gain access to new therapies at low or no cost.

3. Add home remedies to the mix.

To relieve nausea, try acupuncture or acupressure on point P6 (about three finger-widths above the wrist crease on the arm), says Sat Dharam Kaur, N.D., author of The Complete Natural Medicine Guide to Breast Cancer. Kaur also recommends the omega-3 fatty acids in fish oil capsules to help inhibit cancer cells, and nettle tea to fight fatigue. Also, a daily adaptogen like ashwagandha, Siberian ginseng, or rhodiola can help the body deal with stress.

Meanwhile, add seaweed to your stir-fries; the wakame and mekabu varieties are particularly effective in stopping the growth of tumors, says Christine Horner, M.D. Plant foods are also part of a healthy low-fat diet, which can decrease the risk of breast-cancer recurrence by 20 percent.

coping: support systems

HEARING HER DIAGNOSIS of cancer was "stunning," says Donna Kuyper, a writer/filmmaker in Los Angeles. "But I'm a person who goes into warrior survival mode in an emergency--and warriors don't fight alone."

Eventually, Kuyper sought out weSPARK in Sherman Oaks, Calif. This cancer-support center came about after actress Wendie Jo Sperber (known for the 1980s sitcom Bosom Buddies) was diagnosed with breast cancer in 1997. Finding few resources, Sperber launched a support group that met in her living room; subsequently, she used her connections to raise money and open a facility offering free services and a homey, soothing atmosphere that's filled with flowers and waterfalls.

The program director is Sperber's longtime friend, actress Nancy Allen. "The idea behind the center is that cancer affects the whole family," says Allen. "Children, in particular, don't have words to describe their feelings." Consequently, the center's schedule includes support and activities for kids and teens, as well as for spouses and caregivers.

As for the patients, they're offered information on treatments, energy healing like yoga and qi gong, guided imagery sessions, meditation, creative writing, and mah jongg and poker nights. "Some people say the games help them focus their minds," says Allen. "And some don't want to think about the disease at all but just want somewhere to come for the camaraderie."

Kuyper found the workshop in creative writing to be particularly helpful. "The facilitators never said everyone had to write about cancer," she says. "I wasn't ready to deal with it directly. But once you see other people doing just that, it quietly inspires you to face it."

To find a support group or center, ask doctors, nurses, and fellow patients for referrals. The Wellness Community (thewellnesscommunityorg) has facilities nationwide. The Y-ME National Breast Cancer Organization offers 24-hour support online or by phone (y-me.org; 800-221-2141). Or start a group in your own home or community. Local businesses, organizations, and religious institutions will often supply meeting spaces, refreshments, and so on.

coping: the care package

Women with breast cancer empower themselves by taking practical steps--and so do their friends. If you know someone with the disease, why not put together a few items that will make a difference?

yoga book

Researchers at the M.D. Anderson Cancer Center in Houston found that chemotherapy patients who did Tibetan yoga slept better and longer. Attend a class together, or give her Healing Yoga for People Living With Cancer by Lisa Holtby.

garlic

This natural antioxidant and immune-function supporter is a prime weapon in preventing and treating breast cancer, says Christine Horner, M.D. The allicin in garlic induces anti-cancer activity, and might reduce chromosomal damage, says David Simon, M.D., author of Return to Wholeness: Embracing Body, Mind, and Spirit in the Face of Cancer.

green tea

Each sip contains polyphenols that inhibit the growth of breast cancer, according to Japanese studies; tea also reduces cancer-provoking estradiol, and may protect organs from drug damage.

maitake mushrooms

Grifola frondosa help arrest and reverse tumor growth and prevent spreading, says Horner; in one study, symptoms improved in 68 percent of patients. Horner suggests 3 to 5 grams of powder or capsules daily.

essential oils & candles

Aromatherapy provides a variety of benefits for cancer patients. For example, jasmine oil has a detoxifying and antidepressant effect, while black pepper oil is a digestive stimulant, says Simon. Add a few nontoxic, soy-based lavender-scented candles to aid relaxation.

journal

Write it all down to relieve stress, suggests a report in Psychooncology journal. Healing Journals are available at bookstores, or visit hayhouse.com.

pillow

The Breast Cancer Support Pillow, designed for comfort and easy cleaning, comes with a sample blend of essential oils; go to avianabody.com.

lotions

Alra Therapy Lotion (alra.com) was created by a chemist to soothe his wife's skin after her radiation therapy.

ginger

Sip ginger tea or take ginger to relieve nausea from cancer therapy, says Sat Dharam Kaur, N.D., but use it with caution due to its anti-clotting properties.

turmeric

This spice inhibits the COX-2 enzyme, which is often high in cancer cells. It fights tumor growth and may enhance chemotherapy, says Horner. Turmeric and green tea are synergistic, boosting each other's anti-cancer properties.

iodine

This essential trace element is toxic to breast-cancer cells, says Horner. Check with a doctor before taking iodine supplements. (Seaweed is rich in iodine; see page 62.)

flaxseed muffins

Flaxseed contains Cancer-fighting lignans. University of Toronto research showed that eating a muffin with 25 grams of flaxseed daily for about five weeks resulted in a reduction in breast-tumor size. (Add flaxseed to a diet slowly to avoid GI upset.)

how you can help

IF SOMEONE YOU'RE CLOSE TO has breast cancer, you might not be certain of the best way to respond. But that shouldn't prevent you from trying.

"Don't run away," says Donna Kuyper. In talking to other patients, she learned that she wasn't the only one who had someone bail on her after cancer surgery. "This was a very close friend, so I was surprised and disappointed," she recalls. "Maybe she felt guilty for not having to go through the trauma I did. Whatever the reason, this is a rotten time to run out on a friend."

So what can you do? First, be there without being pulled into the drama. "Allow for emotional outbursts of grief, anger, depression, and worry," says cancer survivor and counselor Brenda Michaels. "Getting a diagnosis of cancer is shocking, and this tends to bring to the surface behavior that isn't necessarily normal."

Offers of specific help are greatly appreciated. "For one patient it might be a ride to the doctor, for another it might be just going out to lunch," says Kuyper. You could stock the freezer with healthful meals or do some household chores like gardening or pet care. Take the kids on an outing; they may be feeling scared or overlooked, and mom will get a break.

Be circumspect with your opinions. "It's bad enough to get cancer, but it's worse when people tell you it's your fault because, in their eyes, you're eating or drinking the wrong thing," says Kuyper. "Once we are through treatment, most of us appreciate people behaving toward us the way they did before the cancer. In other words, be normal."

If your friend has enough casseroles and pet sitters, you can always champion the cause by raising money for cancer research in her name. Participate in one of the national events like the Avon Walk for Breast Cancer (avonwalk.org), the Breast Cancer 3-Day (the3day.org), or the Revlon Run/Walk (revlonrunwalk.com). Or do a little conscientious shopping at oneineight.org, where 50 percent of the proceeds go to breast-cancer research.

take a walk

Participating in a charity event like the Race for the Cure (komen.org) raises spirits as well as research funds. In addition, breast-cancer patients in the Nurses' Health Study reduced their risk of dying from breast cancer by 50 percent with regular exercise, such as taking brisk walks for three to five hours a week. This was particularly true of women with hormone-responsive cancers.

COPYRIGHT 2005 Weider Publications
COPYRIGHT 2005 Gale Group

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