Nutrition and Breast Cancer

Lately many of our friends, family, and acquaintances have reported they have been diagnosed with breast cancer. Just two weeks ago, we heard from a close relative in her early 40s that she has breast cancer and is now scheduled to undergo a mastectomy. 

At present, there are 2.8 million breast cancer survivors in this country, including those currently being treated. The incidence of breast cancer was rising until after the year 2000, when the rate of new cases fell off by 7 percent. This drop was thought by many experts to be due to a decline in the number of women who stopped hormone replacement therapy after the Women’s Health study released data inferring that HRT had been fueling some of these cases. 

This was true because oral non-biodentical hormones were being used, and these do definitely increase the risk of breast cancer. In contrast, current bioidentical estradiol and progesterone topically administered do not increase this risk of breast cancer. In regards to causative agents for breast cancer, it seems that nutritional intake, body weight, and carbohydrate ingestion make a lot of difference in the incidence of this disease and other health problems that affect us.

The development of breast cancer in susceptible individuals has to do with the basic molecule of life, namely glucose. From sunlight, energy is directed to earth to induce photosynthesis in the presence of carbon dioxide, water, and chlorophyll, which results in the production of glucose. The light energy is compressed into this basic glucose molecule to be released for our bodies from various plant-produced glucose-based compounds, including starches and sugars, which we eat to gain energy. When we eat, we are able to burn (oxidize) this basic molecule to maintain body temperature, keep our heart and brain active, and power our muscles for moving around. So far, so good, but when we eat more of these compounds than we need, our bodies store this, with the help of insulin, in the form of body fat. 

With the availability of too much excess food, especially carbs, we have, in the majority of our population, far exceeded the  average amount of body fat stores. The BMI (body mass index) is a number which relates height to body weight, and the higher the number, the more body fat is present. This number indicates the potential risk for certain diseases such as cancer, heart disease, and arthritis. 

In order to utilize incoming food for energy, our insulin must process each molecule to meet the body’s energy needs, so that the glucose is burned as energy or stored as fat or glycogen. Glycogen is produced in small quantities, while the amount of fat that can be stored has a very high limit. At this point, part of the energy goes to stimulate IGF-1, a protein-based molecule, which is a growth factor important in body metabolism—and not very healthy when it is over-produced. Increased IGF-1 levels are associated with the development and stimulation of cancer cells in our bodies, which means that increased carb intake produces more new breast cancers and also changes the recurrence rate of treated cancers in an unfavorable way. 

Increased carb intake, mostly due to eating excess sugars and starches, is primarily responsible for increased individual susceptibility to cancer and a higher recurrence rate with a poorer prognosis. This fact is well documented in the medical peer-reviewed literature. High carb intake is also the basis for inflammation in the body that is responsible for the diseases mentioned such as heart disease, type II diabetes, arthritis, and even Alzheimer’s disease. Without an excess of carb intake, the prevalence of these problems would be far less. 

Each individual has a different genetic make-up, so the increase in carb intake may have more of an impact in a more susceptible individual, such as a woman with a BRCA gene mutation, which doubles the risk of breast cancer. If the IGF-1 level in a person is high, the risk of recurrence of that cancer is increased threefold. 

A practical example of this is documented in a study of dietary habits in Asian women, which showed that increased intake of polished white rice doubles breast cancer risk, while eating lower glycemic brown rice decreases the risk. As you might remember from other articles in TW, the glycemic index (GI) measures how fast ingested food produces glucose in the body. 

Another large study showed that a higher glycemic diet increased the risk of breast cancer by 53 percent, while a high glycemic load increased it by 153 percent. This basically means that it may be OK to taste a sliver of cake or a doughnut, but don’t eat too much more. 

This is also the basis of the Zone Diet which emphasizes limited caloric intake with balanced portions of protein, carbs, and fat in every meal and every snack. This manner of eating allows you to eat less and not experience the hunger pangs which are characteristic of a high carb-only intake.

There are multiple other factors to consider in your diet as well. As you age, the genes which control cell growth may have spontaneous mutations and influence the breast tissue cells to have more rapid growth as a result of toxic food choices and high glycemic food. We know that hydrogenated fats, fried foods, and low nutrient-dense foods, especially when combined with high carb intake, increase cancer risks. 

Higher levels of Vitamin D and increased intake of cruciferous vegetables, such as broccoli, kale, cabbage, and cauliflower, definitely reduce the risks of cell mutations. These plants contain phytochemicals, which can neutralize carcinogens and help reduce cancer formation. They represent an excellent example of how a nutrient-dense food reduces cancer risk. 

The Western diet of increased meat and sugars/starches increases risks, while the addition of soy products decreases the risks by 50 percent. The active nutrients in soy, especially fermented soy foods, called isoflavones also reduce the incidence of heart disease and osteoporosis. Fish oil with Omega 3s has a protective effect as well. Another phytonutrient, D-gluconate from apples, oranges, and grapefruit adds another layer of protection. A nutrient compound found in flaxseed called lignans has been shown to slow the speed of cancer cell growth. Green tea contains an anti-oxidant compound known as Epigallocatechin gallate, which is also helpful in the diet.

To sum it up, your diet is strongly responsible for increasing risk for breast cancer as well as decreasing recurrence after treatment. You might take this opportunity to review your own habits regarding food intake and change your diet accordingly. Eating a healthier diet increases the likelihood that you will live longer without the standard diseases of the Western culture. 

Dr. Carraway is the director of the Plastic & Cosmetic Surgery Center of EVMS.  Call 757-557-0300 for more information.

James H. Carraway, M.D.

Dr. James Carraway is a full-time academic and practicing clinical plastic surgeon.  He is Director of the Cosmetic & Plastic Surgery Center of EVMS, is board certified in surgery and plastic surgery, and is a fellow of the American College of Surgeons.  Dr. Carraway has been teaching and practicing for 30+ years and has been director and chairman of residency training programs and fellowship programs in plastic surgery.
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