how to reduce breast density to decrease risk of breast cancer by sat dharam kaur nd
TRANSCRIPT
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How to Reduce Breast Density to Decrease Risk of Breast Cancer
by Sat Dharam Kaur ND
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Breast Density and Cancer Risk
• Increased breast density causes a 4-5 fold greater risk of breast cancer in women who have increased density in > 75% of breast tissue
• 1/3 of all breast cancers are found in women who have increased density in > 50% of their breast tissue Lancet Oncol. 2005 Oct;6(10):798-808
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Breast Density and Cancer Risk
• 43.3% of US women ages 40 to 74 years of age have heterogeneously or extremely dense breasts (about 27.6 million women) as determined by mammography
• Breast density is inversely associated with age and BMI
• Women aged 40 to 49 years account for 44.3% of this group J Natl Cancer Inst. 2014 Sep 12;106(10)
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Detecting Increased Breast Density
Breast density can be evaluated using:
• Mammography
• MRI PLoS One. 2014;9(6): e99027
• Ultrasound AJR. Jul 2012; 199(1):224-235.
• Skilled Clinical Breast Exam - may not match mammographic exam - high and low densities were detected in 84.5% and 15.5% of clinical breast examinations and 59.7% and 40.3% of mammographies, respectively. There was a significant difference between breast tissue densities in breast examination with those in mammography Asian Pac J Cancer Prev. 2013;14(6):3685-8
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Detecting Increased Breast Density
• Breast tissue is composed of fat, glandular tissue and fibrous tissue
• Fat is radiolucent and appears dark on a mammogram; glandular and fibrous tissue are radiodense and appear light.
• When more glandular and fibrous tissue are present, breast density is greater
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Grading Breast Density
• the American College of Radiology developed a Mammography Breast Imaging Reporting and Data System scoring method using a 1-4 rating
• BI-RADS 1: less than 25% Dense Breast Tissue
• BI-RADS 2: 26-50% Dense Breast Tissue
• BI-RADS 3: 51-75% Dense Breast Tissue
• BI-RADS 4: more than 75% Dense Breast Tissue
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Breast Density Comparison
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Age and Breast Density
• ¾ of women in their 30’s have increased breast density
• ¼ of women in their 70’s have increased breast density
• Mammographic breast density can diminish over time
• Women whose breast density does not diminish over time are more likely to be diagnosed with breast cancer Int J Cancer. 2104 Oct 1;135(7):1740-4
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Causes of Increased Breast Density
• Genetic
• Neonatal
• Reproductive
• Hormonal
• Lifestyle
• Dietary
• Nutritional
• Environmental
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Genetic Factors
• density is influenced by age, parity, body mass index and menopause, but these factors account for only 20-30% of the variation in density
• twin studies show that mammographic density is highly heritable – inherited factors explain 63% of the variance Methods Mol Biol 2009;472:343-60
• Ashkenazi Jews have breast density compared to other Caucasians Breast Cancer Res 2013 May 13;15(3)
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Neonatal Factors
• higher birth weight (>4000 grams or 8 lb, 13 oz ) is correlated with premenopausal breast cancer, in comparison to lower birth weight (<2500 grams or 5 lb, 8 oz) Lancet. 1996 Dec 7;348(9041):1542-6.
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Hormonal Factors
• increased estradiol, estrone, IGF-1, prolactin
• use of birth control pill
• use of hormone replacement therapy
• increased weight gain in adulthood
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Menstrual and Reproductive Factors• earlier age at onset of menstruation (<11
yrs old)
• shorter menstrual cycle length (< 25 days)
• later age at menopause (>53 years)
• premenopausal women have increased density compared to postmenopausal women
• prior benign breast disease
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Menstrual and Reproductive Factors• parity (not having children) is significantly
inversely associated with breast density
• mean percent dense breast volume (%DBV) decreases from 20.5 % in nulliparous women to 16.0 % in parous women.
• breast density is inversely associated with the age women start using hormonal contraceptives
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Menstrual and Reproductive Factors
• breast density increases the longer hormonal contraceptives are used
• mean %DBV decreases from 21.7 % in women who start using hormones at 12-17 years of age to 14.7 % in those who start using hormones at 22-28 years of age
• age at which women started using hormonal contraceptives and duration of hormone use are inversely correlated
• mean %DBV increased from 15.8 % in women who used hormones for not more than 2.0 years to 22.0 % in women who used hormones for more than 8 years
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Dietary Factors
• increased red meat consumption, particularly in adolescence
• alcohol consumption
• saturated fats (meat, butter, ice cream)
• high glycemic load, from simple sugars and refined carbohydrates
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Breast Density and Sweets
BMC Public Health. 2014 Jun 26;14:554
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Environmental Factors
• Postmenopausal women with high serum levels of Bisphenol A (BPA) and mono-ethyl phthalate had elevated breast density Breast Cancer Res. 2013 may 27;15(3):R45
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Ways to Reduce Breast Density and
Cancer Risk• have a child before age 24
• have three or more children
• breastfeed
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Dietary Recommendations
• Decrease or eliminate red meat, transition towards a plant-based diet
• Decrease saturated fat (meat, butter, ice cream, fatty cheese)
• Decrease sugar, refined carbohydrates and high glycemic carbohydrates
• Avoid alcohol or limit to less than 3 alcoholic beverages per week
• Eliminate caffeine
• Decrease caloric intake
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Consume Daily
• increase fiber to 45 mg/day - use chia, flax, legumes, psyllium, rice bran, wheat bran if tolerated
• use 2 or more Tbsp freshly ground flaxseed
• eat 1-2 cups of legumes daily (bean soup, bean dip, bean and grain casserole)
• eat 6 servings of vegetables daily (2 cups salad, 2 cups steamed vegetables)
• eat vegetables containing carotenoids (carrots, squash, sweet potato)
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Consume Daily
• eat 2 Tbsp or 3000 mg of linolenic acid from flax and/or fish oil . Pour flaxseed oil over rice, pasta, baked potato; add to salad dressing, use in smoothies. Never heat it. Keep refrigerated.
• use 1 Tbsp olive oil daily in salad dressing
• use ½ cup organic tofu or 1 glass soymilk daily, or both. Avoid if allergic.
• drink green tea or take a green tea supplement
• use rosemary as a spice and as tea
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Nutritional Factors to Decrease Breast
Density • vitamin D >1750 IU/day
• calcium >700 mg/day
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Other Nutritional Factors to Prevent
Breast Cancer• inositol and alpha lipoic acid
• curcumin
• rosemary
• N-acetyl cysteine
• Coenzyme Q10
• Green tea extract
• Grape seed extract
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Other Nutritional Factors to Prevent
Breast Cancer• B complex
• magnesium
• kelp
• indole-3-carbinol
• tocotrienols
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Lifestyle Factors to Decrease Breast
Density• Exercise 40 minutes a day
• Spend more lifetime hours in the sun
• Avoid weight gain during adulthood and after menopause
• Avoid birth control pill and hormone replacement therapy
• Avoid plastics containing bisphenol-A and phthalates, especially during pregnancy
• Use organically grown food as often as possible