Breast Health

I'm often asked by my patients what can be done to prevent breast cancer. Breast cancer is the most frequent type of non-skin cancer and the most frequent cause of cancer death in women worldwide, and it is the second most frequent cause of cancer death in the United States.

Known Risk Factors for breast cancer include weight gain after menopause, decreased physical activity, regular alcohol use, hormone use, late menopause, BrCa1 and BrCa2 (genetic mutations), and night shift work.

In addition to exercise, increasing fruits and vegetable intake, and limiting alcohol, here are 10 lifestyle measures that are very important for breast health.

1. Maintaining an ideal weight, especially after menopause

2. Eating enough organic fruits and vegetables

3. Having a healthy Omega 3/6/7/9 balance with cold water fatty fish 3-4 times per week, flaxseeds or supplement with high quality EPA/DHA/GLA

4. Eating enough cruciferous vegetables (like arugula, Brussel sprouts, cabbage, broccoli, cauliflower daily!)

5. Maintaining a healthy Vitamin D level which can be tested with a blood test, ideally around 50 ng/mL

6. Consuming enough soluble and insoluble fiber - aiming for around 35 grams per day

7. Consuming Tumeric/Curcumin - an Indian spice in cuisine

8. Getting enough antioxidants in the diet like berries and favonols founds in plants

9. Getting antioxidant catechins like those found in green tea.

10. Consuming iodine rich foods like those found in the sea vegetables Nori, Kombu, wakame.

Early detection gives us opportunity to balance hormones, replace micronutrients, detoxify, find and correct inflammation to restore breast health.

There are so many guidelines for screening that I personalize the decision to each patient and provide them with some of the guidelines that most of us use in the U.S. (USPSTF - which shows an evidence based guideline https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breast-cancer-screening-adults). All our national guidelines are based off of mammography. They are the best studied at detecting breast cancer. There are no known risks to getting breast thermography for patients wanting a closer look and it can be useful as an adjunct to mammography. Mammography looks at structure, and Thermography is a functional assessment of the breasts. https://www.mdanderson.org/cancerwise/mammograms-vs--thermography--what-you-need-to-know.h00-159385890.html

Mammogram Expert Recommedations	Frequency of screening	Initiation of screening for women at average risk	40 to 49 years of age	50 to 69 years of age	≥70 years of age
US Preventive Services Task Force (2016)	every 2 years	50, until 5/2023 lowered to 40	yes	yes	Until age 74
Canadian Task Force on Preventive Health Care (2018)	every 2 to 3 years	age 50	No, recommend against	yes	Until age 74
National Health Service, United Kingdom (2018)​	every 3 years	age 47	At age 47	yes	Until age 73
Royal Australian College of General Practitioners (2018)	Every 2 years	age 50	No	yes	Until age 74
American College of Obstetricians and Gynecologists (2017)	Every year	age 40	yes	yes	yes to at least age 75
American College of Physicians (2019)	every 2 years	age 50	No	Yes	Yes to age 74
​American Cancer Society (2015)	Every year if between 45 to 54 years old, then every 1 to 2 years age >55	Age 45	Yes	yes	Yes
American College of Radiology (2017)	every year	Age 40	yes	yes	yes