Breast Cancer Awareness Month | EP. 01

Female breast cancer surpassed lung cancer as the most commonly diagnosed cancer in the world 2.3 million new cases in 2020 (approx. 12%).
(Sung, H, Ferlay, J., Siegel, R.L., et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians. 2021 May/June; 71(3): 209-249. https://doi.org/10.3322/caac.21660.)

1 in 8 women & 1 in 833 men will be diagnosed with Breast Cancer in their lifetime.

Breast Cancer prevalence has risen over the last 50 years.
Why?
· NATURE: Genetic predisposition
· NURTURE: Diet, lifestyle, environmental triggers

“Genes load the gun, environment pulls the trigger”

Commonly Known Risk Factors

•Lifetime estrogen exposures:
•Late or no pregnancy
•Late menopause after age 55
•Early menarche
•Hormone replacement therapy (HRT) More than 5 yrs - especially estrone estrogens + progestins
•Oral contraceptives – estrogen-based
•Obesity
•Sedentary Lifestyle
•Personal & Family History of Cancer
•Dense breasts
•Radiation Treatment
•DES exposure – medication given to pregnant women to prevent miscarriage between 1940 - 1971
•Alcohol – risk related to consumption amount
•Smoking – stronger risk in pre-menopausal women
(BCPP -Breast Cancer Prevention Partners (BCPP). 2017. https://www.bcpp.org/.)

“Epidemiological data strongly suggest that a woman's risk of developing breast cancer is directly related to her lifetime estrogen exposure. Estrogen replacement therapy in particular has been correlated with an increased cancer risk.”
(Zhang F, et al. Equine estrogen metabolite 4-hydroxyequilenin induces DNA damage in the rat mammary tissues: formation of single-strand breaks, apurinic sites, stable adducts, and oxidized bases. Chem Res Toxicol. 2001;14(12):1654-9.)

1. Hormones
a. Estrogen dominance/Decreased progesterone à Balance

b. Risk factors
i. Foods with growth hormone injected to promote more meat production
1. Commercially produced meat
2. Dairy
3. Food dye (FD&C Red No. 3/phenosulfothizaine)
4. Preservative (butylated hydroxyanisole (BHA))

ii. Inflammation
1. Obesity – fat release estrogens
2. Stress – increase cortisol stress hormone à blood sugar increase à insulin released
3. Insulin – decrease sex hormone binding globulin (SHBG), increase free estrogens
4. Infection – certain gut bacteria produce estrogens

iii. Medication:
1. Birth control pill – estrogen dominant
2. Testosterone HRT – Decrease SHBG, increase free estrogens, testosterone turns into estrogen (aromatase) (mixed data)
3. Antibiotics – alter microbiome, risk for c.difficile gut infection

iv. Environment: Xenoestrogen (mimics estrogen hormone)
1. BPA plastics
2. Insecticides/herbicides (Glyphosate/R*und Up)
(Thongprakaisang S et al. Glyphosate induces human breast cancer cells growth via estrogen receptors. Food Chem Toxicol. 2013 Sep;59:129-36. doi: 10.1016/j.fct.2013.05.057.)
3. Occupational – factory workers 3x, lawyers/journalists (printer/copier) 4x, Hair dressers & F&B production workers up to 5x higher risk
4. EMF/Cell phones à Heats breast tissue, decrease melatonin
(West J, Kapoor N, Liao SY, Chen J, et al. Multifocal breast cancer in young women with prolonged contact between their breasts and their cellular phones. Case Reports in Medicine. 2013; Article ID 354682. Available at http://www.hindawi.com/journals/crim/2013/354682/.)

v. Genetics: COMT enzyme metabolizes estrogen

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