BREAST CANCER PREVENTION

1. BREAST CANCER PREVENTION What You Can Do Now to Prevent Breast Cancer in Your Future

2. Breast Cancer Prevention • Pastora Beerman, MSN, APRN-BC Advanced Oncology Certified Nurse Practitioner, Acute Care Nurse Practitioner • Alpharetta Wellness Clinic Alpharetta, Georgia

3. Learning Objectives • Increase awareness re: known and potential risk factors of breast cancer • Understand appropriate dietary and lifestyle changes that may promote healthy breast cells • Increase knowledge of available diagnostic screening methods that may promote earlier detection

4. Disclaimer The information contained in this presentation is intended for the viewer’s education and awareness. The following discussion of risk factors and recommendations does not imply a cause and effect relationship, nor is any of the information contained herein intended to replace the advice of your practitioner.

5. Scope of the Problem • One out of eight women will develop breast cancer at some point in her life • It is estimated that breast cancer will claim the lives of 39,840 U.S. women in 2010, despite the availability of mammographic screening and information regarding breast self-exam (BSE) • What steps can you take to prevent it from happening to you? • Let us begin by identifying some risk factors

6. Risk Factors for Breast Cancer • Gender: female: male (100:1). Though it is rare in men, they are not immune. • Genetic: although most women with breast cancer do not have a family history, having 2+ first-degree relatives with breast cancer does raise the risk. BRCA 1/BRCA 2 gene. • Age: incidence increases with age • Prior history of breast cancer or precancer • DCIS, LCIS, atypical hyperplasia • High socioeconomic status

7. Reproductive Risk Factors • First pregnancy > 30 years old • Early menarche <12 years old • Late menopause >55 years old • No full-term pregnancies • Never breast-fed a child

8. Risk Factors for Breast Cancer • Environmental exposure to carcinogens: radiation, pesticides, cigarette smoke and possibly, plastics, electromagnetic frequency • Hormonal: endogenous estrogens and progesterone, use of birth control pills, synthetic hormone replacement therapy • Drugs: overuse of antibiotics

9. Risk Factors for Breast Cancer • Dietary: hormone additives in dairy & meat • High animal fat diet • Low intake of fresh fruits, vegetables & fiber • Alcohol consumption greater than one serving per day • High sugar diet promotes tumor growth

10. Risk Factors for Breast Cancer • Insulin resistance leads to overweight & obesity: • 1. aromatization of fat into estrogen, in post menopausal women • 2. increases estrogen production by other organs (adrenals) • 3. promotes inflammation which in turn promotes tumors • Emotional: stress increases cortisol secretion by adrenal gland, impedes immune function, promotes tumor growth

11. What You Can Do Now to Prevent Breast Cancer • Diet: Increase intake of a variety of vegetables, especially the cruciferous type, like broccoli, cauliflower, cabbage and Brussels sprouts • Brightly colored fruits are often rich in cancer preventing nutrients • Limit fats, meats, and dairy • Choose organic sources as much as possible

12. Eat a Variety of Fresh Vegetables

13. Eat a Variety of Colorful Fruits

14. What You Can Do Now to Prevent Breast Cancer • Reduce alcohol: less than 1 / day • Avoid overuse of antibiotics • Probiotics 10-20 mil org bid w/o food • Supplement with flaxseed oil, omega 3 fatty acids, antioxidants (C, E, and selenium), vitamin D3, Co Q10 and iodine, I3C or DIM • Increase fiber intake

15. What You Can Do Now to Prevent Breast Cancer • Avoid use of birth control pills, synthetic hormone replacement therapy • Avoid exposure to radiation, pesticides, cigarette smoke • Avoid using plastic containers for drinking and food preparation • Replace antiperspirant w/ natural deodorant

16. What You Can Do Now to Prevent Breast Cancer • Maintain ideal body weight • Daily aerobic exercise • Reduce hours in constrictive bra • Manage and decrease stress effects in your life • Get adequate rest and sleep • Get help to deal with emotional issues

17. What You Can Do Now to Prevent Breast Cancer • Self Breast Exam every month after menstrual cycle • If you find a suspicious lump, or any unusual change, do not ignore or deny it! See your health practitioner • Clinical Breast Exam every year by a trained practitioner

18. Breast Self Exam

19. Diagnostic Imaging • Mammography: fails to detect 20% of breast cancers • Ultrasound: helps to differentiate solid from fluid filled masses • MRI: more sensitive in detecting cancer than mammograms • BSGI: breast specific gamma imaging • PEM: positron emission mammogram

20. What You Can Do Now to Prevent Breast Cancer • Thermography is a painless, safe screening tool for breast health • Thermography can detect changes in breast years before mammogram • Recommended frequency: yearly, but may be repeated as needed • Mammograms may miss 20% of breast cancers, including TNBC, a very invasive, aggressive type w/ limited tx options • Young and AA at higher risk for TNBC

21. Thermography • It takes 8-10 years for a dime-sized tumor to grow • Digital Infrared Imaging (DII) can be the first signal that such a possibility is developing • DII does not require radiation, compression, contact, or intravenous injection • Detects increased blood vessel circulation and metabolic changes associated with a tumor’s neoangiogenesis and growth

22. Thermography

23. Thermography The image to the left shows a significant amount of heat and vascularity (angiogenesis) in the right breast, especially over the lump in the upper outer quadrant. A biopsy confirmed that the lump was cancer.

24. What You Can Do Now to Know Your Risk of Breast Cancer • Breast cancer risk assessment by simple urine test. Detects ratio of beneficial to harmful estrogen • Serum tumor markers CA 27-29 and CA 15-3 for suspected or monitoring of existing breast cancer • Ductal lavage • Genetic testing for BRCA 1 and BRCA 2 in high risk patients

25. Breast CA Research Project • Recent changes in screening recommendations include a decrease in frequency of mammography and BSE • It is proposed that these new recommendations may put certain populations at higher risk of breast cancer: young & AA, inflammatory (basal), TNBC

26. Breast CA Research Project Purpose is to design and evaluate a program of public education for the prevention and early detection of breast cancer to include: • Dietary and lifestyle changes that promote healthy breast cells • Monthly BSE and yearly clinical breast exam • Baseline and annual digital infrared imaging (DII) • ID specific populations at risk for TNBC, and other invasive and aggressive types, which may not be detected by mammography or ultrasound, but are detected by DII

27. Significance of Research Project • Promote the use of DII, a highly sensitive and underutilized screening method for the early detection of breast cancer • Assist Doctors & Nurse Practitioners to improve client outcomes (survival) regarding breast cancer, especially invasive, aggressive forms • Clients will be empowered with knowledge to take responsibility for their breast health

28. Help Us Win the Race • Schedule your breast thermography by calling 770-777-0129 • If you would like to contribute toward this research project send your tax deductible donation (designate for Breast CA Research Project) to: • Alpharetta Wellness Clinic 18 Cumming Street Alpharetta, GA 30009

29. Help Us Win the Race • Thank you!

30. Contact Information • Alpharetta Wellness Clinic • 18 Cumming St, Alpharetta, GA 30009 • Hours: Mon-Fri 8AM-12PM and 1PM-5PM • Phone: (770) 777-0129 • Email: alpharettawellness@clear.net • Web: alpharettawellness.com

31. Dedication • To my mother, who fought cancer for 20 years • To Fawn and all the women and men with breast cancer who have taught me the value of faith and courage in the midst of life’s trials

32. Credits

33. References • Anderson GL, et al. Prior hormone therapy and breast cancer risk in the Women’s Health Initiative randomized trial of estrogen plus progestin. Maturitas. 2006 sep 20;55(2):103-15. • Bradlow HL, et al. 2-hydroxyestrone: the ‘good’ estrogen. J Endocrinol. 1996 Sep;150 Suppl:S259-65. • Dalessandri KM, et al. Pilot study: effect of 3,3’-diindolylmethane supplements on urinary hormone metabolites in postmenopausal women with a history of early-stage breast cancer. Nutr Cancer. 2004;50(2):161-7. • Love SM, Lindsey K. Dr. Susan Love’s Breast Book.Cambridge:Da Capo. 146. • Johnson B, Barnes K. The Secret of Health Breast Wisdom. Garden City: Morgan James. 47-59. • Breast cancer. (2010). Retrieved June 26, 2010, from National Cancer Institute: http://www.cancer.gov/cancertopics/types/breast • Screening for breast cancer. (2009). Retrieved June 26, 2010, from U.S. Department of Health and Human Services: http://www.ahrq.gov/clinic/uspstf/uspsbrca.htm

34. References • http://www.breastthermography.com/infrared_imaging_review.htm • http://videos.howstuffworks.com/discovery-health/14450-human-atlas-breast-self-exam-video.htm • http://www.cancer.org/docroot/CRI/content/CRI_2_6x_How_to_perform_a_breast_self_exam_5.asp • http://www.newmedicine.ca/breast.php • http://news.yahoo.com/s/hsn/20081204/hl_hsn/latestbreastimagingtechniquesoffernewviews/print • http://dimfaq.com/BreastResearchUpdate060508.pdf

35. References • http://www.mayoclinic.com/health/breast-cancer-prevention/WO00091 • http://www.webmd.com/breast-cancer/tc/breast-cancer-screening-patient-information-nci-pdq-breast-cancer-screening • http://www.cancer.gov/cancertopics/factsheet/risk/brca • http://www.purehealthmd.com/conditions/prevention/environmental/hazards-of-plastic.pdf • http://www3.interscience.wiley.com/cgi-bin/fulltext/121405195/PDFSTART • http://www.ultrawellness.com/blog/reducing-breast-cancer-risk?utm_campaign=2301-12312009&utm_medium=email&utm_source=newsletter&utm_content=default

36. Picture Credits • http://www.ilovedogs.com/media/vegetables.jpg • http://www.breastthermography.com/breast_thermography_mf.htm • http://www.cancer.org/docroot/CRI/content/CRI_2_6x_How_to_perform_a_breast_self_exam_5.asp • http://search.live.com/images/results.aspx?q=Fruits&go=&form=QBIR# • http://search.live.com/images/results.aspx?q=Pomegranate&FORM=QSIR4# • http://search.live.com/images/results.aspx?q=Watermelon+filterui%3aimagesize-large&FORM=I5IR#focal=bd910c75c8f04a0e57510ba0434e1f5c&furl=http%3A%2F%2Fstatic.flickr.com%2F3%2F5563390_2d68886926.jpg