Breast cancer is when a cancerous tumor occurs inside the breast. Each year more than 185,000 women are diagnosed with breast cancer. The incidence of this disease is rising in developed countries. About 43,500 women die from breast cancer annually, making this disease second to lung cancer as the leading cause of death by cancer among women. Women detect 90% of breast cancers themselves, often through breast self-examination (BSE).

According to the National Cancer Institute, breast cancer is often accompanied by the following signs and symptoms:

• A lump or thickening in or near the breast or in the underarm area
• A change in the size or shape of the breast
• Nipple discharge or tenderness, or the nipple pulled back (inverted) into the breast
• Ridges or pitting of the breast (the skin looks like the skin of an orange)
• A change in the way the skin of the breast, areola, or nipple looks or feels (for example, warm, swollen, red, or scaly)

While the cause of breast cancer is not known, it is clear that the disease is hormone-dependent. Women whose ovaries do not function and who never receive hormone replacement therapy do not develop breast cancer.

People with the following conditions or characteristics are at a higher-than-average risk for developing breast cancer:

• Women (over 99% of cases)
• Increasing age
• History of cancer in one breast
• History of benign breast disease
• Never giving birth or first pregnancy after age 30
• Family history (first-degree relative) of breast cancer (significant for premenopausal women)
• Early onset of menstruation and late menopause
• High doses of ionizing radiation before age 35
• History of cancer of the colon, thyroid, endometrium, or ovary
• Diet high in animal fat, excessive alcohol consumption, and, obesity
• Alterations in certain genes
• Breast implants

Despite the relevance of risk factors, 70 - 80% of women with breast cancer have none of the known risk factors.

If you have symptoms associated with breast cancer, see your health care provider immediately. Your health care provider can help make a diagnosis and help you determine which treatment or combination of therapies will work best for you.

Your health care provider will do a breast exam and run some laboratory tests, including a study of breast tissue and genetic testing. Imaging techniques may include mammography, ultrasound, magnetic resonance imaging (MRI), and other methods that help distinguish a cyst from a tumor or make a distinction between cancerous and noncancerous disease. Nuclear imaging techniques like positron emission tomography (PET) and single photon emission tomography (SPECT) may help physicians monitor the growth of tumors. Your doctor may also recommend a surgical biopsy to determine which type of breast cancer you have.

Prevention

Early detection is important. Monthly breast self-examination and annual gynecologic exams play a large role in early detection. Nutrition may play a role in prevention.

Treatment Plan

Treatment options depend on the size and location of the tumor, results of lab tests, and the stage, or extent, of the disease, along with the patient's age and menopausal status, general health, and breast size.

Drug Therapies

Your health care provider may prescribe one or more of the following therapies:

• Radiation therapy -- the use of high energy x-rays to kill cancer cells and prevent them from growing
• Chemotherapy -- the use of drugs to kill cancer cells
• Hormonal therapy, which keeps cancer cells from getting the hormones they need to grow
• Antitumor antibiotics
• Antiestrogens, such as tamoxifen, which block estrogen from reaching breast cancer cells, reducing the risk of recurrence
• Monoclonal antibodies to block the protein receptor that is produced in large numbers in women who have breast cancer
• High-dose progestogens (steroid hormones)
• Non-steroidal anti-inflammatory drugs (NSAIDs), which may reduce features of breast cancer and play a role in the prevention and treatment of the disease

Surgical and Other Procedures

Surgery is the most common treatment for breast cancer. The choice of surgeries includes the following:

• Mastectomy -- removal of the breast or as much of the breast tissue as possible. This treatment may be followed by breast reconstruction.
• Lumpectomy -- removal of the tumor and a small amount of tissue around it, usually followed by radiation therapy
• Segmental, or partial, mastectomy -- removal of the tumor and a small amount of tissue around it, as well as the lining of the chest muscles below the tumor and some of the lymph nodes under the arm. It is usually followed by radiation therapy.

Complementary and Alternative Therapies

A comprehensive treatment plan for breast cancer may include a range of complementary and alternative therapies. Many naturally oriented doctors believe that nutritional supplementation and herbal medications are important for cancer patients. Other doctors are concerned that certain supplements may interfere with conventional cancer therapies. It is important that patients educate themselves and inform all of their health care providers about the therapies they are using.

Psychotherapy and support groups may help improve quality of life and survival. Always tell your health care provider which herbs and supplements you are taking.

Nutrition and Supplements

Following these nutritional tips may help reduce symptoms:

• Try to eliminate suspected food allergens, such as dairy (milk, cheese, and ice cream), wheat (gluten), soy, corn, preservatives and chemical food additives. Your health care provider may want to test you for food allergies.
• Eat foods high in B-vitamins, calcium, and iron, such as almonds, beans, whole grains (if no allergy is present), dark leafy greens (such as spinach and kale), and sea vegetables.
• Eat cruciferous vegetables (such as broccoli, cabbage, and cauliflower).
• Eat antioxidant foods, including fruits (such as blueberries, cherries, and tomatoes) and vegetables (such as squash and bell pepper).
• Avoid refined foods, such as white breads, pastas, and sugar.
• Eat fewer red meats and more lean meats, cold-water fish, tofu (soy, if no allergy is present) or beans for protein. You should eat quality protein sources, such as organic meat and eggs, whey, and vegetable protein shakes, as part of a balanced program aimed at gaining muscle mass and preventing wasting, a common side effect of cancer therapies.
• Use healthy cooking oils, such as olive oil or vegetable oil.
• Reduce or eliminate trans fatty acids, found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, and margarine.
• Avoid caffeine and other stimulants, alcohol, and tobacco.
• Exercise, if possible, 5 days a week.

You may address nutritional deficiencies with the following supplements. Remember to inform all of your health care providers about any natural therapies or supplements you are using.

• A multivitamin daily, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals such as magnesium, calcium, zinc and selenium.
• Probiotic supplement (containing Lactobacillus acidophilus), 5 - 10 billion CFUs (colony forming units) a day, for maintenance of gastrointestinal and immune health. You should refrigerate your probiotic supplements for best results.
• Omega-3 fatty acids, such as fish oil, 1 - 2 capsules or 1 tbsp. of oil one to two times daily, to help decrease inflammation and help with immunity. Cold-water fish, such as salmon or halibut, are good sources.
• Calcium d-glucarate, 1,500 - 3,000 mg daily, for support of breast cancer.
• Vitamin C, 500 - 1,000 mg one to two times daily, as an antioxidant and for immune support.
• Lycopene, 5 mg one to three times daily, for antioxidant and anticancer activity.
• Alpha-lipoic acid, 25 - 50 mg twice daily, for antioxidant support.
• Resveratrol (from red wine), 50 - 200 mg daily, to help decrease inflammation and for antioxidant effects.
• Coenzyme Q10, 100 - 200 mg at bedtime, for antioxidant and immune activity.
• Ipriflavone (soy isoflavones) standardized extract, 200 mg three times a day, for breast cancer support.
• Melatonin, 2 - 6 mg at bedtime, for immune support and sleep. Higher doses may be needed in breast cancer. Ask you health care provider.

Herbs

Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your health care provider to diagnose your problem before starting treatment.

You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.

• Green tea (Camellia sinensis) standardized extract, 250 - 500 mg daily, for antioxidant, anticancer and immune effects. Use caffeine free products. You may also prepare teas from the leaf of this herb.
• Reishi mushroom (Ganoderma lucidum) standardized extract, 150 - 300 mg two to three times daily, for anticancer and immune effects. You may also take a tincture of this mushroom extract, 30 - 60 drops two to three times a day.
• Cat's claw (Uncaria tomentosa) standardized extract, 20 mg three times a day, for anticancer, immune, and antibacterial or antifungal activity.
• Milk thistle (Silybum marianum) seed standardized extract, 80 - 160 mg two to three times daily, for detoxification support.
• Fermented wheat germ extract, 1 packet dissolved in favorite beverage once daily, for anticancer and immune effects.
• Bitter melon (Momordica charantia) standardized extract, 200 mg two to three times daily, for anticancer and immune support.
• Black cohosh (Actaea racemosa) standardized extract, 20 - 40 mg two times a day, for symptoms of menopause if breast cancer is present.

Homeopathy

An experienced homeopath considers both your symptoms and constitutional type in order to create an individualized treatment regimen. Some of the most common homeopathic remedies that may treat symptoms associated with breast cancer are the following:

• Arsenicum for anxiety and nausea, with restlessness and burning pains
• Ipecac for nausea unrelieved by vomiting
• Nux vomica for sharp abdominal pains with anger and collapse

Acute dose is three to five pellets of 12X to 30C every 1 - 4 hours until symptoms are relieved.

Acupuncture

While acupuncture is not used as a treatment for cancer itself, evidence suggests it can be a valuable therapy for symptoms associated with cancer and the side effects of chemotherapy. In a study of 104 women with breast cancer and nausea from chemotherapy (all of whom were taking anti-nausea medication), women treated with acupuncture had fewer attacks of nausea than women who received the medication alone.

Other studies suggest that acupuncture can help alleviate fatigue and cognitive dysfunction in breast cancer patients undergoing chemotherapy. Acupuncture may also help eliminate pain and hot flashes caused by tamoxifen (a breast cancer medication). One study found that acupuncture markedly improved breathlessness in women with late stages of breast cancer. Acupressure (pressing on rather than needling acupuncture points) has also proved useful in controlling breathlessness and chemotherapy-induced nausea and vomiting. Patients can learn this technique to treat themselves.

Some acupuncturists prefer to work with breast cancer patients only after they have completed conventional medical cancer therapy. Others will provide acupuncture and herbal therapy during active chemotherapy or radiation. Acupuncturists treat breast cancer patients based on an individualized assessment of the excesses and deficiencies of qi located in various meridians. In many cases of cancer-related symptoms, a qi deficiency is usually detected in the spleen or kidney meridians.

Most complications result from surgery, radiation, chemotherapy, or use of the drug tamoxifen, which is effective in preventing recurrence but increases a woman's risk of developing endometrial cancer and blood clots. Other potential complications include:

• Restricted shoulder movement
• Increase in size of operative scar
• Inflammation of connective tissue in the affected arm
• Cancerous tumor of the lymphatic vessels in the affected arm
• Accumulation of fluid in the breast; swelling of tissue in the arm
• Discoloration of the skin from radiation, or a red spot
• Inflammation of the lung from radiation
• Death of the fat cells underlying the breast tissue
• Recurrence of the disease

The prognosis for breast cancer patients depends primarily on the stage, or extent, of the disease at the time of the initial diagnosis. With increased early detection rates and improved treatments, the 5-year survival rate is greater than 85%.

Breast cancer patients should see their health care provider every 3 months for 18 months to 4 years, then every 6 months thereafter.

Adelson KB, Loprinzi CL, Hershman DL. Treatment of hot flushes in breast and prostate cancer. Expert Opin Pharmacother. 2005;6(7):1095-106.

Agrawal A, Fentiman IS. NSAIDs and breast cancer: a possible prevention and treatment strategy. Int J Clin Pract. 2008;62(3):444-9.

Botanicals and the treatment of cancer I. Botanicals, Vitamins, and Dietary Supplements for Improving Survival in Cancer: A Systematic Review of Prospective Clinical Trials: Andrew Vickers. J Soc Integr Oncol. 2005;3(4):139-42.

deVries EF, Rots MG, Hospers GA. Nuclear imaging of hormonal receptor status in breast cancer: a tool for guiding endocrine treatment and drug development. Curr Cancer Drug Targets. 2007;7(6):510-29.

Drugan S, Nicola T, Ilina R, Ursoniu S, Kimar A, Nicola T. Role of multi-component functional foods in the complex treatment of patients with advanced breast cancer. Rev Med Chir Soc Med Nat Iasi. 2007;111(4):877-84.

Gardani G, Cerrone R, Biella C, Mancini L, Prosperio E, Casiraghi M, Travisi et al. Effect of acupressure on nausea and vomiting induced by chemotherapy in cancer patients. Minerva Med. 2006;97(5):391-4.

Gomide LB, Matheus JP, Candido dos Reis FJ. Morbidity after breast cancer treatment and physiotherapeutic performance. Int J Clin Pract. 2007;61(6):972-82.

Hanausek M, Walaszek Z, Slaga TJ. Detoxifying cancer causing agents to prevent cancer. Integr Cancer Ther. 2003;2(2):139-44.

Johnson MA. Nutrition and aging -- practical advice for healthy eating. J Am Med Womens Assoc. 2004;59(4):262-9.

Johnson MF, Yang C, Hui KK, Xiao B, Li XS, Rusiewicz A. Acupuncture for chemotherapy-associated cognitive dysfunction: a hypothesis-generating literature review to inform clinical advice. Integr Cancer Ther. 2007;6(1):36-41.

Nahleh Z, Tabbara IA. Complementary and alternative medicine in breast cancer patients. Palliat Support Care. 2003;1(3):267-73.

Nan S, Anderson KE, Nagamani M, et al. Effect of a soymilk supplement containing isoflavones on urinary F2 isoprostane levels in premenopausal women. Nutr Cancer. 2005;53(1):73-81.

Nedstrand E, Wyon Y, Hammar M, Wijma K. Psychological well-being improves in women with breast cancer after treatment with applied relaxation or electro-acupuncture for vasomotor symptom. J Psychosom Obstet Gynaecol. 2006;27(4):193-9.

Nettleton JA, Greany KA, Thomas W, et al. Short-term soy and probiotic supplementation does not markedly affect concentrations of reproductive hormones in postmenopausal women with and without histories of breast cancer. J Altern Complement Med. 2005;11(6):1067-74.

Price S, Lewith G, Thomas K. Acupuncture care for breast cancer patients during chemotherapy: a feasibility study. Integr Cancer Ther. 2006; 5(4):308-14.

Sarkar FH, Adsule S, Padhye S, Kulkarni S, Li Y. The role of genistein and synthetic derivatives of isoflavone in cancer prevention and therapy. Mini Rev Med Chem. 2006;6(4):401-7.

Swaby RF, Sharma CG, Jordan VC. SERMs for the treatment and prevention of breast cancer. Rev Endocr Metab Disord. 2007;8(3):229-39.

Usui T. Pharmaceutical prospects of phytoestrogens. Endocr J. 2006;53(1):7-20.

Wane D, Lengacher CA. Integrative review of lycopene and breast cancer. Oncol Nurs Forum. 2006;33(1):127-37.

Wood CE, Register TC, Franke AA, et al. Dietary soy isoflavones inhibit estrogen effects in the postmenopausal breast. Cancer Res. 2006;66(2):1241-9.

Yasui Y, Hosokawa M, Sahara T, et al. Bitter gourd seed fatty acid rich in 9c,11t,13t-conjugated linolenic acid induces apoptosis and up-regulates the GADD45, p53 and PPARgamma in human colon cancer Caco-2 cells. Prostaglandins Leukot Essent Fatty Acids. 2005;73(2):113-9.