1 in 8 women in Australia will be diagnosed with breast cancer at some stage during their lifetime. There are around 17,600 cases of breast cancer diagnosed on a yearly basis. Breast cancer is the most common cause of (non-skin) cancer in women and the second most common cause of cancer death.
The incidence of breast cancer has increased significantly over the past few decades and the obvious question here is why? Firstly, there has been significant publicity over the past decade about the genetics of breast cancer. There has been much media attention around the decision from Angelina Jolie to undergo a preventative bilateral mastectomy because of the detection of the BRCA 1 gene, after her mother had previously died from the condition. This is only one of a number of genes present in women which may increase breast cancer risk. This, however, does not explain the increased incidence over the past few decades.
Firstly, let us examine what hurts. One of the key and well-accepted factors in the increased incidence of breast cancer is the modern epidemic of diabesity i.e. a combination of diabetes and obesity. As now, around 50% of Australian women are either overweight or obese. Until we can address this issue by engaging the public in better lifestyle practices, we will continue to see cardiovascular disease, diabetes and all its complications and many common cancers as a result.
The second issue which I have addressed in the recent past is that of alcohol consumption and breast cancer. There is no doubt that there is a link between even a daily glass of alcohol and breast cancer but as I have stated, I believe this is far too simplistic. The Mediterranean data clearly shows that low-dose consumption of red wine in combination with a high-quality diet and the Mediterranean lifestyle actually assists in reducing risk for both cardiovascular disease and cancer. I believe when a poor quality Western diet is combined with alcohol consumption, this is where you see the problems arising. Interestingly, the Nurses Health study also showed that those nurses living in the affluent New England region who consumed low-dose alcohol but also took a daily multivitamin had no increased risk for breast cancer. The New England region of America typically consumes a better diet than say, for example, the southern states and this would have also been a significant factor. Regardless, it is irresponsible for any doctor to encourage people to drink alcohol but, if you choose to do so, I would strongly suggest you combine your alcohol consumption with the Mediterranean diet and lifestyle program along with a daily multivitamin.
Again, in keeping with our modern society, is that of physical inactivity. Not only is there a clear link between being overweight and breast cancer but being inactive can also lead to both scenarios.
Finally, I believe a major factor in the increased incidence of breast cancer is what is known as xeno-oestrogens. These are the synthetic oestrogens found ubiquitously in our modern society in all manner of synthetic substances such as plastics, aluminium cans and many other common household products. Young children and even babies in utero are being exposed to these substances in some form, and one of the unintended consequences is that immature breast tissue is being flogged with oestrogen-like substances from a very early age. Couple this with the delay in a woman becoming pregnant which is happening on a more significant basis in our modern world, markedly increases the risk for breast cancer. The female breast exposed to excessive doses of oestrogen throughout its lifetime is much more prone to developing breast cancer and the combination of these commonly used household products and food containers, along with synthetic oestrogens used to prevent pregnancies and to treat the symptoms of menopause, are also major factors.
So, after this somewhat depressing lot, we must ask ourselves the question — what helps? Following on from this argument is the obvious factor of early pregnancy. The shorter the time between the onset of puberty and your first baby markedly reduces the risk for breast cancer. As we were all designed to be hunter-gatherers living a short life of somewhere between 30–40 years, with young girls going through puberty in their early teens and having babies soon after with the grandmothers being in their late 20s or early 30s helping look after the child, in a very simple top of the food chain life.
Clearly in our modern world, teenage pregnancy is still unacceptable and many women are delaying pregnancies to establish a career. Although this may seem to be a good idea, it does come with significant health consequences.
There is also very strong work to show healthy lifestyle principles such as consuming high doses of fruit and vegetables, regular physical activity and minimising alcohol intake are clearly linked to lower rates of breast cancer. You may be surprised to know that there is a World Breastfeeding Week and it was announced that 18 studies of breastfeeding showed that for every 5 months a woman breastfeeds, there is a reduced breast cancer risk of around 2%. There are a number of proposed reasons as to why this occurs but suffice to say the statistics are very clear. The strong suggestion is that a woman should breast feed for at least 6 months and interestingly, 80% of mothers start breastfeeding but by 6 months only 50% continue. It is my feeling that if women can breastfeed, that they should do so for somewhere between 6–12 months.
The most comforting statistic from this entire discussion is that the current 5 year survival rates for breast cancer are 90% which is attributed to early detection through excellent screening programs, along with much better management programs. Another very important statistic is that one in 3 breast cancers could be avoided by greater attention to the aforementioned lifestyle factors. It is a very simple message, “they’re your breasts, look after them”.