Breast Cancer, Part 2: Risk Factors and Prevention

Natasha Ratajczak, PT, DPT

In the last post, I discussed the risk factors and role of genetics with breast cancer. The factors that mainstream lets us hear about include gender, age and family history. However, did you know that there are several other things that could potentially increase the risk of breast cancer? Let’s take a look at a few of these and see if there are some manageable steps to decrease personal risk of breast cancer.

1.   Being overweight: Women that have a BMI (Body Mass Index) greater than 25 are more likely to be at risk for breast cancer than women who maintain a healthier body weight, especially after menopause. The reason for this is because fat cells produce estrogen; therefore, extra fat cells in the body mean more estrogen in the body. However, this risk factor is complex because the area of where the extra fat is stored is important – extra fat around your middle section may increase risk more than having the same amount of fat around the thighs and hips. So, how can you take step to manage or prevent this? Create a healthy eating and exercise plan, after consulting with your physician. For helpful tips, please look here. For more information on healthy eating, dietary supplements, and nutrition resources, visit the Breastcancer.org Nutrition section.

2. Pregnancy history: Women who delivered before full term, or had their first child after the age of 30 have a higher incidence of breast cancer. According to breastcancer.org, “when breast cells are made in adolescence, they are immature and very active until your first full-term pregnancy. The immature breast cells respond to the hormone estrogen as well as hormone-disrupting chemicals in products. Your first full-term pregnancy makes the breast cells fully mature and grow in a more regular way. This is the main reason why pregnancy helps protect against breast cancer. Being pregnant also reduces your total number of lifetime menstrual cycles -- which may be another reason why earlier pregnancy seems to offer a protective effect.” Regardless of this fact, you can manage any increased risk by looking at lifestyle choices to keep your breast cancer risk as low as it can be: maintain a healthy weight, exercise regularly, limit alcohol, eat nutritiously, and never smoke, or quit smoking if you do so currently.

3. Going along with pregnancy histo is breastfeeding history: breastfeeding, especially for a year or more, can decrease your risk of breast cancer for several reasons. First, making milk 24/7 limits breast cells' ability to overgrow and misbehave. Also, most women have fewer menstrual cycles when they're breastfeeding (added to the 9 missed periods during pregnancy) resulting in lower estrogen levels. And of course, many women tend to eat more nutritious foods and follow healthier lifestyles (limit smoking and alcohol use) while breastfeeding. Whether or not you breastfeed, following the same lifestyle habits listed above can keep your breast cancer risk at bay.

4. Drinking alcohol: Research shows that drinking any type of alcohol excessively can increase risk by increasing estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells. Minimize drinks per week to 3 or less in order to reduce the risk maximally.

5. Lack of exercise: Exercising regularly at moderate intensity (60-70% of your max heart rate) for 4-7 hours per week helps reduce breast cancer risk, according to research.

For more information on risk factors and more tips for prevention, please visit breastcancer.org/risk/factors.

Breast Cancer Prevention, Part 1

Natasha Ratajczak, PT, DPT

In the last month and a half, my mom has gone through receiving the diagnosis of stage 1 breast cancer 75% chance stemming from genetic etiology, undergoing a radical mastectomy and getting bilateral breast reconstruction, all in what feels like the blink of an eye. It all has left me amazed, incredibly grateful and completely humbled by how far technology has come and how strong and graceful my mom has handled everything thus far.

A little back story: my maternal grandmother passed on after breast cancer metastasized into her liver, lungs and bones in the mid 1990s. Several years later, my mom’s sister developed breast cancer early on in her right breast. She had a lumpectomy, then went into remission. The cancer returned in the following years so the doctors and my aunt decided to remove the breast. Unfortunately, the cancer returned in the other breast this year, so she had the second breast removed right about the same time as my mom began her journey (btw, my mom found her own lump by doing a regular monthly self-exam that she had done for years...she rocks!). Both women are currently recovering, but they are both proceeding with caution.

I am extremely grateful for and extremely proud of these strong women in my life. And because I now know how quick this type of cancer can occur and progress, I wanted to write up this blog post to give a little more background information to the men and women out there who have been affected by as well as may have breast cancer in their family DNA.

First off, breast cancer occurs like other cancer: it is an abnormal growth of cell tissue that comes from the genes that are supposed to help the tissue stay regulated and healthy. Therefore, “breast cancer” is caused by a malignant tumor that has developed from breast tissue. (Please refer here for current staging of breast cancer.)

Of course, you’ve probably noticed that breast cancer is embedded in my family history; my sister and I have discussed the potential of having inherited a genetic mutation, and are wondering the next steps to take for prevention for ourselves. Here are some interesting statistics that I found while doing my research:

1. About 5-10% of breast cancers can be linked to gene mutations (abnormal changes) inherited from one’s mother or father. Mutations of the BRCA1 and BRCA 2 genes are the most common. Women with a BRCA1 mutation have a 55-65% risk of developing breast cancer before age 70, and often at a younger age that it typically develops. For women with a BRCA2 mutation, this risk is 45%. An increased ovarian cancer risk is also associated with these genetic mutations. In men, BRCA2 mutations are associated with a lifetime breast cancer risk of about 6%; BRCA1 mutations are a less frequent cause of breast cancer in men.

2. About 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the aging process and life in general, rather than inherited mutations. The two highest risk factors for breast cancer are gender (women >>men) and age (increased risk comes with growing older).

Given our family history, my sister and I have decided to undergo genetic testing, because after speaking with my mom’s physicians, they have told us that we each have 50% chance of having the mutation. Although you should know that there are also screening tests that can be done for early detection. These screening tests include yearly mammograms, and are usually given to those individuals who appear to be healthy and have no history of breast cancer. If an abnormality is found, then tests (usually a biopsy) are done to the abnormality to determine if the tissue is benign or malignant.

As mentioned above, there are two genetic mutations that can be tested for: BRCA1 (BReast CAncer gene 1) and BRCA2 (BReast CAncer gene 2). Mutations in these genes that are supposed to keep breast cells growing normally can lead to increased risks in malignant tumors in breast as well as ovarian tissue (or prostate tissue in men). Abnormal BRCA1 and BRCA2 genes may account for up to 10% of all breast cancers, or 1 out of every 10 cases. For more information about genetic testing please visit here.

I encourage you to please pay attention to your breast tissue. Start regular monthly self-exams to learn about your tissue enough to detect when something does not feel right. Also get your mammograms done yearly, even if you are not at risk. In my next blog posting, I will address more preventative options for all of you when contemplating breast cancer as I continue by my mom’s side on this journey.

Tune in to the next few posts for more on breast cancer prevention!

More information can be found at breastcancer.org.

Meditation: Go to the Well, daily!

Maureen Mason-Cover, PT, WCS                                       

Got Vagus? Vagus as in the mind-body-nerve connection, not Las Vegas!  When you think of taking a break, and relaxing, do you think of Las Vegas? Las Vegas is oriented for action, adventure, or in the case of the hangover movies, partying until injury and mayhem set in. Yet this is where many people go to relax. What about a place you can go to that is refreshing, and involves no travel or spending? Sort of an antidote to Vegas.

At CTS we have a new mind-body relaxation, stress management, and meditation teacher on board, and he is training a small group of us in several skills, or practices, for shifting our attention towards mindfulness and calming. Just think of it as visiting a refreshing well! Jim Cahill is teaching us to be able to “turn the dial” from our busy cognitive brain activity, which is danger and worry focused, to a place of calmness, breath awareness, control and creative visualization.  Our group shares our varied experiences, as we like, in the form of a brief chat at the group start, or we don’t share-perhaps if we have been too busy, or too stressed, to practice! We are an imperfect group of 8, with many distractions, life issues from young to old, and we have had a laugh at our occasional “non compliance” with our self-study as a home practice. This may seem ridiculous as most attendees are therapists and we expect regular compliance with programs that we provide for our patients. However, cultivation of new habits, such as exercise, or mind-body stress management and relaxation, require habit change, and a space and time for the new behavior to take place. Habit change also requires coaching with a trainer or teacher.

The Vagus nerve, cranial nerve 10, works with many other nerves and systems to help regulate heart rate, blood pressure, and digestive functioning. The Vagus nerve is part of the autonomic (think automatic) nervous system. The autonomic nervous system functions are complex, and may place us on alert, as in driving us into fight or flight, the “stress response”, to flee danger or fight against a threat. The autonomic system has a relaxation mode, which should activate after a threat is no longer present. With chronic stress, the “on switch” is chronically activated and individuals suffer ill health with many conditions and symptoms. The fight or flight response is mediated by the sympathetic side of the autonomic system. The parasympathetic side, which is activated when we feel safe and at peace, involves the Vagus nerve, which allows valves to open for digestion, and heart rate and blood pressure to lower. Studies have shown that relaxation training, and specifically calming techniques that can lower the heart rate and therefore activate the Vagus nerve, can help in many medical conditions, such as anxiety, depression, panic attacks, fibromyalgia, and depression.

Got vagus? Learn to activate the refreshing, mind-body calming method of mindful meditation for your health, wellness, and peace.

Please check out www.cahillmindbody.com for more information about mindful meditation throughout Comprehensive Therapy Services.

We here at Comprehensive Therapy Services would like to be the first to welcome you to our new blog! We are thrilled to be sharing our knowledge, experiences and ideas with you, our current and future friends and patients. In this blog, you will be hearing from all of our wonderful physical therapists, including Cindy Furey, PT, CEO, April Douglas, PT, DPT, OCS, MTC, Crystal Hazelton, PT, OCS, Elizabeth Leeds, PT, DPT, Jill Menifee, PT, Katherine Dahl, PT, MPT, CD (DONA), Kim Zevin, PT, DPT, Kira Shirz, PT, DPT, Maureen Mason-Cover, PT, WCS, and Natasha Ratajczak, PT, DPT, our physical therapy aide, Mandy Johnston, PTA, our acupuncturist, Sarah Knaup, LAc, our biofeedback therapist, Jim Cahill, BCB, and our Pilates instructors, Kristin Evans, NSCA-CPT, Briana Barnhill and Kelsey Beckman and as well as our exercise aides.

There is no doubt that when you come through our clinic you will hear our mantra, “It’s not normal… it’s common!”

Happy Healing!

Please let us know if there is something you’d like to know about! Do not hesitate to contact us at FureyCTS@gmail.com.