Diet and Breast Cancer: Interview with Cookbook Author Jeanne Besser

Maintaining a balanced diet and healthy weight is a controllable factor that may lower the risk of breast cancer and other health conditions, such as heart disease. A healthy diet provides your body with nutrients to keep your strength up while undergoing treatment for breast cancer and can manage the side effects of treatment. National Cancer Institute guidelines for breast cancer prevention include:

  • Increase intake of fruits, vegetables and whole grains
  • Decrease fat intake to less than 30 percent of calories
  • Minimize intake of cured, pickled and smoked foods
  • Achieve and maintain a healthy weight
  • Alcohol consumption should be done in moderation, if at all

This week, BBN had the opportunity to speak with the best-selling cookbook author, Jeanne Besser. Jeanne Besser is a former food columnist for the Atlanta Journal-Constitution and author of numerous cookbooks, including the American Cancer Society’s New Healthy Eating Cookbook, The Great American Eat-Right Cookbook, and What to Eat During Cancer Treatment. Among her other cookbooks are The 5:30 Challenge: 5 Ingredients, Dinner on the Table; The First Book of Baking; and Working Mom’s Fast & Easy One-Pot Cooking. She is also the co-author of Tell Me the Truth, Doctor: Easy-To-Understand Answers to Your Most Confusing and Critical Health Questions. With contribution from the American Cancer Society experts, Besser’s cookbooks offer scientifically-based information on the importance of diet, exercise, and portion control.

Do you believe in “superfoods,” or is cancer prevention more about a balanced diet?

There is a misconception that miracle foods exist. General healthy eating—more fresh fruits and vegetables, lean protein, and whole grains and less preservatives and additives—is the best thing for your body. The Healthy Eating Cookbook includes an array of accessible recipes and guidance on serving sizes and nutritional information. You should avoid red and processed meats like bacon and sausage. Portion control and understanding normal portion sizing is critical for a healthy diet. It is also important for people to have a better relationship with food so that it does not become a reward or punishment. Foods should not be vilified. For people who are overweight, it becomes a constant battle against “bad food,” which leads to excessive eating of “non-fat cookies.” Instead, everything should be in moderation.

Do you have any advice on ways to maintain a healthy diet while balancing a busy schedule?

Meal prepping for the week is a great way to create healthy options while on the go. Soups and stews are easy to freeze for future meals. Try prepping your vegetables for the week—chop onions and cut up sides to minimize dinner prep times. So much of healthy eating is having nutritious options in the fridge to grab when you are rushed and hungry. Cut fruit or carrots with hummus are a much better alternative to chips. Boiled eggs are easy snacks and a great source of protein. The 5:30 Challenge offers a different way of looking at cooking—recipes made from 5 easy-to-remember ingredients that take 30 minutes to prepare. While it may seem hard to balance that some things take more time, such as buying versus making salad dressing, making something yourself allows you to control factors like salt and fat content.

What are low-cost changes people can make while shopping for groceries, if they cannot afford or do not have access to more expensive organic options?

 Everyone has different means and economic situations. The most important thing for prevention and nutrition is to incorporate as many real foods as possible. Beans, eggs, and peanut butter are inexpensive and great sources of protein. Any dark leafy green vegetable—broccoli, kale, spinach—are all great options, so you can look for whatever is on sale that week. Small incremental changes you can make include switching from white to brown rice for more fiber or swapping white potatoes for sweet potatoes. Other cost-effective options include buying groceries in groups or doing group meals, where one family makes a meal each night. Becoming more in touch with what you are eating can help you shop smarter and have less wasted food and money.

Do you have any advice specifically for patients undergoing breast cancer treatment?

While writing What to Eat During Cancer Treatment, I worked directly with a nutritional oncologist to ensure that the book included information that was most valuable to her patients. The recipes address common side effects associated with cancer treatments including; nausea, diarrhea, constipation, unintentional weight loss, sore mouth or throat, taste changes and trouble swallowing. It is helpful to remember that during treatment, your appetite can change dramatically—there is a chapter in the cookbook that specifically addresses taste alteration. You may also face digestive issues as a side effect of some treatments, so it may be helpful to keep your meals on the bland side until you see how you personally take to different treatments.

If you are receiving treatment at a cancer center, ask if there is an on-site nutritionist or dietitian. It is important to advocate for yourself and ask what services are available. The book I co-wrote with my husband, Tell Me the Truth Doctor, offers great advice and easy-to-understand answers for these types of questions and concerns. If you are not feeling well or feel uncomfortable asking these questions yourself, consider bringing a family member or friend who can advocate on your behalf.

Comfort foods, such as soups or roast chickens, are great options that offer adaptable recipes for family members who are not suffering from certain side effects. While undergoing treatment, it is crucial to take care of yourself and do what makes you feel good. Let yourself feel comfort. Accept how you are feeling and listen to your body. It is important to fuel your body with sufficient nutrients, but if you are craving ice cream or want breakfast for dinner, then go ahead and do what it takes to make yourself feel better. There are no right or wrong choices.

Click on the in-text links to purchase Jeanne Besser’s books. Remember to support the Bridge Breast Network with your Amazon purchases at no extra cost through Amazon Smile.

Resources

“American Cancer Society Guideline for Diet and Physical Activity.” American Cancer Society, June 9, 2020. https://www.cancer.org/healthy/eat-healthy-get-active/acs-guidelines-nutrition-physical-activity-cancer-prevention/guidelines.html.

Brown, Ken. “Nutrition for Breast Cancer Patients and Survivors: Johns Hopkins Breast Center,” January 9, 2017. https://www.hopkinsmedicine.org/breast_center/treatments_services/nutrition.html.

“Diet and Breast Cancer.” Susan G. Komen®, February 13, 2020. https://ww5.komen.org/BreastCancer/BreastCancerAndDiet.html.

“Nutrition.” Breastcancer.org, June 22, 2019. https://www.breastcancer.org/tips/nutrition.

Breast Cancer in the Time of Coronavirus (COVID-19)

On March 11, 2020 the World Health Organization declared COVID-19 a global pandemic. Most people infected with the COVID-19 virus will experience mild respiratory symptoms and recover at home in about two weeks. It is important, however, to understand that you may be at a higher risk for more serious complications if you are immunocompromised. Being diagnosed with breast cancer does not automatically increase your risk of developing severe complications, but the following breast cancer treatments can weaken the immune system:

  • Chemotherapy drugs, such as Taxol, Cytoxan, or carboplatin
  • Certain targeted therapies, such as Ibrace, Kisqali, Verzenio, and Piqray

For more information on increased risks related to cancer, researchers at Vanderbilt University launched the COIVD-19 and Cancer Consortium (CCC19) to track outcomes to adults diagnosed with cancer who have been infected with COVID-19. The best way to avoid becoming sick is to avoid exposure. Follow CDC Guidelines closely; socially distance, wear a face mask, and frequently wash your hands. If you are receiving treatment for breast cancer and have a weakened immune system, extra precautions may help you protect yourself:

  • Stock up on medications
  • Make a plan with your caregiver in case they or you become ill
  • Avoid close contact with families and friends and take extra precautions if you rely on them for care
  • Be extra vigilant about hand hygiene
  • Make a plan with your employer to work from home if you are not already doing so
  • As a friend or family member to shop for groceries or pick up medications for you
  • Discuss with your doctor about ways to monitor symptoms

If you are undergoing breast cancer treatment during the pandemic, here are some tips to navigate the challenging and uncertain times:

  • Do not delay treatment. According to Dr. Elizabeth Potter, plastic surgeon and faculty members at the University of Texas at Austin Dell Medical School, “breast cancer surgery, reconstruction, and treatment are all safe to receive at this point. And if you have breast cancer, it needs to be treated. It will progress otherwise. It would be a tragedy if fear of COVID-19 kept women from getting treated for breast cancer.”
  • If you are not permitted to bring someone with you to in-office appointments, ask a family member or friend to virtually join you by video or phone call.
  • Get a second opinion or consider talking to your doctor about traveling to a medical center in a different area.
  • Take care of your mental health. It is normal to be anxious or depressed during this unprecedented time. Consider scheduling virtual appointments with a mental health profession or a support group for people with breast cancer.

People with cancer should continue their treatment, when possible. A recent survey by the Prevent Cancer Foundation found the 35% of Americans have missed cancer screenings due to COVID-19 and 43% of Americans have missed medical appointments. According to National Cancer Institute Director Dr. Norman Sharpless, models from the medical magazine Science predict that the lack of screenings and treatments could result in almost 10,000 excess deaths from breast and colorectal cancer in the next decade. Dr. Theres Bevers, medical director of the University of Texas MD Anderson Cancer Center, urges people to schedule screenings, emphasizing that people are “more likely to die from cancer that has progressed as they sit at home to prevent COVID-19 … than they are to die from COVID-19.” For more information on delayed surgery, mammograms, telemedicine, and how to plan with your doctor, watch this video by breastcancer.org. Dr. Marisa Weiss, Founder and Chief Medical Officer of breastcancer.org, also answers more questions regarding safety, treatment, and patient needs during the pandemic in a Q&A video that can be found here.

You and your loved ones can protect yourself from becoming infected with the coronavirus without compromising your cancer screening or treatment. Healthcare facilities across the country are having to change how healthcare is delivered due to the pandemic. If you need to visit a clinic or hospital, be assured that healthcare facilities have adopted COVID-19 safety strategies including:

  • Screening for COVID-19 symptoms over the phone prior to and when you arrive at an appointment
  • Universal mask requirements
  • Medical appointments via telemedicine, either by phone or online video. Medicare, Medicaid and most private insurances now cover telehealth visits
  • Social distancing in healthcare facilities
  • COVID-19 testing before surgery and chemotherapy
  • Shorter hospital visits to reduce chance of exposure
  • Limiting visitors during hospital visits

For patients with breast cancer the uncertainty, physical distancing, and possible delays in cancer treatments caused by this pandemic can be distressing. If you or a loved one are undergoing treatment for cancer, make sure to consult with your primary physicians and oncologists for special guidance.

Resources

“Breast Cancer and COVID-19: Risks and Precautions.” Medical News Today. MediLexicon International, April 15, 2020. https://www.medicalnewstoday.com/articles/breast-cancer-and-covid-19.

“Common Questions About the COVID-19 Outbreak.” American Cancer Society, August 7, 2020. https://www.cancer.org/latest-news/common-questions-about-the-new-coronavirus-outbreak.html.

“Coronavirus (COVID-19): What People With Breast Cancer Need to Know.” Breastcancer.org, July 30, 2020. https://www.breastcancer.org/about_us/press_room/news/coronavirus.

“Coronavirus Information.” Susan G. Komen®, July 17, 2020. https://ww5.komen.org/BreastCancer/coronavirus-information/.

Rodriguez, Adrianna. “People ‘Afraid to Go to Doctors’: A Third of Americans Miss Cancer Screenings, Survey Suggests,” July 29, 2020. https://www.usatoday.com/story/news/health/2020/07/28/coronavirus-pandemic-americans-keep-canceling-cancer-screenings-survey/5524899002/.

Sharpless, Norman E. “COVID-19 and Cancer.” Science. American Association for the Advancement of Science, June 19, 2020. https://science.sciencemag.org/content/368/6497/1290.

“Special Report: COVID-19’s Impact on Breast Cancer Care.” Breastcancer.org, August 3, 2020. https://www.breastcancer.org/treatment/covid-19-and-breast-cancer-care.

Subramaniam, Vaidyanathan. “Information About COVID-19 for Breast Cancer Patients.” Breast Cancer News, August 5, 2020. https://breastcancer-news.com/information-about-covid-19-for-breast-cancer-patients/.

Benefits of Yoga for Breast Cancer Patients

Yoga, meaning “union,” is a 5,000-year-old system of principles and practices originating in India. Most types of yoga practiced in the United States focus on movement and breathing, the most frequently practiced being hatha yoga. Hatha yoga uses physical poses and breathing techniques to increase strength, flexibility, and well-being. Research on the benefits of yoga for breast cancer patients has shown that it can: improve physical vitality, reduce fatigue, reduce stress, improve sleep, and improve quality of life. To learn more about the benefits and precautions of yoga for people with breast cancer, listen to a podcast for breastcancer.org by Vicki Flannery, a nurse, yoga instructor, and breast cancer survivor.

If you are interested in trying yoga, there are plenty of free resources online for guided workouts. For example, LiveWell After Breast Cancer, a Johns Hopkins Sidney Kimmel Cancer Center initiative, offers fun and easy exercise routines, including guided yoga workouts. Mass General Cancer Center also offers a gentle yoga practice video instructed by Luba Zagachin, Mass General yoga instructor.

Important risk factors to consider before trying yoga:

  • Risk of inexperienced instructors. Ask your oncologist or cancer center staff to recommend highly trained instructors who regularly work with cancer patients.
  • Risk of lymphedema. If you have recently had lymph nodes removed, some of the more strenuous yoga types and poses may present a risk. An instructor who has taught breast cancer patients will be aware of safe yoga types and poses.
  • Risk of fracture in patients with bone metastasis. If you have bone metastasis, ask your doctor if yoga is right for you, or if a gentler form of yoga, such as mediated or guided imagery, would be more fitting.

There is ongoing research about the impact of mind-body interventions on the health of cancer patients. At the 2003 meeting of the American Society of Clinical Oncology (ASCO), results from a yoga study of 126 women showed that women who did yoga while receiving chemotherapy or hormonal therapy had a 12% improvement in fatigue, physical functioning, and quality of life. In 2006, a study from the MD Anderson Cancer Center reported that women who took yoga classes twice a week while receiving radiation treatment reported having more energy and less daytime sleepiness, better physical functioning, and better overall quality of life.

Research from The University of Texas MD Anderson Cancer Center found that patients who participated in yoga exercises that incorporated controlled breathing, meditation and relaxation techniques into their treatment plan experienced improved ability to engage in their daily activities, better general health and better regulation of cortisol (stress hormone). The study also found that women in the yoga group were better equipped to find meaning in the illness experience. Dr. Lorzeno Cohen, principal investigator of the study and director of MD Anderson’s Integrative Medicine Program, emphasized that “research has shown that yoga and other types of mind-body practices, incorporated into the standard of care, can help improve patient outcomes, particularly quality of life.” Following the results of this study, The National Cancer Institute awarded more than $4.5 million to MD Anderson to conduct a Phase III trial in women with breast cancer that investigates improvement in physical function and quality of life during and after radiation treatment. This marks the largest amount ever awarded by NCI for the study of yoga in cancer and emphasizes the growing importance of relaxation-based interventions that can contribute to the well-being of people with cancer.

BBN - Yoga Benefits

BBN - Yoga Benefits

Resources

MD Anderson Cancer Center, and Null. “Yoga Gets Resounding Support From NCI,” July 27, 2010. https://www.mdanderson.org/publications/conquest/yoga-get-nci-support.h34-1585890.html.

MD Anderson Cancer Center, and Null. “Yoga Gets Resounding Support From NCI.” MD Anderson Cancer Center. MD Anderson Cancer Center, July 27, 2010. https://www.mdanderson.org/publications/conquest/yoga-get-nci-support.h34-1585890.html.

Release, MD Anderson News. “Yoga Regulates Stress Hormones and Improves Quality of Life for Women with Breast Cancer Undergoing Radiation Therapy.” MD Anderson Cancer Center, March 3, 2014. https://www.mdanderson.org/newsroom/yoga-regulates-stress-hormones-and-improves-quality-of-life-for-.h00-158906967.html.

Simon, Stacy. “Say Yes to Yoga.” American Cancer Society, May 15, 2020. https://www.cancer.org/latest-news/say-yes-to-yoga.html.

“What Are the Best Yoga Poses for Breast Cancer Patients? [Infographic]: Dana-Farber Cancer Institute.” Dana, December 19, 2018. https://blog.dana-farber.org/insight/2016/04/what-are-the-best-yoga-poses-for-breast-cancer-patients-infographic/.

“Yoga Shows Benefits to Quality of Life in Some Breast Cancer Patients.” NCI Formulary, August 12, 2013. https://cam.cancer.gov/health_information/highlights/breastcancer_yoga.htm.

“Yoga.” Breastcancer.org, May 5, 2020. https://www.breastcancer.org/treatment/comp_med/types/yoga.

“Yoga.” Susan G. Komen®. Accessed August 3, 2020. https://ww5.komen.org/BreastCancer/Yoga.html.

The Importance of Mental Health for People with Metastatic Breast Cancer

A breast cancer diagnosis can be one of the most distressing events a woman ever experiences and can cause emotions of shock, anxiety, anger, sadness, and confusion. Along with the physical impacts of cancer, fear of recurrence, changes to identity, and perceived loss of support can exacerbate pre-existing mental health conditions. It is important, however, to understand that you are not alone. Stress and anxiety are natural reactions to a cancer diagnosis and can be overwhelming. Managing stress can greatly impact the length of survivorship. One study showed that breast cancer patients who participated in small group sessions that proposed strategies for reducing stress, improving mood, adhering to treatment, and changing health-related behaviors had a 45% lower risk of cancer recurrence and a 56% lower risk of dying from breast cancer. According to the National Cancer Institute:

  • One in three with cancer experience mental or emotional stress.
  • Nearly 25% of cancer survivors experience symptoms of depression and up to 45% experience anxiety.
  • Many cancer survivors experience symptoms meeting criteria for PTSD (Post-Traumatic Stress Disorder)

Breast cancer patient may experience some of the following psychological conditions:

  1. Severe emotional distress is the most common mental health issue among breast cancer patients. The National Comprehensive Cancer Network has endorsed a questionnaire, the “Distress Thermometer” as a resource for assessing the impact of distress on a patient’s life.
  2. Major depression is characterized by depressed mood and inability to feel pleasure, in addition to mental and physical symptoms, that interfere with daily activities. Talk to your doctor if you are experiencing symptoms of: negative or suicidal thoughts, general unhappiness, reduced concentration, guilt, low self-esteem, or physical problems.
  3. Post-Traumatic Stress Disorder occurs in cancer patients as they suffer from questions about their mortality and safety. Symptoms include: reliving the moment, increase arousal, feeling easily angered, and avoidance.
  4. Generalized Anxiety Disorder is characterized by a constant feeling of fear and worry to the point of mental exhaustion and physical symptoms of restlessness, sleep disturbances, and irritability.

Call your doctor or seek immediate medical help if you are experiencing any of the following symptoms:

  • Thoughts of suicide
  • Reckless behavior, such as excessive drinking until blackout or erratic driving
  • Inability to eat or sleep for consecutive days
  • Acute trouble breathing from anxious feelings

It is crucial for patients with MBC to prioritize their emotional wellbeing. There are many ways to get mental health help, and choosing the best option can be based on cost, availability, and personal preference. Here are ten resource options for mental health support:

  1. Join a support group to talk with other people who are experiencing some of the same symptoms. Support groups can be online, in-person, or over the phone. More resources for social support for breast cancer patients and support groups for family and loved ones can be found by visiting the Susan G. Komen page Coping with Cancer – Support Resources.
  2. Visit a mental health professional to voice your concerns and learn about adaptive strategies to control stress. You can meet with a counselor or psychologist or participate in small group sessions. If you are receiving cancer treatment at a hospital or medical center, ask if there is a Licensed Clinical Social Worker or psychologist on staff.
  3. Reduce stress to manage anxiety and improve blood pressure, heart health, and fatigue. Some ways to relieve stress include: music, painting, yoga, tai chi, mindfulness meditation, deep breathing exercises, and guided imagery.
  4. Stay active in your community by volunteering for local charities or organizations like Susan G. Komen or the American Cancer Society.
  5. Reach out to loved ones for support. Openly discuss your emotions, fears, and frustrations with your family and friends.
  6. Meet with a social worker. Social workers can help connect you with the community and available support services.
  7. Consider asking your doctor or a mental health profession about medications to treat clinical depression.
  8. Exercise releases endorphins, which can reduce stress, increase feelings of positivity, and decrease fatigue. Activities that reduce stress might include cycling, swimming, yoga, jogging, or walking. Ask your doctor about what exercise options are best for you.
  9. Eat a healthy diet that includes plenty of fruits, vegetables, and whole grains and avoid highly processed food, fried foods, sugar, and alcohol. Your diet can greatly impact how you feel.
  10. Ask your doctor to refer you to educational websites that can help you learn more about your diagnosis to reduce feelings of uncertainty.

Insurance requirements in the United States can make it more difficult to find and pay for mental health services. It may be difficult to be an insurance advocate for yourself while coping with your diagnosis and the physical symptoms of treatment, so consider having a family member or friend speak with your insurance company. Some other low-cost options include:

  • Outpatient psychotherapy clinics in hospitals and communities usually accept Medicaid, Medicare, and state insurance plans
  • Psychology doctor programs may offer clinical psychologists in training who can provide therapy while under the supervision of senior clinicians.

Other available resources for mental health providers include:

Learn more about disparities in breast cancer treatment and ways to reduce stress while coping with breast cancer in this podcast for breastcancer.org by Dr. Lola Fayanju. Dr. Fayanju is an assistant professor of surgery at the Duke University School of Medicine and researches disparities in outcomes after breast cancer diagnoses to improve the quality of breast cancer care. Her podcast focuses on some of the reasons for disparities in breast cancer care, the idea of choice and how that affects clinical trial enrollment, and resources for patients coping with stress.

Prioritizing your mental health is equally as important as caring for your physical health while living with metastatic breast cancer. If you are having thoughts of suicide or death, call 911 or the National Suicide Prevention Lifeline at 1-800-273-8255.

Resources

“Breast Cancer: How Your Mind Can Help Your Body,” October 2011. https://www.apa.org/topics/breast-cancer.

Cafasso, Jacquelyn. “How to Support Your Mental Health with Metastatic Breast Cancer.” Healthline. Healthline Media, January 8, 2020. https://www.healthline.com/health/metastatic-breast-cancer/mental-health-support.

“Coping with Cancer – Support Resources.” Susan G. Komen, June 2, 2017. https://ww5.komen.org/BreastCancer/SupportIntroduction.html.

Fayanju, Lola. “Breast Cancer and Race: Disparities and Mental Health Effects.” Breastcancer.org, June 24, 2020. https://www.breastcancer.org/community/podcasts/race-care-disparities-20200608.

“Mental Health Care Options for People With Metastatic Breast Cancer,” January 22, 2020. https://www.breastcancer.org/symptoms/types/recur_metast/living_metast/mental-healthcare.

Moses, Tasha, and Sarah Linden. “Mental Health Impacts of a Cancer Diagnosis.” #BHtheChange, September 14, 2018. https://www.bhthechange.org/resources/mental-health-impacts-of-a-cancer-diagnosis/.

Tremblay, Lia. “How Can a Breast Cancer Diagnosis Play Havoc with Your Emotions?” Verywell Health, January 18, 2020. https://www.verywellhealth.com/the-psychological-impact-of-a-breast-cancer-diagnosis-430338.

Complementary and Alternative Therapies for Breast Cancer

If you have been diagnosed with breast cancer, you may consider exploring different treatment methods to supplement traditional medical treatments. Conventional treatments for breast cancer include: surgery, radiation therapy, chemotherapy, hormone therapy, and targeted therapy. Complementary and alternative medicine (CAM) are terms used to describe various products, practices, and systems that are not considered mainstream medicine that use your own body, mind, or things found in nature. “Alternative” methods are used in place of proven medical treatments. “Complementary” refers to methods used to alleviate symptoms and improve quality of life in conjunction with medical treatment. Because complementary medicine can be combined or integrated with traditional medical treatment, it is also referred to as “integrative medicine.” Complementary medicine is not alternative medicine

A number of studies have found that up to 80% of breast cancer survivors have used at least one complementary technique. Complementary medicine, when used along with standard treatment, can reduce symptoms or improve physical or psychological health.

Common CAM treatments to discuss with your doctor include:

Special diet: A healthy diet is an important part of cancer treatment, whether you are using traditional methods or CAM. Special diets avoid foods that are high-fat, salt-cured, smoked, and pickled. Diets should also include increased fruit, vegetable, and plant-based intake. Before making any major changes to your diet, work with your doctor to create a nutrition plan that works best for your body and cancer.

Antioxidant supplements: Antioxidants can lower your risk of cancer by protecting your body from free radicals. Dietary antioxidants include beta carotene, lycopene, and vitamins A, C, and E. These antioxidants are commonly found in goji berries, wild blueberries, dark chocolate, pecans, and kidney beans, or in dietary supplements. However, dietary supplements should be discussed with your doctor, as they may interact with cancer drugs.

Mind-body therapies: Mind-body practices can improve quality of life and are effective at relieving stress, anxiety, and pain. Examples of commonly used meditative and creative activities include art therapy, music therapy, reiki, yoga, tai chi, meditation, labyrinth walking, and aromatherapy.

Massage Therapy: Massage therapy has been found to ease anxiety, pain, and fatigue and can boost immunity. A clinical study from 2003 found that massage therapy reduced the need for pain medication and decreased anxiety levels in breast cancer patients. Another study discovered a link between massage therapy and enhanced dopamine, serotonin, and NK cell number and lymphocytes in women with stage 1 and 2 breast cancer. If you are interested in incorporating massage therapy into your treatment plan, make sure to work with a licensed practitioner who has experience with breast cancer patients.

Acupuncture: Acupuncture is a central practice of Chinese medicine that is used to relieve various symptoms such as fatigue, nausea, and pain. Acupuncture involves a practitioner stimulating your nervous system by placing sterile, hair-thin needles into acupuncture points. Always consult your doctor before pursuing acupuncture, as it does carry risks of infection, bleeding, and lymphedema and some of the herbal supplements incorporated into acupuncture treatment may negatively interact with chemotherapy. 

Only a few examples of CAM therapies are discussed in this article, but more detailed information on a wide range of popular therapies can be found here.

Safety is a major concern with complementary therapies and patients who choose to forgo traditional medicine may be putting themselves at risk. The American Cancer Society strongly urges patients to discuss the use of alternative and complementary therapies with their health care team and does not advise patients to use CAM to treat cancer itself. Few complementary therapies have been studied with the same scientific rigor as standard medicine. Use caution with therapies that claim to be “miracle curses,” “ancient remedies,” or “secret ingredients.” 

The decision to use complementary or alternative methods is an important one, and it is your decision to make. Consult with your doctor before beginning any alternative or complementary therapies so that you can make a truly informed decision. Your doctor can refer you to research on different CAM treatments and can also recommend appropriate methods. While many of these methods do not pose physical harm, they are nearly all unproven to cure cancer.

Resources

“What Are Complementary and Alternative Methods?” American Cancer Society, March 31, 2015. https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/complementary-and-alternative-methods-and-cancer/what-are-cam.html.

“What Are the Risks of Not Using Mainstream Cancer Treatment?,” March 31, 2015. https://www.cancer.org/treatment/treatments-and-side-effects/complementary-and-alternative-medicine/complementary-and-alternative-methods-and-cancer/risks-of-not-using-mainstream-treatment.html.

Scaccia, Annamarya. “Alternative Treatments for Breast Cancer: What Works?” Healthline. Healthline Media, August 20, 2018. https://www.healthline.com/health/breast-cancer/alternative-treatments-for-breast-cancer.

“Complementary Therapies – Integrative Therapies.” Susan G. Komen®, August 3, 2019. https://ww5.komen.org/BreastCancer/ComplementaryTherapiesIntro.html.

“What Is Complementary Medicine.” Breastcancer.org, May 5, 2020. https://www.breastcancer.org/treatment/comp_med/what_is_it.

Robert H. Shmerling, MD. “Alternative Therapies for Cancer.” Harvard Health Blog, January 31, 2019. https://www.health.harvard.edu/blog/alternative-therapies-for-cancer-2019020115888.

Triple-Negative Breast Cancer

A diagnosis of triple negative breast cancer (TNBC) means that the three most common types of receptors known to fuel most breast cancer growth–estrogen, progesterone, and the hormone epiderm al growth factor receptor 2 (HER-2) gene– are not present in the tumor. Since these receptors are not present, common treatments like hormone therapy and drugs that target estrogen, progesterone, and HER-2 are ineffective and therefore make the cancer more challenging to treat. However, other medicines and combinations of surgery, radiation therapy, and chemotherapy have been used to successfully treat TNBC. TNBC can have the same symptoms and warning signs as other types of breast cancers, and it represents 10-15% of all breast cancers. TNBC has shown to be more prevalent in:

  • Premenopausal African-American women
  • Women with an elevated hip-to-waist ratio
  • Women who have had fewer children
  • Women who have not breastfed, or breastfed for shorter lengths of time
  • Younger women, under the age of 40 or 50
  • Those with the BRCA1/BRCA2 gene mutations

Triple-negative breast cancer occurs at different rates among races and ethnicities. Although the reasons for these differences is unclear, TNBC is more frequent among non-Hispanic black women diagnosed with breast cancer, than non-Hispanic white women diagnosed with breast cancer.

Triple Negative Breast Cancer - BBN

Because TNBC cells lack estrogen and progesterone receptors and do not overexpress the HER2 gene, the cancer cells do not respond to hormone therapy or medications that block HER2 receptors. Instead, TNBC treatment involves chemotherapy, radiation, and surgery (either a lumpectomy or mastectomy). Studies show that triple negative breast cancer may respond even better to chemotherapy in earlier stages than other forms hormone receptor-positive breast cancers. The standard care for triple-negative is chemotherapy before surgery. Recently, the addition of newer medications called poly ADP-ribose polymerase (PARP) inhibitors, and other immunotherapies, have shown to be promising treatments for TNBC. Different subtypes of TNBC each have unique abnormalities, which can serve as targets for treatment drugs. Ongoing clinical research is being conducted to improve current and future treatments. After treatment, be sure to continue with a regular appointment schedule. It is important to take charge of your health by maintaining a good diet and exercising. Meditation, support groups, or therapy also offer positive emotional balance.

TNBC is considered an aggressive cancer, as it grows at a quicker rate, is more likely to have spread upon diagnosis, and has a higher chance of coming back after treatment than other forms of breast cancer. 5-year survival rates for TNBC are shown in the chart below, based on women diagnosed with triple-negative breast cancer between 2010 and 2015. This data is courtesy of the American Cancer Society, which relies on data from the National Cancer Institute’s SEER database. SEER tracks 5-year relative survival rates for breast cancer in the United States based on how far the cancer has spread. It does not group cancers by stages (stage 1, stage 2, etc.), but instead groups cancers into three categories:

  • Localized: No sign that the cancer has spread outside the breast.
  • Regional: Cancer has spread outside the breast to nearby structures or lymph nodes.
  • Distant: Cancer has spread to distant parts of the body, such as lungs, liver, or bones.

Triple Negative Breast Cancer - BBN

Remember that every individual has a unique experience with the disease that cannot be exclusively defined by statistics. Survival rates are estimates based on previous outcomes. No one can exactly predict how your breast cancer will progress or respond to treatment.  Women being diagnosed right now may have a better outlook than these numbers show, as treatments improve over time. These numbers only apply to the stage of the cancer when first diagnosed and do not take into consideration cancer growth, spread, or return. It is also important to note that while TNBC is more likely to return within five years than other forms of breast cancer, it rarely relapses after that first five-year period, which offers patients a confident feeling of beating their cancer. Each individuals’ case and experience with cancer is unique. Consult your doctor about how these numbers apply to you and how you can reduce your risk of recurrence.

Click here for a video by the National Breast Cancer Foundation that helps explain the basics of TNBC.

Resources

Godman, Heidi. “Triple Negative Breast Cancer Outlook: Survival Rates.” healthline, December 9, 2019. https://www.healthline.com/health/triple-negative-breast-cancer-outlook-survival-rates-stage.

Nathan-Garner, Laura, and MD Anderson Cancer Center. “Triple-Negative Breast Cancer: 5 Things You Should Know,” April 30, 2015. https://www.mdanderson.org/publications/cancerwise/triple-negative-breast-cancer-5-things-you-should-know.h00-158986656.html.

Silberman, Ann. “Recurrence Rate for Triple-Negative Breast Cancer.” healthline, October 8, 2018. https://www.healthline.com/health/triple-negative-breast-cancer-recurrence.

“Triple Negative Breast Cancer.” National Breast Cancer Foundation. Accessed June 2, 2020. https://www.nationalbreastcancer.org/triple-negative-breast-cancer.

“Triple Negative Breast Cancer.” Susan G. Komen®, May 21, 2020. https://ww5.komen.org/BreastCancer/TripleNegativeBreastCancer.html.

“Triple-Negative Breast Cancer.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, July 26, 2019. https://www.cdc.gov/cancer/breast/triple-negative.htm.

“Triple-Negative Breast Cancer: Details, Diagnosis, and Signs.” American Cancer Society, September 20, 2019. https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-cancer/triple-negative.html.

“Triple-Negative Breast Cancer: Overview, Treatment, and More.” Breastcancer.org, May 13, 2020. https://www.breastcancer.org/symptoms/diagnosis/trip_neg.

Alcohol’s Role in Increasing Breast Cancer Risk

Women are often unaware of alcohol’s role in increasing breast cancer risk. A study published in the online journal BMJ Open found that only one in five women attending a breast cancer clinic knew it was a risk factor. More than 100 observation studies have researched the association between alcohol consumption and breast cancer risk in women. These studies have consistently found an increased risk associated with alcohol intake. Women who have three alcoholic drinks per week have a 15% greater risk of developing breast cancer than women who do not drink at all. It is also estimated that the risk of breast cancer increases another 10% for each additional drink women regularly consume each day. Alcohol has also shown to increase risk for other forms of cancer, including head and neck, esophageal, and liver cancer.

Alcohol is empty calories, which can contribute to weight gain and excess fat has been linked to cancer risk. The connection between breast cancer and alcohol consumption is also thought to be linked to alcohol’s negative effects on hormone levels. Three ways alcohol contribute to breast cancer are:

  1. Alcohol increases estrogen levels. Research shows consuming alcoholic beverages increases a woman’s risk of hormone-receptor-positive breast cancer. Alcohol has an effect on estrogen receptors, thereby increasing exposure to endogenous estrogen levels and the frequency of long menstrual cycles. This can promote breast cancer tumor growth.
  2. Metabolizing alcohol releases carcinogens. As our bodies break down alcohol, acetaldehyde, a cancer-causing molecule, is formed as a byproduct. This molecule is known to induce DNA damage and therefore may promote breast tumor formation.
  3. Consuming alcohol may decrease absorption of essential nutrients. Alcohol can decrease the absorption of important nutrients, including folate, which is involved in DNA synthesis and repair. Regular drinking also contributes to vitamin B-12 deficiencies. These two factors increase the risk of breast cancer. 

The size, alcohol content, and number of drinks can affect risk. Alcohol drinks come in three choices: beer, wine, and liquor. A drink is defined as 12 ounces of beer, 5 ounces of wine, and 1.5 ounces of liquor. Units are a simple way to express how much alcohol is present in a drink. Research from the UK suggests that women drink no more than 14 units per week. The number of units depends on the size of the drink and the strength of the alcohol, which is often expressed as a percentage on the bottle or can.

BBN - Alcohol Risk

The more alcohol consumed, the higher the risk. The infographic below illustrates how many women out of 50 will develop breast cancer in their lifetime depending on how many units of alcohol they consume.

BBN - Alcohol Risk

To cut back on alcohol consumption and decrease your breast cancer risk, here are some guidelines:

  • Select low-calorie alcohol options to avoid excess weight gain.
  • Avoid 100-proof liquor
  • Avoid alcohol as often as possible
  • If you do not want to eliminate drinking alcohol completely, try to limit it to having two or fewer alcoholic drinks per week.
  • Try mocktails – drinks that use all the ingredients of cocktails except for the alcohol. Check out this page for some fun and easy mocktail recipes.

Breast cancer is affected by a combination of factors: genetic predispositions, lifestyle choices, and environmental factors. There is never one exclusive cause of disease. However, Cancer Research UK has found that reducing alcohol consumption was one of the best ways women could reduce their breast cancer risk. Increasing awareness about alcohol’s effect on breast cancer risk empowers women to make modifiable changes in their life that can help shift the odds in their favor.

Resources

“Alcohol.” Susan G. Komen®, February 13, 2020. https://ww5.komen.org/BreastCancer/DrinkingAlcohol.html.

Blackburn, K. B., & MD Anderson Cancer Center. (2019, May 8). Alcohol and breast cancer risk: What to know. https://www.mdanderson.org/publications/focused-on-health/alcohol-breast-cancer-risk-what-to-know.h30Z1591413.html.

“Can Alcohol Consumption Increase Your Risk of Breast Cancer?” Abramson Cancer Center (blog). Penn Medicine, October 5, 2018. https://www.pennmedicine.org/cancer/about/focus-on-cancer/2018/october/can-alcohol-consumption-increase-my-risk-of-breast-cancer.

“Drinking Alcohol.” Breastcancer.org, August 30, 2016. https://www.breastcancer.org/risk/factors/alcohol.

“Women Not Aware Enough of Breast Cancer Link to Alcohol.” BBC News. BBC, June 19, 2019. https://www.bbc.com/news/health-48677953.

“Women Not Aware Enough of Breast Cancer Link to Alcohol.” BBC News. BBC, June 19, 2019. https://www.bbc.com/news/health-48677953.

Male Breast Cancer

Breast cancer is most commonly thought of as a disease that affects women, however, men are born with a small amount of breast tissue and therefore can also develop breast cancer. Male breast cancer is rare, as only 1% of men in the United States are diagnosed with the disease.  The most common sign of breast cancer is a painless lump or thickening of the breast or chest area. Other warning signs and symptoms include:

  • Dimpling, puckering, scaling, or redness of the skin of the breast
  • Hard knot, lump, or thickening in the breast, chest, or underarm area (may be tender)
  • Inversion of the nipple or pulling of other parts of the breast
  • Itchy, scaly sore or rash on the nipple
  • Discharge from the nipple

A breast lump found in men may be a symptom of gynecomastia, a benign and common breast condition in men. It is not caused by a tumor, but instead is an increase in the amount of a man’s breast tissue. It is often common among teenage boys and older men, due to changes in hormone balance. Gynecomastia can manifest as a button-like or disk-like growth under the nipple. As breast cancer and gynecomastia can both be felt as a growth, it is important to have a doctor examine any lumps.

The most common form of breast cancer in men is Infiltrating Ductal Carcinoma (IDC), which involves the cells in or around the ducts invading surrounding tissue. Treatment for male and female cancer patients is similar. Male breast cancer, like female breast cancer, can be classified by cancer cell receptors: HER2, estrogen, and progesterone. About 90% of male breast cancers are hormone-receptor positive, while another 9% are hormone-receptor positive and HER2-positive. These receptors are targeted with cancer drugs to slow or stop the disease’s growth. The standard care for men is to undergo a mastectomy surgery, rather than a lumpectomy. Hormone therapy is commonly part of the treatment regime and chemotherapy may be recommended if the surrounding lymph nodes test positive for cancer or if the tumor exhibits high-risk features. Radiation treatment is also commonly recommended if the lymph nodes are positive.

Men with breast cancer have a higher mortality rate than women. This higher rate of mortality is primarily due to the fact that men are often diagnosed at an older age and more advanced stage of breast cancer than women, as they are less likely to assume a lump to be breast cancer. Studies show that patients of the same age and stage have similar survival rates.

Men who inherit the BRCA1 or BRCA2 gene are at higher risk of developing breast and prostate cancers. Approximately 8-15% of male breast cancer patients have a BRCA mutation, compared to 5-10% in female populations. BRCA2 mutations are particularly linked to breast cancer, and men carrying this mutation have a near 10% lifetime risk of developing the disease. The risk of breast cancer is doubled for men who have a parent, sibling, or child with the disease. If you have a strong family history of cancer, consult your doctor, who may recommend genetic counseling. Other risk factors include:

  • The risk of breast cancer increases as you age. Male breast cancer is most frequently diagnosed in men in their 60s.
  • Exposure to estrogen. Taking estrogen-related drugs, such as those used for hormone therapy for prostate cancer, increase your risk of breast cancer.
  • Klinefelter’s syndrome. This genetic syndrome occurs when boys are born with more than one copy of the X chromosome. Klinefelter’s syndrome causes abnormal development of the testicles, which causes lower levels of certain male hormones (androgens) and higher levels of female hormones (estrogens).
  • Liver disease. Certain conditions, including cirrhosis of the liver, can reduce male hormones and increase female hormones.
  • Enlarged breasts caused by a hormone imbalance or certain medications increases risk.
  • Obesity is associated with higher levels of estrogen in the body.
  • Testicle disease or surgery. Having inflamed testicles (orchitis) or surgery to remove a testicle (orchiectomy) can increase your risk of male breast cancer.
  • African-American men have a higher risk of male breast cancer than non-Hispanic white men.
  • Heavy alcohol use. High levels of alcohol intake can limit the liver’s ability to regulate blood-estrogen levels.
  • Radiation exposure. Receiving radiation treatment in the chest area, such as for lymphoma, increases the risk for developing breast cancer.

If you exhibit any of the mentioned symptoms or have a strong family history of breast cancer, be sure to contact your doctor about your concerns. If you are diagnosed with male breast cancer and feel isolated, reach out to other breast cancer survivors. Male breast cancer may be rare, but it is important to raise awareness as early diagnosis and treatment are key to beating this disease.

Resources

“Male Breast Cancer.” Mayo Clinic. Mayo Foundation for Medical Education and Research, February 28, 2020. https://www.mayoclinic.org/diseases-conditions/male-breast-cancer/symptoms-causes/syc-20374740.

“Male Breast Cancer.” National Breast Cancer Foundation. Accessed June 10, 2020. https://www.nationalbreastcancer.org/male-breast-cancer.

Richardson, Lucy, and MD Anderson Cancer Center. “Male Breast Cancer: What Men Should Know.” MD Anderson Cancer Center. MD Anderson Cancer Center, January 10, 2013. https://www.mdanderson.org/publications/cancerwise/male-breast-cancer-what-men-should-know.h00-158826489.html.

“Male Breast Cancer.” MD Anderson Cancer Center. Accessed June 10, 2020. https://www.mdanderson.org/cancer-types/breast-cancer/male-breast-cancer.html.

Brown, Ken. Male Breast Cancer Treatment and Prognosis: Johns Hopkins Breast Center, October 27, 2017. https://www.hopkinsmedicine.org/breast_center/breast_cancers_other_conditions/breast_cancer_in_men.html.

“What Is Breast Cancer in Men?: Male Breast Cancer.” American Cancer Society, April 27, 2018. https://www.cancer.org/cancer/breast-cancer-in-men/about/what-is-breast-cancer-in-men.html.

“The Risk Factors for Male Breast Cancer.” Breastcancer.org, September 29, 2016. https://www.breastcancer.org/symptoms/types/male_bc/risk.

“Warning Signs of Male Breast Cancer.” Susan G. Komen®. Accessed June 10, 2020. https://ww5.komen.org/Blog/Warning-Signs-of-Male-Breast-Cancer/.

Dispute Between BBN and Event Space for Gala

That’s 5 women who need surgery that we’ll have to say no to’: Dispute between breast cancer nonprofit, event space fueled by canceled gala deposit

”The initial deposit for both the venue and the catering ― $13,000 — translates into $130,000 in medical care… That’s enough for five surgeries for breast cancer”.

Link To Dallas Morning News Article (June 16, 2020)

We believe in doing everything possible for our patients, $1 = $10 of direct patient care for uninsured/underinsured breast cancer patients in Dallas.

Losing this deposit money means we have to turn five women who need care, who need surgery. We appreciate all of your support. Thank you. 

Donate Now

Breast Self-Examination

Breast self-examination is a screening method used to detect early signs of breast cancer. Studies show that forty percent of women diagnosed with breast cancer detected a lump while performing a self-examination. Self-exams are a convenient, no-cost tool that can be incorporated into daily activities, such as bathing or dressing. Adult women of all ages are encouraged to perform a breast self-exam at least once a month. Here are five steps on how to perform a breast self-exam:

  1. Breast Self-Examination - BBNLook at your breasts in the mirror and visually inspect your breasts with your shoulders straight and arms on your hips.
    • Look for:
      • Breasts that are their usual shape, size and color
      • Evenly shaped breasts without distortion or swelling
    • Alert your doctor if you notice:
      • Dimpling, puckering or changes, particularly on one side
      • Inversion or pulling of the nipple
      • Redness, soreness, rash, or swelling

 

  1. Breast Self-Examination - BBNRaise your arms above your head and look for the same signs.

 

 

 

 

  1. Look in the mirror for any signs of discharge coming out of one or both nipples (water, milky, or yellow fluid or blood).

 

  1. Breast Self-Examination - BBNFeel the breast tissue while lying down on your back. This allows the breast tissue to spread evenly along the chest wall. Place a folded towel or pillow under your shoulder. Use your right hand to feel your left breast and then your left hand to feel your right breast. Apply light, medium, and firm pressure with the first few fingers pads of your hand, keeping the fingers flat and together. Gently examine the entire breast area and armpit using circular motions, about the size of a quarter. Cover the entire breast from top to bottom: side to side –  from your collarbone to the top of your abdomen, and from your armpit to your cleavage.  Squeeze the nipple and check for discharge.
  1. Breast Self-Examination - BBNFeel your breasts while standing or sitting. Cover your entire breasts with the same hand movements described in step 4. Some women prefer to do this step in the shower, when their skin is wet and slippery.

 

 

 

Here are some other helpful tips to consider:

  • Pick the same day of the month. Monthly hormonal fluctuations can affect breast tissue, so it is important to select the same day of the month to distinguish between normal and irregular breast changes.
    • Premenopausal women: Perform self-exams toward the end of your menstrual period, when the breasts are least tender.
    • Postmenopausal women: Choose a memorable day of the month (1st or 15th) and consistently perform your exam on that day each month.
  • Follow a pattern during your exam. For example, imagine the face of a clock over your breast, or move your fingers vertically in rows as if you were mowing a lawn.
  • Start a journal where you record findings of your self-exams. This may help you remember what is “normal” in your breast, especially around times of menstruation, or distinguish when a lump is abnormal.
  • Here are links to some videos that help visualize the breast self-exam: https://www.youtube.com/watch?v=clOEgvgUxfk and https://www.youtube.com/watch?v=LrfE6JUwIms (see videos at the the bottom of the page)

Performing breast self-exams does not replace annual mammograms or clinical breast exams. However, self-exams in conjunction with other screening methods can increase the odds of early detection and improve chances of survival. Most breast changes detected during a self-exam have benign causes, however, there is a chance it may be linked to something more serious, so always be sure to alert your doctor right away. Share this information with your mother, sister, aunt, or friend. Early detection could save a life.

Resources

Breast Self-Exam. (n.d.). Retrieved May 27, 2020, from https://www.nationalbreastcancer.org/breast-self-exam

Breast self-exam for breast awareness. (2018, July 3). Retrieved from https://www.mayoclinic.org/tests-procedures/breast-exam/about/pac-20393237

Breast Self-Exam: How to Check for Lumps and Other Breast Changes. Breastcancer.org. (2019, October 24). https://www.breastcancer.org/symptoms/testing/types/self_exam

Brown, K. (2017, March 6). Breast Self-Exam Guidelines: Johns Hopkins Breast Center. Retrieved from https://www.hopkinsmedicine.org/breast_center/treatments_services/breast_cancer_screening/breast_self_exam.html