It’s Time to Talk about Breast Cancer (And How We Can Help)

As National Breast Cancer Awareness Month is rapidly approaching…

And as we recently invested heavily in some new imaging equipment to help women battle this pernicious disease, I want to focus on why breast cancer has become one of those diseases we seemingly can’t get away from.

The good news about breast cancer is that treatment has improved dramatically in the past few decades, and more women are being diagnosed.

Which is a good thing, because it means more women can get ahead of the disease and survive.

The American Cancer Society reports that breast cancer incidence in the United States has been increasing by about 1% per year in recent years.  Much of that is due to the push to get screened and the growing attention the national news media is paying to the disease.

The truth is, among women younger than 50, the increase has been a little faster, around 1.4% per year.

At the same time, breast cancer death rates have fallen 44% since their peak in 1989, largely because of earlier detection and better treatment.

That’s encouraging, to be sure, but the rising number of diagnoses still deserves a serious look. 

Especially to see why it’s happening!

The Integrative Reason Explaining The Rise

In functional medicine, we spend a lot of time looking upstream. What is creating the environment in which disease becomes more likely?

With breast cancer, while there is no single answer…we can make assumptions about some of the leading causes.

Age remains one of the biggest risk factors. And yes, genetics matter. Some women inherit variants in genes such as BRCA1 or BRCA2 that can substantially increase their risk.

But genetics are only one part of the story.

Breast cancer risk is also associated with alcohol consumption, physical inactivity, excess body weight after menopause, certain forms of menopausal hormone therapy, breast density, and reproductive factors that affect a woman’s lifetime exposure to estrogen and progesterone.

Other factors like having their first child later in life, having fewer pregnancies, early menstruation, and later menopause can all influence cumulative hormonal exposure.

I also think it’s fair to talk about a category of risk that sometimes gets dismissed as a little too “crunchy”: our chemical environment.

We’re exposed every day to substances that can interact with the endocrine system, including compounds found in some plastics and food packaging, pesticides, personal-care products, PFAS, and other persistent chemicals.

Because breast tissue is highly responsive to hormones, researchers have been asking whether some of these endocrine-disrupting chemicals could influence breast development or cancer risk by mimicking, blocking, or altering normal hormonal signals. The biological case is plausible, and laboratory, animal, and some human epidemiological studies have raised legitimate concerns.

The Endocrine Society has reviewed evidence involving compounds such as PFAS and parabens, among others.

At the same time, the National Cancer Institute notes that, for many individual environmental chemicals at the exposure levels most people encounter, the human evidence linking a specific chemical to breast cancer is still inconclusive.

So I wouldn’t tell a patient that throwing out every plastic container will prevent breast cancer…but I also don’t think it makes sense to assume our changing chemical environment has nothing to do with a hormone-sensitive disease.

Reducing unnecessary exposure where it’s practical is reasonable; fear and obsession are not.

None of that means a woman caused her breast cancer.

Risk factors are not guarantees of future illness.

Some health-conscious people develop this disease, while others with multiple risk factors remain healthy for decades.

Biology rarely follows a simple equation.

Still, saying we cannot control everything is very different from saying we cannot influence anything.

Here’s How to Improve Breast Health Before There’s a Lump

This is where I think an integrative approach has value.

I don’t view prevention as taking one supplement or eating one special food. It’s foolhardy to think that would work.

I think of it more like tending the soil. 

The goal is to create the healthiest biological environment we reasonably can over years, not to chase a quick fix for a disease that develops through a complicated mix of genetics, hormones, metabolism, aging, and chance.

Regular movement is one of the more useful places to start.

Physical activity is associated with a lower risk of breast cancer, and it also supports insulin sensitivity, body composition, cardiovascular health, bone health, and mood.

If you maintain a healthy weight, particularly after menopause, it can positively affect metabolic signaling and estrogen exposure that play a role in breast cancer.

Limiting alcohol matters too; breast cancer risk rises as alcohol intake increases.
Women should also pay attention to sleep, nutrition, and stress because they affect the whole person.

But I’m careful about what I promise.

There is not strong clinical evidence showing that a particular diet, supplement, or stress-management technique can prevent breast cancer in an individual woman.

Healthy habits may improve overall physiology and reduce certain risks, but they don’t make you immune to cancer.

Integrative Care Can Also Support Women During Treatment

Once breast cancer has been diagnosed, the conversation changes.

Surgery, radiation, chemotherapy, endocrine therapy, and targeted therapies are used because they have evidence for treating cancer.

Integrative medicine should work alongside that care, not compete with it.

I know people argue that you should forgo chemo, radiation, and the other treatments and just drink ”Apple Cider Vinegar” to cure yourself.

I wish that were true.

And while I can’t come up with a universal treatment plan on the spot, I’ll hang my hat on the claim that supportive integrative therapies have been studied in women undergoing breast cancer treatment and help immensely.

This is where integrative oncology can get more individualized.

Supplements may help when there is a clear reason to use them, such as correcting a deficiency or addressing a specific treatment-related symptom. But more is not better. Some supplements can interfere with medications, and strong evidence for many commonly promoted products is still limited.

Repurposed medications are another interesting area. These are older drugs originally developed for other conditions that may affect pathways involved in cancer. Metformin is a good example. Its effects on insulin signaling and cellular metabolism made it biologically interesting, but a large randomized breast cancer trial did not show improved disease-free survival in patients without diabetes. (JAMA — DOI)

IV therapies deserve the same caution. Intravenous vitamin C can achieve blood levels far beyond oral dosing, and early studies have explored possible effects on symptoms and quality of life. But the evidence remains limited, and it is not an established cancer treatment. (National Cancer Institute)

The better question is always: What problem are we trying to solve, what does the evidence support, and could this interfere with the treatment doing the heavy lifting?

A Society for Integrative Oncology guideline endorsed by the American Society of Clinical Oncology found evidence supporting meditation, stress management, yoga, and music therapy for anxiety and stress as ways to heal from cancer.

Meditation and yoga also have evidence for improving quality of life, while acupuncture and acupressure may help with chemotherapy-related nausea and vomiting in appropriate patients. 

Exercise deserves special attention here.

ASCO’s guideline on exercise during active cancer treatment recommends regular aerobic and resistance exercise for many patients receiving curative treatment. Across clinical studies, exercise has been shown to reduce fatigue and help preserve strength, physical function, and cardiovascular fitness. In some groups, it also improves quality of life, anxiety, and depression.

What it has not been proven to do during treatment is improve cancer control or survival. I think that’s an important distinction. Exercise can make the body more resilient during a difficult season without pretending it is chemotherapy in sneakers.

The evidence for specific diets and intentional weight-loss programs during active cancer treatment is much less developed. I know social media is filled with people who make all kinds of cancer claims related to a certain diet.

Again, I would love to believe these claims are true.

But I don’t want to sell people on a silver bullet that doesn’t exist.

Nutrition still matters, of course. Adequate protein, enough calories, stable blood sugar when possible, and maintaining muscle can all be clinically important. But the right nutritional strategy depends heavily on the person, the treatment, and what her body is tolerating.

Sometimes the healthiest-looking diet on paper is completely unrealistic for someone who is nauseated, losing weight and struggling to eat.

That’s why individualized care matters.

A woman can exercise, eat well, manage stress, and pay attention to her metabolic health.

She still cannot feel every change developing inside breast tissue.

That is why breast health also depends on appropriate screening and imaging.

I think prevention is sometimes framed too narrowly, as if it only means what we eat or which supplements we take.

Good prevention also means gathering useful information early enough to act on it. In fact, it’s one of the more important things we can focus on! 

That thinking is one reason Robinhood invested in a newer breast-imaging technology called QT Breast Acoustic CT.

The system uses ultrasound rather than X-rays and images the breast while it is suspended in a water bath, so the scan does not require breast compression; instead, it uses reflection and transmission ultrasound to produce volumetric breast images.

I’m intentionally not going deeply into that technology in this article because it deserves its own discussion…but to that end, I think this new technology can help women who are looking for alternative ways to combat breast cancer with another arrow in their quiver. 

The bigger point though is this: breast health is rarely about one intervention.

It involves understanding risk, working on the factors we can influence, supporting the body through treatment when treatment becomes necessary, and using good information to make better decisions.

We cannot control every variable in breast cancer.

But we can do quite a bit with the variables in front of us.

In the next article, I’ll explain why Robinhood made such a significant investment in this breast-imaging technology, how it works, and why it was worth bringing to Winston-Salem.