Breast Health: Building Awareness
This morning, as I slipped into my underwire, c-cup-with-a-hint-of-padding Donna Karan bra, I realized, again, that I have yet to find the perfect-fitting brassiere. No, I am not seeking a nature-defying, power-boobs effect (I need to be able to see the book in my lap, for starters) nor am I negating DKNY’s efforts to help us in the support department. Rather, in years of quizzing my doctors and reading reams of material on the subject of breasts, I have realized how important a really good bra is to breast health (not to mention comfort). But more about that later. First, a disclaimer: I am not a physician, I don’t even have Red Cross training and, despite having read many physician-authored texts, from Andreas Vesalius’s De Humani Corporis Fabrica (1543) to Christian Northrup’s Women’s Bodies, Women’s Wisdom (3rd ed., 2006), I couldn’t begin to draw a basic diagram of the breast’s ducts, muscles, and lobes. Thus, I am not dispensing medical advice, but sharing information about breast health that I have gleaned over many years of obsessive research and discussion.
According to the American Cancer Society, in 2009 approximately 192,000 “cases of invasive (i.e., carcinogenic cells have invaded surrounding tissue) breast cancer will be diagnosed among women” and an additional 62,000 “cases of in situ (carcinogenic cells have not spread to surrounding areas) cancer” will also be discovered. We do not know yet what the actual numbers turned out to be. What is known, of course, is that the earlier cancer is detected and treated, the greater the chances for survival. Which brings me to the topic of detection and some of the methods currently available. For over two decades, women have been told that mammograms are the surest way to detect cancer in its early stages—“early” meaning before one is able to feel a lump via a manual exam (and how many of us do those important monthly self-exams?). Mammographies, in fact, have picked up many Stage 1 cancers, as well as those that have progressed much further. Orthodox medical guidelines state that a woman should get a baseline screening at age forty and then have follow-up mammographies each year. While mammograms continue to be touted by many physicians as the best method for the early detection of breast cancer, the safety and effectiveness of this screening tool are being debated more and more within the medical community. For example, there have been many instances of both false positives and false negatives, which, in turn, have led to unnecessary biopsies—or, in the latter case, led to fatal consequences. Also, if a woman has dense breast tissue, a mammogram might not be able to detect a tumor until it is large.
Mammographies, moreover, are x-rays and x-rays contain radiation, a known carcinogen. But isn’t the risk of supposedly minimal exposure to radiation a small price to pay if disease can be uncovered, you may ask? Each person has to answer that question for herself (preferably in consultation with her doctor, after she has done some of her own research), though I will note some recent findings. In 2002, for instance, the British medical journal, The Lancet, published the results of a Swedish study, which revealed that routine screening (vs. diagnostic) mammograms in women under fifty are overused and overrated. Further studies in Europe and the United States support this claim; indeed, in October 2009, Dr. Otis Brawley, chief medical officer for the American Cancer Society, stated in The New York Times “that American medicine has overpromised when it comes to screening. The advantages to screening have been exaggerated”
(http://www.theatlantic.com/doc/200911u/mammograms). In Breast Cancer? Breast Health! (for which Dr. Northrup wrote the foreword—think what you may of Northrup’s New Age style, she is still a physician), Susan S. Weed writes, “The American Cancer Society claims that the radiation danger from a screening mammogram is no more than that caused by natural radiation in the environment. Not so. The amount of radiation from even one breast x-ray is 11.9 times the yearly dose absorbed by the entire body, according to Diana Hunt, former saleswoman for an x-ray manufacturing company, UCLA Medical Center graduate, and senior staff x-ray technologist for 20 years.”
Am I denouncing mammograms? Certainly not. The doctor’s daughter in me respects science and is excited about advances in medical technology. However, there appears to be enough peer-reviewed material to suggest that routine mammograms—especially for women in low-risk categories—are not always the safest or most effective screening tool.
Other screening tools include sonograms which gather images using sound waves rather than radiation, and digital mammography, which, like its conventional counterpart, still emits radiation but purportedly is more effective in screening dense breast tissue for abnormalities. There is also a test known as thermography. This FDA-approved test takes a digital infrared image of the breasts and produces a colored “map” of their thermal patterns. Abnormal heat areas (i.e., potentially cancerous or precancerous “hot spots”) can then be further tested via mammograms, sonograms and/or biopsies. While advocates of thermography seldom state that it should supplant more conventional technologies, they do claim that regular thermographies can accurately chart changes in heat patterns and thus help a patient detect problematic areas before a malignant tumor has begun to grow. It should be noted that this technology does not fall under the rubric of naturopathic medicine, but is rooted in science. Moreover, theses images, while taken by thermographers, are interpreted by physicians.
I have been discussing ways of finding disease, but would like to conclude on the more positive subject of trying to promote breast health. We have all heard that cruciferous vegetables like broccoli, kale, and cauliflower should be part of our regular diets and that hormone-fed animals that end up on our plates can raise our estrogen levels. One also should reduce dietary fat intake and reduce or eliminate dairy products (which some studies link to elevated levels of estrogen).
Again, please do some research yourselves, but my own physician advises women to avoid dairy. Exercising regularly also helps the body to reduce fat and expel toxins, not to mention reduce stress, which many scientists argue is a contributing factor to various breast diseases.
And, finally, back to brassieres. A tight-fitting bra that leaves marks not only can make it difficult to absorb the ideas of (the other) Marx, it also impedes the flow of lymphatic fluid, hence the optimum expulsion of the body’s toxins. Underwire—that vestige of corsetry that nonetheless keep things buoyant—is an impediment to lymphatic drainage. Similarly, anti-perspirant—by succeeding in what its name implies—prevents the elimination of toxins. Deodorant does not pose the same problem.
My final bit of advice? Talk to your doctor—talk to several doctors. Be a pest if you have to. Read The Lancet. Google your heart out. Visit Macy’s and Victoria’s Secret and try on every bra. And by all means, keep this conversation going.
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