October is Breast Cancer Awareness Month

Saturday, October 17, 2020 3:01 PM | Amy Habeck
  • October is Breast Cancer Awareness Month

    Chat with an RDN Breast Cancer Specialist

    By Marissa Lau, WRDA Student Volunteer

    PACE University Graduate Student, MS 2022

    October 9, 2020

    October is Breast Cancer Awareness Month and is recognized internationally to spread awareness of breast cancer.1 Many foundations, organizations, and charities worldwide, use this month to educate people about this disease as well as to gain support and funds for research associated with breast cancer.1  

    What Is Breast Cancer?

    Breast cancer is a disease where atypical cells in the breasts are unable to stop multiplying and can spread to other nearby tissues.2,3 There are different types of breast cancer including ductal carcinoma, lobular carcinoma, and Paget’s disease which form in the milk ducts, the breast’s milk-producing lobules, and the skin of the nipple, respectively.4 Symptoms of breast cancer include:

  • ·              Changes in the size, shape, or appearance of the breast4,5
  • ·              Development of a lump or thickening in the breast that feel different (lumps can form in the underarm as well)4
  • ·              Nipple discharge other than breast milk, such as blood4
  • ·              Irregular skin texture around the pigmented area of the nipple, such as peeling or flaking5
  • As one of the most common cancers in women, there are approximately 1.38 million new cases diagnosed globally every year and 458,000 breast-cancer related deaths. Research continues its struggle in ascertaining the cause of the disease.1

    Causes, Risk Factors, And Risk Reduction in Breast Cancer

    Researchers speculate that rather than being caused by a single trigger, breast cancer development is caused by multiple interactions between a person’s genetic makeup, environment, and lifestyle.1,2 Prioritizing early detection is the primary recommendation for improving disease outcomes since the early stages of breast cancer are easier to treat, and these patients are more likely to be cured.1 As of now, mammography, taking an X-ray picture of the breast, is the best method to screen for breast cancer.6 Routine screening is especially important for people who have certain risk factors including, being female, being over the age of 50, being obese, and having genetic changes to BRCA1 or BRCA2 genes.3,5 Individuals aged 75 or older should consider refraining from routine breast cancer screenings since the screenings themselves can be harmful to an older individual’s health.7

    Breast Cancer: A Clinical Dietitian Nutritionist’s Point of View

    Cara Anselmo, MS, RDN, CDN, is a clinical dietitian nutritionist and breast cancer specialist at Memorial Sloan Kettering Cancer Center (MSKKCC). I was fortunate enough to ask her a few questions about her input on breast cancer and her role as an RDN at MSKKCC.

    Cara treats her patients on an individual basis to ensure that they are well-nourished and have a good nutritional status after receiving surgery or treatments. Such treatments include chemotherapy, radiation therapy, endocrine therapy, and biologic therapy. These treatments kill off cancer cells, but they also may cause a variety of side effects which vary, depending on the type of treatment and cancer. Cara helps breast cancer patients manage weight gain, which is a common treatment side effect. This is unique to breast cancer treatment because most cancer patients tend to lose weight. Cara helps patients lose and maintain an appropriate weight after treatments.

    Some research has suggested the use of ketogenic diets for breast cancer patients receiving chemotherapy, and these diets are gaining popularity among those in the general public who wish to lose weight.8,9 Cara feels there is not enough research to recommend ketogenic diets to her patients. She also referred to pre-clinical studies that suggest that high fat diets may increase the risk of breast cancer. Upon further research, I found a study which speculated that increased consumption of saturated fats can increase the risk of breast cancer.10 Therefore, ketogenic diets which mainly rely on proteins and fats, may be harmful for those who have breast cancer or who are at risk for the disease.11

    Cara stays informed of emerging research on weight management and breast cancer in post-menopausal women. She recommended the work of Jennifer Ligibel, M.D., a Harvard researcher specializing in this area. According to Cara, appropriate weight management is key to reducing risk, and that body compositions consisting of high proportions of fat can also increase risk. She provided some tips that can lower one’s risk for breast cancer:

  • ·      Eat whole-food diets that include more plant-based foods, limit added sugars, and limit processed/red meats
  • ·      Maintain a healthy body weight and body composition
  • ·      Stay physically active
  • ·      Limit alcohol
  • Diets To Reduce The Risk of Breast Cancer

    Below are some eating plans that include more plant-based food components, which research suggests may help reduce the risk of breast cancer:

    DASH Diet12,13

    The DASH acronym stands for Dietary Approaches to Stop Hypertension. This diet was designed to lower blood pressure without the use of medication. The Nurses’ Health Study followed 86,621 women for over 25 years and found an association between the DASH diet and a lower risk of developing breast cancer. Below are the DASH diet recommendations:

  • ·      Grains, 6 to 8 servings, daily
  • ·      Vegetables, 4 to 5 servings, daily
  • ·      Fruits, 4 to 5 servings, daily
  • ·      Dairy, 2 to 3 servings, daily
  • ·      Lean meat, poultry, and fish, 6 one-ounce servings or fewer, daily
  • ·      Nuts, seeds, and legumes, 4 to 5 servings, weekly
  • ·      Fats and oils, 2 to 3 servings, daily
  • ·      Sweets, 5 servings or fewer, weekly
  • ·      Limit intake of alcohol and caffeine
  • Mediterranean Diet14,15,16

    Several studies have found an association between adherence to the Mediterranean diet and reduced risk of breast cancer in both pre- and post- menopausal women. The Mediterranean diet consists of:

  • ·      Vegetables, fruits, whole grains, and healthy fats, daily
  • ·      Fish, poultry, beans, and eggs, weekly
  • ·      Moderate intake of dairy and dairy products
  • ·      Limited intake of processed and red meat
  • The New American Plate17

    The American Institute for Cancer Research has new recommendations for healthy meals, called “The New American Plate,” that focus on cancer prevention. These guidelines consist of:

  • ·      3 ounce serving of meat (such as fish, poultry, or red meat)
  • ·      Two types of vegetables
  • ·      An appropriate serving of a whole grain (such as brown rice, barley, or quinoa)
  • References

  • 1.     Breast Cancer Awareness Month in October. who.int. https://www.who.int/cancer/events/breast_cancer_month/en/. Accessed October 1, 2020. 
  • 2.     Nelms M, Sucher KP. Nutrition Therapy and Pathophysiology. 4th ed. Boston, MA: Cengage; 2020.​
  • 3.     Breast Cancer. mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/breast-cancer/symptoms-causes/syc-20352470. Published November 9, 2019. Accessed October 4, 2020.
  • 4.     Breast Cancer. mskcc.org. https://www.mskcc.org/cancer-care/types/breast#what-is-breast-cancer-. Accessed October 4, 2020.
  • 5.     Breast Cancer Awareness. cdc.org. https://www.cdc.gov/cancer/dcpc/resources/features/breastcancerawareness/index.htm. Accessed October 1, 2020.
  • 6.     What Is a Mammogram?. cdc.org. https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm. Accessed October 6, 2020.
  • 7.     Older Americans receive cancer screenings past recommended age. news.psu.edu. https://news.psu.edu/story/627134/2020/07/29/research/older-americans-receive-cancer-screenings-past-recommended-age#:~:text=%E2%80%94%20Older%20Americans%20may%20be%20receiving,colorectal%2C%20cervical%20and%20breast%20cancers. Published July 29, 2020. Accessed October 1, 2020.
  • 8.     Khodabakhshi A, Akbari ME, Mirzaei HR, Mehrad-Majd H, Kalamian M, Davoodi SH. Feasibility, Safety, and Beneficial Effects of MCT-Based Ketogenic Diet for Breast Cancer Treatment: A Randomized Controlled Trial Study. Nutr Cancer. 2020;72(4):627-634. doi:10.1080/01635581.2019.1650942
  • 9.     Khodabakhshi A, Seyfried TN, Kalamian M, Beheshti, Davoodi SH. Does a ketogenic diet have beneficial effects on quality of life, physical activity or biomarkers in patients with breast cancer: a randomized controlled clinical trial. Nutri J. 2020;19(87):2020. https://doi.org/10.1186/s12937-020-00596-y
  • 10.  Zhu Y, Aupperlee MD, Haslam SZ. Schwartz RC. Pubertally Initiated High-Fat Diet Promotes Mammary Tumorigenesis in Obesity-Prone FVB Mice Similarly to Obesity-Resistant BALB/c Mice. Transl Oncol. 2017;10(6):928-935.
  • doi: 10.1016/j.tranon.2017.09.004
  • 11.  Ketogenic diet: Is the ultimate low-carb diet good for you?. health.harvard.edu. https://www.health.harvard.edu/blog/ketogenic-diet-is-the-ultimate-low-carb-diet-good-for-you-2017072712089. Published July 27, 2017. Accessed October 6, 2020.
  • 12.  Fung TT, Hu FB, Hankinson SE, Willett WC, Holmes MD. Low-carbohydrate diets, dietary approaches to stop hypertension-style diets, and the risk of postmenopausal breast cancer. Am J Epidemiol. 2011;174(6):652-660. doi:10.1093/aje/kwr148
  • 13.  DASH diet: Healthy eating to lower your blood pressure. mayoclinic.org. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456. Accessed October 8, 2020.
  • 14.  Mourouti N., Kontogianni M.D., Papavagelis C., Plytzanopoulou P., Vassilakou T., Malamos N., Linos A., Panagiotakos D.B. Adherence to the Mediterranean diet is associated with lower likelihood of breast cancer: A case-control study. Nutr. Cancer. 2014;66:810–817. doi: 10.1080/01635581.2014.916319.
  • 15.  Turati F, Carioli G, Bravi F, et al. Mediterranean Diet and Breast Cancer Risk. Nutrients. 2018;10(3):326. 2018. doi:10.3390/nu10030326.
  • 16.  Mediterranean diet: A heart-healthy eating plan. mayoclinic.org. https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801. Accessed October 8, 2020.
  • 17.  New American Plate Setting Your Table to Prevent Cancer. aicr.org. https://www.aicr.org/cancer-prevention/healthy-eating/new-american-plate/. Accessed October 1, 2020.

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