The Truth About Breast Cancer Risk

Despite excellent advances in detection and treatment, the specter of breast cancer dominates many decisions about hormone supplementation around and after menopause. While breast and uterine cancer can occur at any age after puberty, the statistics seem to show that the likelihood for developing one of these hormone related cancers increases with age, especially post menopause. Estrogen still gets a bad rap as the cause of breast and uterine cancer, so let’s look at these issues in more detail.

Statistics can be confusing. One set of statistics can indicate one picture, and another set of statistics suggests something completely different. Take for example, the oft quoted statistic that 1 in 8 women will get breast cancer at some point in her life. When we look at that number, it can be quite disturbing to think that the breast cancer incidence rate is this high. However, statistics from the same set of reports also provide this information:

• a 30-year- old woman has a risk of developing breast cancer in the next decade of 1 in 204 (0.5%)
• a 40-year-old woman has a decade risk of 1 in 65 (1.5% risk)
• a 50- year-old woman has a decade risk of 1 in 42 (2.4% risk)
• a 60-year-old woman has a decade risk of 1 in 28 (3.6% risk)
• a woman over 70 has the highest risk, 1 in 24 (4% risk)

The statistical risk in any decade of life is never more than 1 in 24, and that’s in the 70+ age range. We have to remember that statistics are always going to be influenced by the sample sizes used, the health of people in the sample, and any other range of factors which can cause cancerous cells to develop. So, while the statistic 1 in 8 chance of getting breast cancer is definitely attention grabbing, other statistical analysis suggests that for the average woman, the likely highest chance of a getting breast cancer is when she is over 70. While it’s true that the risk of developing breast cancer does increase with age, it is also true that the risk of developing a wide range of other health conditions and diseases also increase with age … particularly heart disease, osteoporosis, and dementia.

Regardless of risk, it is important to remember that now detection is so much better than it ever has been! Ninety percent of women diagnosed with early breast cancer will survive without a mastectomy or chemotherapy. 

To understand the wide range of factors that can affect cancer cell growth, we must look at the environment those cells attempt to grow in. Cancer cells need damaged DNA, sugar (glucose), an acidic environment, and lots of toxins which will damage the DNA. A combination of all these things will create a “dirty” or inflammatory environment where cancer cells can grow faster than the immune system can knock them out. When this happens, cancer cells can cluster together and start forming a mass called a tumor.

When we are younger, our internal cleaning processes (the immune system) are good at destroying cancer cells before they start to build a mass and grow blood vessels. Kiddies do get cancer, but these cancers are most often related to a genetic mutation. We’re not talking about these types of cancers; we’re talking about the increased risk for normal DNA being damaged and spinning out of control into cancer cell development.

As we get older, our lifestyle choices, food choices, and the natural process of aging make it harder for the immune cells to keep up. Here is a list of all the factors that can increase the risk of creating an inflammatory environment where DNA can be damaged and where cancer cells can grow and flourish:

Factors That Can Increase Cancer Cell Growth

Lifestyle & Diet	Nutritional Deficiency	Emotional	Toxicant Risk	Genetic
high inflammatory	low iodine	unexpressed grief	exposure to xenoestrogens	BRAC1/ BRAC2 gene
diet	low vitamin D	over giving	synthetic HRT	BRAC1/2 plus family history
smoking	low selenium	emotional shock	exposure to BGH in milk
excess weight	low antioxidant diet	learned helplessness	environmental toxicant exposure
alcohol consumption	low magnesium	race/ power/ social inequities	birth control
lack of exercise	low omega 3 fats
not having children
low fiber diet
high glycemic diet
diet high in starchy carbohydrates
high breast density
high level of anxiety and stress

That’s 30 items in this list that, individually may not seem too much of a risk, but collectively will steadily increase risk of creating an inflammatory environment where cancer cells can gain some ground. It’s like the more of these factors exist, the grubbier cells are on the inside of the body, and in this grubbiness, things go wrong.

So—Does Estrogen Cause Cancer?

Ever since the Women’s Health Initiative (WHI) study was stopped in 2002, supposedly because synthetic estrogen increases the risk of invasive breast cancer, there have been misunderstandings about the role of hormones post menopause. In 2002, the press leapt upon this situation and the buzz was crazy. Close to 70% of women stopped taking their synthetic HRT over the next seven years. The big challenge was that although statistics can identify a possible increase in risk, that does not always translate into a medical increase in risk.

Many of the statistical analyses from the WHI were misinterpreted for years. In the meantime, the recurrent message was that estrogen causes cancer. This statement just doesn’t make sense! If estrogen caused cancer, women from puberty onwards would be dropping like flies. And they don’t. What was rarely discussed was the negative effects women experienced through not using some form of hormone replacement.

Patients in the WHI study continued to be followed for more years and nothing indicated any increased risk of developing breast cancer; however, this news did not make the headlines. It’s important to note that no long-term study has ever been conducted on women’s use of bioidentical hormones, basically because no one (such as a pharmaceutical company) will pay for it. Women have, however, been using bioidentical estrogen, progesterone, testosterone, and DHEA very successfully and very safely for decades. Studies do exist, and while not very large, they are robust enough to demonstrate that when used in balance and dosed appropriately, millions of women benefit from bioidentical hormone replacement.

Why Does the Misunderstanding Continue?

It may come as a surprise that most family practice doctors have less than 10 hours of training on how to work with hormones post menopause. This area of health is not a specialty. Medical professionals may not have had training on bioidentical hormones, and as a result, may base treatment decisions on what they have learned from pharmaceutical reps about synthetic HRT. Consequently, an uninformed medical field and an eager pharmaceutical company can perpetuate the myth that estrogen can cause cancer, and while HRT can be helpful with symptoms during the menopause transition, get women off them as soon as possible.

Progestin v Progesterone

There are many doctors who don’t understand the difference between bioidentical progesterone and the often harmful progestins made by pharmaceutical companies. Doctors do understand that progestins are harmful and, when combining that with a lack of understanding of the role of inflammation in the body, they decide to advise patients against using any hormones post menopause. Progesterone is an important counterbalance to estrogen. Estrogen, balanced with progesterone, can be used safely for many years post menopause without increasing the risk of breast cancer development. Women are well served when they are advised to worry less about estrogen use and more about their overall risk factors for developing inflammation and DNA damage.

Conclusion

We all have the potential to develop cancer … our cells are constantly mutating, making precancerous cells, and being cleaned up by the immune system. It’s only when we create the right inflammatory conditions for those cells to grow exponentially that a mass can begin to grow. Yes, genetics can play a part, but for most of us, we get to be in control of whether explosive growth happens or not. Estrogen can play a role in breast cancer growth, but it is a small component in the overall picture of risk. The actions we take concerning our health can increase or decrease the chances of developing cancer. When you look at that list of potential risk factors, you will get some good ideas on how you can keep your own risk to a minimum.

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