The Unknown Facts About Breast Cancer You May Not Know

Breast cancer, the second-most common malignancy among women worldwide, has an impact on everyone. (Only non-melanoma skin cancer comes in second.) If you haven't experienced it personally, you probably know someone who has. You start to realise that you might also be at risk the more breast cancer survivors you know.

Dr Disha Sridhar

I am a Gynaecologist Obstetrician ( MD, DNB OBGYN) with an emphasis on INTEGRATIVE MEDICINE.

I have treated several patients with breast cancer who sought my assistance as an obstetrician/gynaecologist. When a patient receives a new diagnosis, I always inquire as to "why or how you got breast cancer."

In almost every case, it turns out that the fundamental ROOT CAUSE problem was never addressed.

And believe me when I say that everything changes once we determine the root causes of my patient's breast cancer. She gains confidence and stops feeling helpless. 

The issue is that the majority of women are unaware of ways to lower their risk.

While there is unquestionably a hereditary component to getting breast cancer, and some known environmental and lifestyle factors can contribute, much of the "why" behind a breast cancer diagnosis for any woman is still unclear. Although there is a growing list of potential contributing factors, the specific causes of the great majority of breast cancer occurrences (estimated to be as high as 70%) remain unknown.

I address the ROOT CAUSE in the patients who have sought my assistance over the years after receiving a breast cancer diagnosis. I do consider bioidentical hormones to these ladies since many of them could no longer treat menopausal or vaginal health issues with estrogen hormone therapy.

I would discuss with them any possible underlying root reasons that might have influenced the development of their breast cancer, or that could provide a concern going forward in the course of their breast cancer therapy.

Many people have been startled to learn that there are some risk factors that we can influence (beyond the generally known lifestyle factors such as not smoking, etc.). Knowing that you have options is motivating! Suppose you have already been diagnosed with breast cancer. In that case, it can be comforting to know that you no longer need to wait for the other shoe to drop or for the next diagnosis because you can feel confident in acting and better-protected thanks to the ongoing research.

Today, I'd like to discuss a potential risk factor for breast cancer that you might not be aware of: the health consequences of the countless bacteria that live inside of you. These unique microbes comprise a diversified community of fungi, bacteria, viruses, and archaea.

I know that sounds disgusting, but thankfully most of them are wonderful people. It would be best if you took care of them since they can influence cancer onset, progression, and aggressiveness when they are out of balance or otherwise negatively affected. According to studies, microorganisms may be responsible for all cancer types globally, or potentially more, 16–18%, or potentially more.

There are various microbe species, and each resides in a different body region (gut, mouth, urogenital, vagina, skin, and even breast tissue, etc.). Others raise the risk of infections, inflammation, and cancer. Some bacteria are protective. How a woman reacts to certain cancer treatments or medication therapy may depend on her microbiome.

When estrogen is successfully detoxified or recirculated in a woman's body, it depends on specific microorganisms. These hormone-driven microorganisms have been linked to additional risk factors for breast cancer, including those related to ageing (particularly in people over 50) and obesity.

Recent studies have shown that the mammary microbiome, which includes breast tissue and the nipple, does exist and may be connected to a woman's risk of developing breast cancer.

Today's article will cover the following topics:

●        Risks of breast cancer that you can change.

●        The world of the oncobiome (microbes and their influence on cancer).

●        The estrobolome (microbes and their influence on estrogen).

●        Breast cancer, obesity, insulin control and the microbiome.

●        Protection measures against breast cancer.

Changing your breast cancer risk factors

Throughout their lifetime, one in eight women will acquire breast cancer. Additionally, 1 in 883 men will be affected.

However, how do you recognise and alter your risks?

Some risks are absolutely impossible to avoid (including gender, age, high breast density, family and reproductive history, and genetic "susceptibility").

Making deliberate lifestyle adjustments, however, will help you reduce various other modifiable hazards. I'll go over a few of these in this post. Still, the good news is that by concentrating on lowering generalised inflammation and boosting your immune system, you may lower your risks for all illnesses, including breast cancer.

Genetics, family and reproductive history:

Your chance of developing breast cancer might be influenced by your genetic makeup and general family history of the disease. This blog on preventing breast cancer lists the many family relationships that could raise your risk, like having a mother, sister, or daughter with the condition.

Although genetic "susceptibility increases your risk," it's crucial to remember that most women who get breast cancer do not have a family history of the condition.

Although having a close relative who has breast cancer indeed increases your risk (approximately 15% of breast cancer patients have a family member who has it), genetic expression can be changed. How you spend your life can affect whether or not genetic risks are activated (this is called epigenetics).

Consider epigenetics as various interpretations of a certain set of genetic codes, one of which results in an elevated risk of breast cancer and the other not. Through epigenetics, elements including food, exposure to endocrine disruptors like heavy metals, smoking, binge drinking, and stress (among others) can all have an impact on a highly technical genetic process called DNA methylation, which in turn affects how inheritable genes are expressed.

Other families and reproductive characteristics can also affect risk. On websites dedicated to treating cancer, like the Susan G. Komen website, you can get more detailed information on determining your risk based on genetics, family history, and reproductive history.

But realising the potential risk variables you may influence gives you authority; you must take action.

Environmental and lifestyle factors (modifiable risk factors):

Environmental and lifestyle influences are things you can change or remove. It includes oral contraceptive usage, high alcohol consumption, poor diet, obesity (and insulin regulation), sedentary behaviour, chronic stress, periodontal disease, radiation exposure, and exposure to hormone disruptors such parabens and other chemicals in the air, food, and personal care items. These factors collectively may raise your total risk. But keep in mind that you have the power to decide whether or not to do so.

Emerging factors influencing a woman's risk for breast cancer:

Recent research adds new areas of research focus: how the body's microbes affect overall inflammation and immune system health, particularly how that has been linked to breast cancer. The dangers brought on by a compromised microbiome are modifiable.

First, let's go over the definitions of bacteria, the microbiome, and the connections between these two concepts and cancer.

The world of the oncobiome

There are trillions of bacteria in your body, each of which has a unique phenotypic and species (collectively called your microbiome). Pro-health bacteria make up a large portion of your microbiome, as was already mentioned; they facilitate nutrient absorption, maintain the health of your immune system, and are necessary for a number of metabolic activities that keep you healthy. They defend you against invasive germs and control inflammatory reactions. Most of the time, they are "nice guys."

However, the pro-health properties of certain populations of microbes can be impacted by genetic vulnerability and/or environmental factors (such as poor diet, drug/antibiotic usage, food sensitivities, excess oestrogen, obesity, stress, insulin resistance, etc.). Microbial dysbiosis (imbalance or malfunction), leaky gut (when the intestinal barrier dissolves), systemic inflammation, and abnormal immunological reactions can all result from it. A decrease in microbial diversity, which has been found to lead to a pro-inflammatory state, as well as an increase in oestrogen metabolism and levels, can also be brought on by these changes in lifestyle and environment (all associated with increased cancer risk).

Studies have linked the gut and breast microbiomes to breast cancer.

According to research, cancer patients and postmenopausal women had less diversified microbiomes (in what is called the enteromammary pathway, which is the gut to mammary gland pathway in the body). Additionally, there are more some microorganism species there. The female breast has an ideal environment for developing a wide range of microbial communities due to its extensive duct system, lymphatics, and vasculature. 

It has been discovered that various microorganisms in breast tissue correspond with various breast cancer subtypes. The fluid from the nipple of breast cancer patients revealed unique populations of microorganisms in comparison to healthy controls.

In the brand-new field of oncobiome, scientists investigate the interactions between the microbiome and cancer. Scientists use next-generation sequencing methods to discover microbe species diversity as well as the consequences of various microbial communities on resulting in healthy or pathological states, such as cancer.

To date, they have found.

●        Some "unhealthy" microorganisms are connected to cancerous tissue (some have been identified and correlated with specific cancers; others are suspected).

●        These "dangerous" bacteria alter the immune system or cause persistent inflammation, which promotes cancer development.

●        It's possible to find harmful microorganisms in the gut and certain tissues (in both the gut and breast tissue in the case of breast cancer).

●        Some supposedly "helpful" microbes seem to boost the immune system, which in turn curbs cancerous activity and confers a localised protective benefit.

●        When "good" bacteria are lost or rendered dysfunctional, the immune system is no longer stimulated, which increases the risk of cancer development.

●        Different anti-cancer medications and treatments may be less effective when certain microorganisms are present.

●        Some microorganisms, or a decline in microbial diversity, may have a role in the emergence of estrogen-driven (hormone-driven) malignancies like breast cancer.

This last point introduces us to the estrobolome. This is the term used to refer to hormone-driven microbes, estrogen being of primary concern. 

The estrobolome

Breast cancer is directly related to higher levels of circulating endogenous estrogens and changes in normal estrogen metabolism (especially among postmenopausal women). 

Where is all of this estrogen coming from? 

Hormone contraceptive use, hormonal imbalances associated with pregnancy and menopause, and hormone replacement therapy (HRT) can all have an impact on the amount of circulating oestrogen by lengthening estrogen exposure or increasing oestrogen levels. It has been established that enhanced estrogenic effects and breast cancer are risk factors for obesity and other underlying metabolic conditions (such as insulin resistance). The effects of estrogen on your body can be imitated by endocrine disrupting substances present in your surroundings, food, and personal care products.

Research has found associations between the estrobolome and breast cancer

Numerous studies also point to the role of the microbiome in the circulation and metabolism of estrogen.

There are specific types of gut microbes (the estrobolome) that can produce enzymes that break down estrogen, and clinical investigations have linked these microbes to the body's levels of estrogen metabolites. Certain hazardous germs can likely grow more quickly in the body because of estrogen-like chemicals.

SO WHY DOESN'T BODY DETOXIFY ALL THIS EXCESS ESTROGEN?

Normal conjugated estrogens, which are chemically coupled for transport and detoxification, are often eliminated in the bile (and subsequently in the faeces). Still, certain gut-dwelling bacterial species have the ability to deconjugate (separate) these tightly bound estrogens.

Instead of being detoxified and removed, estrogen is reabsorbed into the circulatory system. These recirculating estrogens can then have an impact on tissues like breast tissue, either directly or indirectly promoting the growth and proliferation of hormone-driven cancers (impacting the immune system). Thus, estrogen metabolism, excretion, and recirculation can all be impacted by the estrobolome.

It has been discovered that many harmful microorganisms present in the estrobolome are influenced by outside variables, such as poor food, sedentary lifestyles, high alcohol use, obesity, etc. (remember, these are adjustable factors over which we have control!).

Studies have indicated that the normal "Modern diet," is linked to greater estrogen levels and metabolism. 21st century diet staples, including processed meats and refined carbohydrates, have been linked to inflammation.

In contrast, a study discovered that a Mediterranean diet, which is rich in vegetables, fruits, oils, and foods with a higher proportion of unsaturated than saturated fats, had anti-inflammatory and mildly anti-estrogenic characteristics. In postmenopausal women, the diet caused total urine oestrogen levels to drop by 40%. Foods that reduce inflammation have a negative correlation with breast cancer.

The absence of physical exercise is one more element that has been found to affect oestrogen metabolism. In one study, it was discovered that physical activity decreased oestrogen metabolism and obesity.

One's risk of developing breast cancer is increased by a bad diet, a sedentary lifestyle, being overweight or having insulin control problems. When compared to samples from healthy breasts, many microbe species found in obesity are comparable to those found in breast cancer samples. Let's expand on this a little.

Breast cancer, obesity, insulin control and the microbiome

There are numerous connections between obesity, insulin regulation, gut microbiota health, and breast cancer. Specific microbial communities in the gut have been found to have some influence on obesity, perhaps as a result of long-term dietary decisions. A compromised gut microbiome has an impact on physiological functions, including insulin regulation, glucose/lipid metabolism, changes in metabolic signalling, and gut barrier integrity (which prevents leaky gut and systemic inflammation). Obesity and inflammatory diseases can both be influenced by all of these. Each of these may be a factor in inflammation and obesity.

The gut microbiome also controls how much fat is stored (referred to as energy harvest). Different microbial communities may be more effective at gathering and extracting energy from a particular diet in fat people than in lean people, according to research. As an illustration, gut microbiome impairment or dysbiosis has been linked to an increase in microorganisms that produce carbohydrate-specific enzymes, which promote excessive fat storage. In laboratory investigations, numerous microorganism species have been discovered to be more (or less) prevalent in obese animals. Research on body fat, obesity, and its effects on inflammation and a wide range of unhealthy illnesses is actually rather extensive.

In women, where does all of this fat storage go? 

Most of us would probably say that it goes to our bellies, and it does. Our breasts are also affected, though.

Adipose tissue, where fat is stored in your body, is mostly found in the fatty acid-rich environment of breast tissue. The problem? Adipose tissue has vital metabolic and endocrine activities and serves as a storage area. There are several strong correlations between estrogen accumulation and breast cancer, particularly oestrogen receptor (ER)-positive breast cancer, including the adipose tissue of the breast and other tissues.

Last but not least, more recent studies are implicating the gut microbiota as a critical factor in the emergence of chronic low-grade inflammation, which can lead to metabolic illnesses like insulin resistance, obesity, the development of hyperglycemia, and even Type 2 Diabetes.

Defences against breast cancer

Can women alter their gut or breast microbiomes to prevent breast cancer?

Well, not by simply taking a single pill or probiotic (although pre- and probiotics can be helpful).

The consumption of kefir and other fermented foods is associated with a lower incidence of breast cancer, and studies have suggested that Lactobacillus may play a protective role. However, this is only one preventive measure. It can't be the only step, either. In order to support a healthier microbiome and maximise your risk reduction for breast cancer and other inflammatory disorders, you may need to address several of the factors shown in the earlier image.

What are the specific health objectives that you need to focus on, and what should you do?

You want a diet and lifestyle plan based on the studies that will:

Be anti-inflammatory

Boost your immune system

Reduce your overall acidity

Provide ongoing and healthy detoxification

Be supportive of gut microbial diversity

Maintain your gut intestinal barrier to prevent infections and inflammation

Reduce estrogen metabolism and levels

Provide insulin control

Balance hormones

Help maintain a healthy BMI

●        To sum up, have an anti-cancer lifestyle and a proven anti-cancer diet (high in vegetables, high in fibre, low in sugar, low in processed "white" foods, free of reactive foods like gluten, and supportive of the production of short chain fatty acids,moderate exercise, no smoking, improved stress management, limited alcohol, reduce exposure to endocrine disruptors, etc.)

Offer superfoods and antioxidants that have been proven to have anti-cancer qualities.


In a study comparing the self-reported duration of intermittent overnight fasting and breast cancer incidence, a prolonged overnight fasting period of about 12.5 hours was connected with a lower risk of breast cancer. Researchers came to the conclusion that intermittent fasting probably increases insulin sensitivity and reduces inflammation because it promotes sleep (given your digestive system can relax and repair itself).

Autophagy, a cellular "cleaning" procedure that helps get rid of dead cells with a higher chance of developing cancer, is supported by intermittent fasting.

Let's discuss about leaky gut at last.

It's possible that you already have a leaky gut. It is widespread in many populations since it is a result of many of the abovementioned factors that contribute to a compromised microbiome. Reactive foods like dairy are often one of the main offenders.

 

By the way, excessive usage of artificial sweeteners (so take those off your shopping list) is another cause of leaky gut. You must maintain your intestinal barrier's integrity to avoid chronic and localised inflammation, which could lead to breast cancer!

 

The training also includes improving stress management. Stress and the associated high levels of cortisol alter the microbiota, increase acidity in the body, and increase the risk of leaky gut.

Bugs as drugs:

As was already discussed, prebiotics and probiotics support the diversity and health of your gut microbiome.

Certain probiotic bacterial strains may prevent and treat breast cancer growth and metastasis by supporting your gut microbiome. For instance, research has revealed that the bacteria Lactobacillus reuteri, which is present in breast milk, has immunomodulatory properties and has been demonstrated to prevent the development of breast cancer cells. Today, a wide variety of probiotic meals and beverages are available. These products contain a wide variety of bacterial strains that have been proved to benefit the gut in various ways.

Try fermented foods with live probiotic bacteria, like kefir, sauerkraut, pickles, and yoghurt. Daily consume probiotic supplements.

Pay close attention to your stool as well. The ideal situation is to have one healthy bowel movement each day (good means it is brown and banana-shape, not greasy, splattered, etc.). Constipation indicates poor detoxification! That has to be fixed.

Microbiome health affects breast cancer treatment, too

Additionally, it indicates that the gut microbiome affects the potential efficacy of cancer treatments and medications. Additionally, it affects how many women respond to radiation and immunotherapy treatments as well as the metabolism of at least forty chemotherapy medications.

This finding is intriguing to me because it raises the possibility that in the future, personalised, patient-centred treatments for breast cancer—or even patient-specific breast cancer prevention—might be based on one's microbiome.

However, even today, we know that having a healthy microbiome gives you better defences and protection against numerous inflammatory diseases, such as breast cancer.

I hope you learned something from this. Prevention is better than cure.

Dr. Disha

Originally published JULY 12, 2022 by Dr Disha Sridhar