If there is one thing women fear, it is breast cancer. Perhaps it is the fact that breasts are such a feminine attribute, strongly associated with attraction and fertility, that women associate breast cancer with a loss of sexuality and even a loss of self. Some women are afraid of the various treatment modalities such as surgery, chemotherapy and radiation. These treatments may cause pain, sickness, or physical changes such as hair loss and even breast loss. I have had many patients state they feel that the treatment is worse than the disease.
Everyone knows someone who has had it – family, friends, or coworkers. According to BreastCancer.org, 1 out of every 8 women will develop invasive breast cancer in their lifetime. And our risk of getting breast cancer increases as we age.
Many women do not go in for regular screening because they do not want to hear bad news. The idea is that “no news is good news.” But nothing could be further from the truth. Breast cancer, like most cancers, is completely treatable if caught early. Regular screening and follow up with your doctor is extremely important, but what can we do to prevent breast cancer?
Research shows that the way our bodies break down estrogen can increase our risk of breast cancer. Estrogen is metabolized in the liver and the metabolites, or byproducts of metabolism, are a key to developing breast cancer. There are six metabolites that we look at – four metabolites are considered “bad” and only two are considered “good”. And although all six metabolites may be present, it is the ratios of these metabolites to one another that are important. One of the most reviewed ratios is commonly called the 2:16 ratio. If this ratio is less than 2, meaning that you have too much of the bad estrogen (16) and not enough of the good estrogen (2), studies show that you are at an increased risk of breast cancer, as well as other estrogen driven cancers such as cervical cancer and ovarian cancer.
How can you find out how your liver is breaking down estrogen? A simple morning urine sample can be sent to the lab for evaluation to determine your estrogen metabolism ratios. Once we have that information, we can assess your risk and take steps to mitigate that risk. This test can also be used to monitor current treatment plans to reduce breast cancer risk, as well as to monitor hormone replacement therapy. It is a great test to determine a woman’s osteoporosis risk as well.
What can affect the balance of this ratio? Diet and exercise have a strong impact on the 2:16 ratio. Adding flax seeds, cruciferous vegetables, and soy products into your diet can increase this ratio. Likewise obesity and alcohol consumption can have a negative impact. Definitely kidney function and fluid consumption can affect this ratio so I recommend a basic CBC and CMP with the estrogen metabolism test. Your doctor will be able to interpret your labs, determine how you metabolize estrogen, and create a plan to shift your metabolism to a different pathway if necessary.