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Look Up > Conditions > Cancer, Breast
Cancer, Breast
Risk Factors
Signs and Symptoms
Differential Diagnosis
Physical Examination
Laboratory Tests
Other Diagnostic Procedures
Treatment Options
Treatment Strategy
Drug Therapies
Surgical Procedures
Complementary and Alternative Therapies
Patient Monitoring
Other Considerations


Breast cancer is characterized by the malignant growth of epithelial cells of the ducts or lobules of the breast. Approximately 185,000 cases of breast cancer are diagnosed each year; there are 43,500 deaths, making breast cancer second to lung cancer as a leading cause of death by cancer among women. Incidence rates of breast cancer are rising (8.2% for white and 7% for black women in U.S.) in developed countries; mortality rates are stable. Breast cancer in men is uncommon (<1%). The different types of breast cancer include: lobular carcinoma in situ (LCIS), ductal carcinoma in situ (DCIS), invasive ductal carcinoma (70% to 80% of all breast cancers), Paget's disease of the nipple, inflammatory carcinoma, and other uncommon types. Women detect 90% of their breast cancers with breast self-examination (BSE). This early detection is associated with a more favorable clinical stage; it does not reduce mortality.


There is no evident cause of breast cancer, though there are many proposed risk factors.

Risk Factors
  • Increasing age
  • History of cancer in one breast
  • History of benign breast disease
  • Nulliparity or first pregnancy after 30
  • Family history (first-degree relative) of breast cancer (especially significant for premenopausal women)
  • Early menarche and late menopause
  • Long-term oral contraceptive use; this is controversial
  • High doses of ionizing radiation before age 35
  • History of cancer of the colon, thyroid, endometrium, or ovary
  • Diet high in animal fat, excessive alcohol consumption, and in some studies, obesity
  • Inherited germline mutations (10% of cases) of the following genes: p53 (Li-Fraumeni syndrome), BRCA-1, and BRCA-2, and the ataxia-telangiectasia gene.
  • History of breast implants

Between 70% and 80% of breast cancer cases present with no evident risk factors.

Signs and Symptoms
  • Palpable lump
  • Dimpled skin
  • Striae and erythema
  • Increased vascularity
  • Enlarged axillary lymph nodes
  • Yellow, clear, or bloody discharge from the nipple
  • Breast pain and soreness (rare except in very advanced cases)

Differential Diagnosis

Benign breast disease

Physical Examination

Gynecologic examinations should routinely include examination of the breasts. The examining physician looks for skin lesions, secondary inversion of the nipples, dimpling of the skin, striae, erythema, or increased vascularity. The breasts should be examined with the patient sitting and palpated while lying down. Women should also be encouraged to do monthly BSEs the week after the menstrual period.

Laboratory Tests
  • Histologic examination of breast tissue, to give a definitive diagnosis
  • Genetic studies for DNA mutations, to determine inherited predispositions to develop cancer


Benign breast masses that demonstrate epithelial hyperplasia are associated with an increased risk of future cancer. Alteration in the basement membrane detected by light microscopy is the standard determinant of invasive breast carcinoma.

  • X-ray mammography
  • Optical and doppler ultrasound, to distinguish a cyst from a solid mass
  • Diaphanography (transillumination of the breast), to characterize differences in breast tissue
  • Thermography, to measure the temperature of the breast (elevated in the area of the breast cancer)
  • Magnetic resonance imaging (MRI), to distinguish benign from malignant disease
  • Digital radiography
  • Radionuclide imaging

Other Diagnostic Procedures
  • Fine-needle aspiration biopsy (FNAB)
  • Percutaneous needle aspiration

Treatment Options
Treatment Strategy

Treatment strategies are based on the TNM staging of the primary tumor. Breast-conserving surgery is now considered as effective as radical surgery because survival statistics with lumpectomy and radiation appear to be equal to that of mastectomy. Mastectomy is recommended if the tumor is large (>7 cm) or encompasses the nipple-areolar area, if there is extensive intraductal disease, or in women with collagen-vascular disease. Systemic treatment is as important as surgical excision of the primary lesion because axillary and distant metastases appear to occur simultaneously, not sequentially.

Drug Therapies
  • Adjuvant therapy delays recurrences and prolongs survival in patients with lymph node involvement.
  • Antitumor antibiotics (e.g., doxorubicin, mitomycin C)
  • Alkylating agents (e.g., cyclophosphamide, melphalan, thiotepa)
  • Antimetabolites (e.g., methotrexate, 5-fluorouracil)
  • Vinca (plant) alkaloids (e.g., vinblastine, vincristine)
  • Antiestrogens (e.g., tamoxifen, LHRH agonists) block the action of estrogen on breast tissue; tamoxifen reduces the risk of invasive breast cancer by 49% and estrogen receptor-positive breast cancer by 69%.
  • Estrogen receptor modulator, raloxifene, blocks estrogen-induced DNA transcription; the risk of invasive estrogen receptor-positive breast cancer is reduced by 90%.
  • Monoclonal antibody, herceptin, blocks the protein receptor (HER2) that is produced in large numbers in women with breast cancer.
  • High-dose progestogens

Surgical Procedures
  • Lumpectomy with or without radiation (for tumors <5 cm); wide excision alone is associated with a high rate of local recurrence
  • Mastectomies (e.g., subcutaneous, partial [quadrantectomy], simple, modified radical [total], radical [Halstead procedure], super radical [Urban procedure])
  • Axillary lymph node dissection (a minimum of 15 to 20 level I and II nodes) for pathologic staging to determine prognosis and treatment options
  • Prophylactic castration for estrogen receptor-positive patients
  • Irradiation as a supplement to surgical excision

Complementary and Alternative Therapies

Herbs and nutrients support cancer treatment and aid in preventing recurrence, as well as minimizing side effects and reducing anxiety. Homeopathy can be useful for treating nausea secondary to chemotherapy. Psychotherapy and support groups may have a significant impact on both survival and quality of life.

  • Eliminate foods that increase estrogen levels in the body and the liver's ability to metabolize it. These include non-organic poultry, dairy, red meat, sugar, white flour and refined foods, and methylxanthines (coffee, tea, chocolate, colas).
  • Cruciferous vegetables (broccoli, cabbage, cauliflower, etc.) enhance glutathione activity.
  • Eat only organically raised foods to avoid hormone-potentiating pesticide residues.
  • Include liver foods such as beets, carrots, yams, garlic, dark leafy greens, lemons, and apples.
  • Fiber facilitates the excretion of metabolized estrogen and toxins.
  • Soy may be protective due to its estrogenic compounds.
  • Coenzyme Q10 (120 mg tid) has anti-tumor effects.
  • Calcium d-glucarate (500 to 1,000 mg tid) enhances excretion of metabolized estrogens.
  • Vitamin A (25,000 IU/day), vitamin E (800 IU/day), and vitamin C (3 to 6 g/day) may decrease side effects of chemotherapy and radiation.
  • Selenium (200 to 400 mcg/day) potentiates glutathione, a powerful detoxifier.
  • Bromelain (500 mg bid between meals) has anti-tumor activity.
  • Melatonin (10 to 50 mg/day) inhibits cancer growth (is used extensively in Europe).


Herbs may be used as dried extracts (pills, capsules, or tablets), teas, or tinctures (alcohol extraction, unless otherwise noted). Dose for teas is 1 heaping tsp. herb/cup water steeped for 10 minutes (roots need 20 minutes).

Herbs that block estrogen receptor sites may be protective: black cohosh (Cimicifuga racemosa), red clover (Trifolium pratense), and alfalfa (Medicago sativa). Use these herbs as a base (1 to 3 g) and add two to three of the following in equal parts, 30 to 60 drops bid to tid.

  • With anxiety: passionflower (Passiflora incarnata), kava kava (Piper methysticum)
  • With lymphadenopathy: poke root (Phytolacca americana), red root (Ceonothus americanus); maximum dose of poke root is 0.4 ml/day.
  • With nausea: ginger root (Zingiber officinale), fennel seed (Foeniculum vulgare)
  • With exhaustion: oatstraw (Avena sativa), skullcap (Scutellaria lateriflora)


An experienced homeopath evaluates an individual's symptoms and constitutional type before prescribing a specific treatment regimen. Some of the most common acute remedies used in treating symptoms that may be associated with breast cancer are listed below. Acute dose is three to five pellets of 12X to 30C every one to four hours until symptoms resolve.

  • Arsenicum for anxiety, deathly nausea, with restlessness and burning pains
  • Ipecac for incapacitating nausea unrelieved by vomiting
  • Nux vomica for cramping, sharp abdominal pains with anger and collapse

Patient Monitoring

Women should be followed every 3 months for recurrent disease for 18 months to 4 years, then every 6 months thereafter. Follow-up care is individualized according to risk factors.

Other Considerations

Studies suggesting an association between breast cancer and a high-fat diet are inconclusive. Nutritional substances such as hydroxyanisole (BHA) and butylated hydroxytoluene (BHT), which are food preservatives, vitamin A, and vitamin E appear to have inhibitory effects in breast carcinogenesis (in animal studies).


Most of the complications result from surgery, radiation, or chemotherapy. Tamoxifen, which is given to women with advanced breast disease, increases a woman's risk of endometrial cancer and thrombo-embolic disease.

Modified radical mastectomy:

  • Lymphedema of the arm
  • Restricted shoulder movement
  • Hypertrophy of the operative scar
  • Cellulitis of the affected arm
  • Lymphangiosarcoma in the affected arm

Lumpectomy plus irradiation:

  • Edema of the breast; lymphedema of the arm
  • Discoloration and telangiectasia of the irradiated skin
  • Irradiation pneumonitis
  • Fat necrosis of underlying breast tissue
  • Recurrence of the carcinoma


Prognosis for breast cancer depends on the TNM staging of disease at the time of the initial diagnosis. Microscopic invasion into the surrounding tissues beyond the basement membrane and positive lymph node status negatively alter prognosis. The more nodes that are involved, the worse the prognosis.


The peak ages for breast cancer are 45 to 50 and 55 to 60 years age; however, there are cases diagnosed when pregnancy is still probable. Approximately 0.03% of pregnant women are diagnosed with breast cancer, and 7% to 10% of breast cancer patients become pregnant after treatment. Pregnant women with cancer should be treated similarly to women who are not pregnant. Abortion is contraindicated except with distant metastases; women who deliver a full-term pregnancy have a much better prognosis than those who abort. Lactation must be discontinued because hormonally induced changes in the breast may obscure breast tumors. The incidence of the teratogenic effects of radiation and chemotherapy are very low and are more common in early pregnancy.


Ariel IM, Cleary JB. Breast Cancer: Diagnosis and Treatment. New York, NY: McGraw-Hill; 1987:35- 43, 172-180, 475-484.

Austin S, Hitchcock C. Breast Cancer: What You Should Know (But May Not Be Told) About Prevention, Diagnosis, and Treatment. Rocklin, Calif: Prima Publishing; 1994:194.

Balch JF, Balch PA. Prescription for Nutritional Healing. 2nd ed. Garden City Park, NY: Avery Publishing; 1997:160-164.

Birdsall TC. Effects and clinical uses of the pineal hormone melatonin. Altern Med Rev. 1996;1(2):94-102.

Bland KI, Copeland EM III. The Breast: Comprehensive Management of Benign and Malignant Diseases. Philadelphia, Pa: W.B. Saunders; 1991:731-747, 877-894.

Blumenthal M, ed. The Complete German Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 1998:462,464, 466.

Boik J. Cancer and Natural Medicine. Princeton, Minn: Oregon Medical Press; 1995:138, 149, 166.

Cummings SR, et al. The effect of raloxifene on risk of breast cancer in postmenopausal women. JAMA. 1999;281:2189-2197, 1999.

Cunningham FG, et al. Williams Obstetrics. 19th ed. Norwalk, Conn: Appleton & Lange; 1993:1269-1270.

Fauci AS, Braunwald E, Isselbacher KJ, et al, eds. Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998:562-568.

Holleb AI, et al. American Cancer Society Textbook of Clinical Oncology. Atlanta, Ga: American Cancer Society; 1991: 177-193.

Morrison R. Desktop Guide to Keynotes and Confirmatory Symptoms. Albany, Calif: Hahnemann Clinic Publishing; 1993:40,42,192,274.

Pawlowicz Z, Zachara BA, Trafikowska U, et al. Blood selenium concentrations and glutathione peroxidase activities in patients with breast cancer and with advanced gastrointestinal cancer. J Trace Elem Electrolytes Health Dis. 1991;4:275-277.

Thomson JD, Rock JA. Te Linde's Operative Gynecology. Philadelphia, Pa: J.B. Lippincott's; 1992:979-907.

Werbach M. Nutritional Influences on Illness. New Canaan, Conn: Keats Publishing Inc; 1987:98-106.

Copyright © 2000 Integrative Medicine Communications

This publication contains information relating to general principles of medical care that should not in any event be construed as specific instructions for individual patients. The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application, use, or misuse of any of the information contained herein, including any injury and/or damage to any person or property as a matter of product liability, negligence, or otherwise. No warranty, expressed or implied, is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. The reader is advised to check product information (including package inserts) for changes and new information regarding dosage, precautions, warnings, interactions, and contraindications before administering any drug, herb, or supplement discussed herein.