HOW TO PREVENT THE BREAST CANCER

Will it be that in fact some exists sorts things out of preventing that disease?
In spite of the wicked publication of American Cancer Society, in 1996, (1) denying the fact, it is known that the modification of several lifestyle factors interferes in a significant way in the casuistry of the breast cancer.
Only 10 to 15% of the cases are of genetic origin, that is, with strong family history, and approximately 75% of the women with positive marker for the disease, they develop the same.
If the lifestyle didn't interfere, 100% of the women with BRCA1, positive BRCA2 should get sick these two genes are suppressors timorous and they protect the cells of if they divide abnormally. A woman with alterations in those genes can have a risk four times larger of developing breast cancer (2) than the rest of the population.
It is added to the fact the atmosphere in that she lives or she works. Immigrant women that arrive in the United States originating from of countries of low breast cancer incidence, quickly increase her risk even comparable values the American women, independent of her family history. (3)
The fact above without any doubt it proves that other factors besides the genetics influence the statistics and that some can be corrected, preventing of this sorts things out, that disease that so much scares the women. It is evident that a woman's risk develops breast cancer it increases dramatically with the age (4) as in most of the other cancers.
The age of the menarca is also important, as well as the one of the menopause, that is, the period that a woman is exposed to the incentive estrogenic, mainly if he is synthetic, in precocious phase of the life (5) (6), as she sees himself at the present time.
Badly the girls enter in the menarca, they already begin to take birth-control pills and a factor still more added difficulty is that the age of the menarca has been decreasing considerably (7) due to the incentive to the sex, through the media.
The pregnancy and mainly the nursing, they have both protecting effect (8) because the pregnancy matures the cells, turning them less vulnerable to the agents carcinogenic while in the nursing there is a blockade hypothalamic and for ovarian consequence in the estrogen production.
The age of the menopause is also important, because the more late, larger the exhibition and risk, mainly in a phase in that other important factors already influence vastly (9).
Out these considerations of genetic and physiologic situations almost that inevitable, the interference of another varied can do the difference, such as:
A - To Avoid the use of birth-control pills in adolescent women, or as much as possible in any age group (10), because the exhibition period to the estrogenic and synthetic progesterone increases the breast cancer risk. The more precocious the use of the medication, larger the risk (11) (12) (13) (14) (15) (16) (17). the solution would be the use of mechanical methods, as the masculine and feminine, the diaphragm, mainly if used with some spermicide or DIU.
B - Hormonal Replacement should always be made with natural hormones - that is, estradiol, estrona and estriol combined with the progesterone that has a structure same chemistry that the organism produces and always in moderate doses, enough to balance the organic metabolism.
The monitored of the progesterone in the period of the pre and later-menopause is extremely important because it is in that phase that the woman losing her second hormone (progesterone) for deficiency of the lúteo body or of the ovulation it is more vulnerable to develop breast cancer (18) (19).
C - To Avoid alcoholic drink - several research works with significant numbers and attendances for more than 10 years have been showing that the alcoholic drink, independent of the type, it increases the breast cancer incidence in the women pre and powder-menopause (20).
The ingest of alcoholic drink in the youth increases the risk of the disease in the maturity, because the alcohol interferes with the hepatic metabolização of the estrogen, it stimulates the prolactina production that is out of the nursing is a cancerous component and it inhibits the melatonin liberation that besides stimulating the immunological system, it modulates the effects of the estrogenic at receiver level (21) (22).

PROSTHESES

Those involved with polyurethane foam are the dangerous ones, because this substance in contact with the local fabrics becomes 2,4 - diamino cotueno - that is cancerous confirmed. It is the same substance of the hair colors that they were removed of the market in 1972.
Fact that still harms more the women with prosthesis are that the routine and habitual evaluation for the mammography done by very experienced technician that will move the prosthesis of the glandular fabric to make the image.
Another possibility that is inaccessible to many, is the magnetic resonance.
To avoid all and any drug type (medication) in long period. Certain substances used in the treatment of the arterial hypertension like Reserpina, the hidrolazina that is a vasodilatation, the espirolactona a diuretic, the atenolol a betabloqueador and antibiotic rights as the metronidazol and the nitrofurozona, as well as tranquilizing and ant depressive rights, when used by lingering periods of time, they increase the incidence for the breast cancer in human beings or in laboratory animals, what dissuades this procedure completely.
The practice of physical activities as, for instance, the walk, and the control of the weight with carbohydrates restriction and of the fats, it can turn possible the gradual suspension of anti-hypertension, as well as it lessens the stress and the depression - and still plus, it reinforces the immunological system, liberating the organism of mushrooms and bacteria.
Actually, several researches have been showing that the routine physical activity reduces the breast cancer incidence. A substance for use of reducing the cholesterol, the provastatina and the antacid ranitidine also increases the incidence of the breast cancer, and once again, the physical activity, applied in a natural way.
To reduce the levels of total cholesterol and it increases HDE, liter protein of high density not to rust in the wall of the arteries.
The control of the weight also and the routine physical activity, they will reach the tensions and to reduce the hiatus hernia sintomatologia, main responsible for the sintomatologia of the pirose and of the epigastric.
Alternative treatment, that besides improving the symptoms, it will allow the consumption of a vegetable belonging to the family of the crucifers that prove has protecting effect to the breast cancer.


EXCESS OF WEIGHT

The obesity that in our half, to example of what happens in the United States, it is increasing frightening , usually in the youngest age group, children and adolescents, definitively it increases the risk for the breast cancer, that has a direct relationship with the weight excess.
The exaggerating consumption of processed foods and of replete fast-food of chemical substances and conservatism and heavy fries.
The sedentary , generated mainly by the noxious habit of hours opposite to television or computer, always with some thing in the hand to eat, is a great ally of the obesity.
Data statisticians collected in the last decades show that the obesity increases the risk for the breast cancer, in the period for menopause, in up to 50 to 100 percent. This percentile one increases more and more in the course of time and other risk factors are existed, such as, family history, and it prevents later pregnancy in the risk, it can arrive up to 600 percent (41).
We know that our fat has capacity to produce estrogen starting from other hormones. As larger the amount of fat, larger the risk (42).
Besides, the obesity interferes a lot of times the ovulation, doing with that the mamma is without the progesterone protection. The fatty fabric metabolizes the estrogen badly, producing a larger amount from 16 to OH estrona, know the cancerous hormone, and it reduces the connection of the hormone with the protein, what still exposes more the mammary fabric (43).

FEEDING

It is believed that the content of saturated fat of the feeding is directly related with the breast cancer. The fat of animal origin is loaded of pollutants, but only of pesticides and pesticides and hormones that are in his/her majority substances lipossolúveis(conferir) and therefore they concentrate on the fabric fatty of the animal.
In the reality it is not the animal fat that increases the risk to that disease is what is in the fat (44).
The pollutants of the foods that affect the mammary glandular fabric, they can be considered in 5 categories:
a) Carcinogenic - that act directly in DNA provoking the cancer.
b) Pseudoestrogênio - that act as the feminine hormone at receiver level, although they are different estruturalmente.
c) Pollutant industrial - proceeding mainly of the packing of plastic and of the internal covering that feels to the cans.
d) The hormones administered in the animals, so that in a fast way, win minimum weight for the discount.
e) chemical Substances that contaminate or with that the foods are treated, as the metileno chloride (for decaffeinate the coffee to little time) and hydrocarbons aromatic policíclicos in the fish and fruits of the sea of estuaries and barbecue meats.
The feeding should base on grains, vegetables, fresh fruits, vegetables foliate , mainly of the family of the crucifers, that contains an antioxidant substance, highly protecting for the mamma, that it is the idol - 3 – carbinol, dry fruits as nuts, macadamia, chestnut of Pará and seeds, as the one of pumpkin, sesame and linseed, rich in acid linoleico.
Soy and flowed, healthy extremely important, because an inverse relationship exists between the soy consumption and breast cancer (45).

PHYSICAL ACTIVITY

Besides predisposing to the obesity and the a series of other diseases, the sedentary
it also predisposes her all of the gynecological cancers. Several researches have been showing (46) that only four hours of exercises a week, reduce already in 60% the incidence of the breast cancer.
The physical activity, mainly outdoors, besides stimulating the production of the 2 alfahidroxiestrona - mamma's protecting estrogenic, allows to modulate the stress better, it increases the melatonin production at night, the formulation of the vitamin D3 in the skin under the effect of solar light that it is ant cancerous and it reduces the prostaglandin E2 that is cancerous.

IRRADIATION

The connection between irradiation and breast cancer is very strong (47). Thousands that survived the atomic bombs of Hiroshima and Nagasaki, had high breast cancer incidence mainly the youngest group (48).
Another evidence of that connection involves the use of the irradiation in the medicine. In the past the irradiation was used not only for diagnosis as treatment of several diseases with disastrous results, increasing the cancer risk, mainly in precocious phase of the life as, the irradiation of the thymus of the newly born (49) and submitted children the fluoroscopy (50). Irradiation of the scalp for treatment of mushrooms (51) and irradiation of the thorax for treatments of Hodgkin (52).
It is important to dose in a discerning way the cost benefit of submitting a child even to the irradiation that for half exam.
In the same way, the mammography should just be made starting from the 40 or 50 years, frequently 1 year-old low, advised in more precocious phase in the group of larger risk, with close relatives' positive family history and it should begin to be done 2 years before the disease shows in members of the family.
The big allied it is the ultrasound scan that completes the image evaluation and it allows in the dense mammas, the exam in the third dimension. Although it elevates the breast cancer chances, the mammography allows the precocious diagnosis of the disease, what allows better evolution.
In the same way the environmental irradiation, also increases the risk for the breast cancer, as the proximity of electromagnetic stems of stations of electricity.
Integration body, lies and spirit.
The psiconeuroimunologia is a new science based in a crucial concept. Our mind and emotions influence our physical health deeply. It is believed that the sensation of the stress, anxiety, depression and to feel without hope contributes to the cancer and other diseases.
There are almost 2000 years, Galena, Greek doctor noticed that the cancer seemed to afflict the melancholic woman more frequently than the cheerful. Actually, several studies have been showing that Galeno was right (53).
The immunological system plays the fundamental part in the correlation between cancer and emotions. The excessive production of cortisol in the periods of great emotional tension (54), the multiplication of the lymphocytes and the thymus where they are programmed decreases. With the deficient immunological system, the organism becomes more vulnerable to the cancer.
The best way to combat the stress is made by the natural roads, as physical activity, meditation, the faith, to participate in support groups, and if necessary the support psychotherapy.

BIBLIOGRAPHY

1- Women may not be able to alter their personal risk factors: Cancer facts and Figures, American, Cancer Society, 1996.
2- Nelson. N.J. "Cancer risk high, but lower than expected with breast cancer genes" New England Journal of Medicine 197; 89 (10); 680-681.
3- Kliewer, E.V., and Smith, K.R. "Breast cancer mortality among immigrants in Austrália and Canada". Journal of the National Cancer Institute, 1995; 87 (15): 1154-1161.
4- Marshall, E. "Epidemiology. Search for a killer: Focus shifts from fat to hormones". Science, 1993; 259 (5095): 618-620.
5- Brinton, L.A. Oral Contraceptives and breast cancer risk among Young women. Journal of the National Cancer Institute, 1995; 87(11): 827-835.
6- Kelsey, J.L. et al. "Reproductive factors and breast cancer" Epidemiologic Reviews, 1993; 338: 389-394.
7- Giddens-Herman, M.E., et al. "Secondary sexual characteristics and menses in young girl see in Office practice" Pediatrics, 1997; 88 (4): 505-511.
8- Petrakis, N.L., et al. "Influence of Pregnancy and lactation on serum and breast fluid estrogen levels: Implications for breast cancer risk". International Jornal of Cancer, 1987; 4: 587-591.
9- Willet, W. "The searcch for the causes of breast and colon cancer". Nature, 1989: 338: 389-394.
10- "Breast cancer and hormonal contraceptives: Collaborative reanalysis of individual data on 53.297 women with breast cancer and 110.239 women without breast cancer from 54 epidemiological studies." The Lancet, 1996;347(9017):1713-1727.
11- Paffenbarger, R.S. et al. "Cancer risk as related to use f oral contraceptives during fertile years." Cancer, 1977;39:1887-1891.
12- Pike, M.C., et al. "Oral contraceptive and early abortion as risk factors for breast cancer in young women." British Journal of Cancer, 1981;43:72-76.
13- Harris, N.V., et al. "Breast cancer in relation to patterns of contraceptive use." American Journal of Epidemiology, 1982:116:643-651.
14- Meirik, O., et al. "Oral contraceptive use and breast cancer in young women. A joint national case-control study in Sweden and Norway." The Lancet, 1986;ii:650-654.
15- Lipnick, R.J. et al. "Oral contraceptives and breast cancer. A prospective cohort study." Journal of the American Medical Association, 1986;225(1):58-61.
16- McPherson, K., et al. "Early contraceptive use and breast cancer: Results of another case control study." British Journal of Cancer, 1987;56:653-660.
17- Kay , C.R., and Hannaford, P.C. "Breast Cancer and the Pill." British Journal of Cancer, 1988; 58:675.
18- Jordan, V.C.; et al " The estrogenic activity of synthetic progestins used in oral contraceptives." Cancer, 1993; 71: 1501-1505.
19- Stanford, J.J., Thomas, D.B. "Exogenous Progestins and Breast Cancer." Epidemiologic Reviews, 1993; 15:98-107.
20- Smith-Warner S., et al. "Alcohol and Breast Cancer in Women". Journal of American Medical Association. 1998: 279: 535-539.
21- Gavaler, J.S., and Van Thiel, D.H. "The association between moderate alcoholic beverage consumption and serum estradiol and testosterone levels in normal postmenopausal women: Relationship to literature." Clinical and Experimental Research, 1992; 16(1):87-92.
22- Reichman, M.E., et al. "Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women." Journal of the National Cancer Institute, 1993; 85(9):722-727.
23- Hueper, W.C. "Polyurethane plastic foam for fractures." Journal of the American Medical Association, 1960;173:860.
24- Hueper, W.C. "Carcinogenic studies on water-soluble polymers." Pathology and Microbiology, 1961;24:77-106.
25- Hueper, W.C. "Cancer induction by polyurethane and polysilicone plastics." Journal of the National Cancer Institute, 1964; 33:1005-1027.
26- Labarthe, D.R., and O' Fallon, W.M. "Resperine and breast cancer. A community-based longitudinal study of 2,000 hypertensive women."Journal of the American Medical Association, 1980;243(22):2304-2310.
27- Boston Collaborative Drug Surveillance Program. "Reserpine and breast cancer." The Lancet, 1974; 2:669-671.
28- Armstrong, B., et al. "Retrospective study of the association between use of rauwolfa derivates and breast cancer in English women." The Lancet, 1974;2:672-675.
29- Heinonen, O.P.. et al. "Reserpine use in relation to breast cancer." The Lancet, 1974;2:675-677.
30- Martinez, A.J. "Prolactin and carcinoma of the breast." Mayo Clinic Proceedings, 1992;67:1011-1012.
31- Haraguchi, S., et al. "Human prolactin regulates transfected MTV LTR-directed gene expression in a human breast carcinoma cell line through synergistic interaction with steroid hormones." International Journal of cancer, 1992;52:928-933.
32- Smithline, F., et al. "prolactin and breast carcinoma." New England Journal of Medicine, 1975; 292(15):784-792.
33- Ingram, D.M., et al. "Prolactin and breast câncer risk." Medical Journal of Australia, 1990; 153(8):469-473.
34- Olsson, H., et al. "Increased plasma prolactin levels in a group of men with breast cancer-a preliminary study." Anticancer Research, 1990; 10(1):59-62.
35- Williams, R.R., et al. "Case-control study of antihypertensive and diuretic use by women with malignant and benign breast lesions detected in a mammograph screening program." Journal of the National Cancer Institute, 1978;61:327-335.
36- Kaufman, D.W., et al. "Hydrazaline and breast cancer." Journal of the National Cancer Institute, 1987;78:243-246.
37- Newman, T.B., and Hulley, S.B. "Carcinogencity of lipid-lowering drugs." Journal of the American Medical Association, 1996;275(1):55-60. Ionternational Agency for Research on Cancer. Some Pharmaceutical Drugs. Lyon, France:World Health Organization, 1980;24:264.
38- "Carcinoma has been reported in patients taking spironolactone": Physicians' Desk Reference, Montvale, NJ: Medical Economics Data Prioduction Company, 1996:2413-2416.
39- Atenolol caused breast and pituitary canceres [in rats]: Ibid.: 2848-2851.
40- Danielson, D.A., et al. "Metronidazole and cancer." Journal of the American Medical Association, 1982;247(18):2498-2499; Beard, C.M., et al. "Lack of evidence for cancer due to metronidazole." New England Journal of Medicine, 1979;301(10):519-522.
41- Sellers, T.A., et al. "Effect of family history, body-fat distribution, and reproductive factors on the risk of postmenopausal breast cancer." New England Journal of Medicine, 1992;326(20):1323-1329.
42- Ziègler, R.G., et al. "Relative weight, weight change, height, and breast cancer risk in Asian-American women." Journal of the National Cancer Institute, 1996;88(10):650-660.
43- Madigan, M.P., et al. "Proportion of breast cancer c ases in the United States explained by well-established risk factors." Journal of the National Cancer Institute, 1995;87(22):1681-1686.
44- Boyd, N.F., et al. "Effects at two years of a low-fat, high-carbohydrate diet on radiologic features of the breasts results from a randomized trial." Journal of the National Cancer Institute, 1997;89(7):488.
45- Zava, D.T. and Duwe, G. "Estrogenic and antiproliferative properties of genistein and other flavonoids in human breast cells in vitro." Nutrition and Cancer, 1997;27(8):31-40.
46- Berstein, L., et al. " Physical exercise and reduced risk of breast cancer in young women." Journal of the National Cancer Institute, 1994;86:1403-1408.
47- Bertell, R. "Breast cancer and mammography." Mothering, Summer 1992:49-52.
48- Wanebo, C.K., et al. "Breast cancer after exposure to the atomic bombings of Hiroshima and Nagasaki." New England Journal of Medicine, 1968;279:667-671.
49- Janower, M. and Miettinen, O. "Neoplasms after childhood irradiation of the thymus gland." Journal of the American Madical Association, 1971; 215: 753-756.
50- Mac Kenzie, I., "breast cancer following multiple fluorosopies." British Journal of Cancer, 1965;19:1-8.
51- Modan, B., et al. "Increased risk of breast cancer after low-dose radiation." The Lancet, 1989;629-631.
52- Bhatta, S., et al. "Breast cancer and other second neo-plasms after child-hood Hodgkin's disease." New England Journal of Medicine, 1996; 334 (12): 745-751.
53- Visintainer, M.A., et al. "Helplessness, chronic stress, and tumor development." Psychosomatic Medicine, 1983;45:75-79.
54- Riley, V. "Psychoneuroendocrine influences on immunocompetence and neoplasia." Science, 1981;212:1100-1108.