Breasts: An Owner’s Manual: Every Woman’s Guide to Reducing Cancer Risk, Making Treatment Choices and Optimising Outcomes. Kristi Funk

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СКАЧАТЬ eyebrow and eyelash loss. On the other hand, when I remove lymph nodes during a cancer operation on someone with upper body art, the pathologist usually identifies tattoo pigment trapped within a node or two because the skin lymphatics drain ink to that location. No reports find that tattoos increase breast cancer risk, or that nodes with ink are more likely to contain metastatic breast cancer; however, ink does contain phthalates, hydrocarbons, and a number of other potential carcinogens and endocrine disruptors,³¹ which, as part of a larger whole, possibly impact breast cancer risk (see chapter 5). For mastectomy patients who worry about FDA warnings to “think before you ink,” pretty real-looking silicone reusable nipple prostheses come in a shade that matches skin tone; they just stick in place. An option: pinklotus.com/adhesivenipple.

      RADIATION REBUKES

      In our increasingly tech-reliant world, a lot of patients worry about radiation affecting breast cancer risk—specifically from mobile (cell) phones and power lines. Based on the studies available, this doesn’t appear to be a concern. Phew.

      In 2018, the number of mobile phone subscriptions (6.8 billion) approached the number of people on Earth (7.5 billion). Since these devices emit radio-frequency (RF) signals and electromagnetic fields (EMF), their ubiquity has generated public concern over possible adverse health effects. The real controversy centers on cell phone use and the risk for brain cancer, but breasts have a way of getting attention too.

      From what we can tell, mobile phones can’t cause breast cancer, even if you tuck them in your bra, because they do not emit the right type of energy (or a high enough amount of energy) to damage the DNA inside breast cells. In order to communicate with service towers, cell phones emit EMF. Body tissues absorb some of this radiation during regular phone use; usually those nearby tissues would be your face and brain, not your breast, but in the quest to be hands-free, many women tuck that smart box into a bra or shirt pocket. Here’s the key concept: mobile phone EMF is nonionizing, and as such, the energy waves are too wimpy to break DNA and other biochemical bonds. Besides your phone, other nonionizing sources of radio-frequency signals include microwaves, television, radio, and infrared.³²

      In contrast to nonionizing EMF, X-rays, gamma rays, and ultraviolet (UV) radiation emit ionizing EMF. These do create enough energy to mutate DNA, which can potentially lead to cancer. Common ionizing sources include sun exposure (UV rays) and medical X-rays like CT scans and mammograms. For a cell phone’s energy to go from nonionizing to ionizing, it would have to get 480,000 times stronger than it currently is.³³

      Several notable studies have examined the cell phone/cancer connection as it relates to brain tumors.³⁴ Only one of these authors observed an increase in brain tumors with the use of mobile phones, and all the other studies could not reproduce the correlation.³⁵ No study has postulated that cell phones cause breast cancer. If you carry your phone in your bra, I’d be more concerned about accidentally texting a photo of your breast to your boss than causing cellular damage to your breast DNA.

      Living near power lines can’t cause cancer either. Power lines emit both electric and magnetic energy that’s too muted to damage breast DNA. Additionally, walls, cars, and other objects shield and weaken the energy from power lines. When rates of female breast cancer on Long Island ranked among the highest in New York State, a 2003 study set out to explain possible environmental reasons why.³⁶ One theory was that EMF caused the hike in cancer. Rather than using indirect measurements of EMF exposure (such as occupation or distance from power lines), investigators performed comprehensive in-home assessments of magnetic field exposure and only looked at women living in the same home for at least fifteen years. They compared these data between almost six hundred local women with and without breast cancer; in the end, they found no link between the disease and EMF emitted by power lines. A nationwide Finnish study and a Seattle-based study also concluded that typical residential EMF generated by high voltage power lines do not elevate overall cancer risk in adults.³⁷

      Similar to the EMF from cell phones, magnetic energy from power lines produces a low-frequency, nonionizing form of radiation that doesn’t mess with the breast. Maintaining that the weak EMF derived from power lines could have a catastrophic biologic effect sounds plausible to most of us because we don’t readily understand physics; but to a physicist, it’s a laughable proposition.³⁸ Consider this factoid: the magnetic field from the earth itself is 150 to 250 times stronger than ones from power lines. If a power line’s small magnetic field could cause breast cancer, then just inhabiting Earth for a few years should lead to a total body cancer transformation.

      HORMONE-RELATED HEALTH WORRIES

      A lot of women express concern that certain health habits increase their risk—most of which circle the topic of affecting their estrogen levels, since estrogen feeds the majority of breast cancers. However, a bunch of these worries are, in fact, myths.

      I’ve repeatedly heard the popular rumor that oral contraceptive pills (OCP)—birth control pills—cause breast cancer. But if you are at normal risk for breast cancer, an unexpected pregnancy will add a lot more worry to your life than OCPs. Strong evidence from fifty-four studies concludes that current OCP users have a tiny 24 percent increase in the risk of having breast cancer diagnosed while they are taking OCPs and then the risk becomes 16 percent one to four years after stopping, 7 percent five to nine years after stopping, and no risk ten years out.³⁹ Why do I call that “tiny”? Let me make this brilliant point: if you are twenty, the probability of developing breast cancer by age thirty is 1 in 1,567, so it only takes one more breast cancer case (2 in 1,567) to suddenly proclaim that rates went up 100 percent. And since studies say it’s 24 percent, your new risk will actually be 1.24 in 1,567 on OCPs. Pretty tiny, right?

      Depending on your personal risks, the bump in breast cancer might be offset by the fact that OCPs reduce colorectal cancer by 14 percent and endometrial (uterine) cancer by 43 percent.⁴⁰ And if you’re a BRCA gene mutation carrier, there’s OCP good news for you too. After six years of use, OCPs reduce the risks of ovarian cancer by 50 percent for BRCA-1 and 60 percent for BRCA-2—with no increase in breast cancer.⁴¹ All premenopausal BRCA carriers with ovaries who are not trying to get pregnant should take OCPs to slash ovarian cancer risk.

      Women who have had or are considering in vitro fertilization (IVF) also shouldn’t fret that it causes breast cancer. Given the causative connection between hormones and breast cancer, fertility treatments have come under suspicion since they involve ten times the normal exposures of estrogen and progesterone each time the ovaries are stimulated.⁴² No evidence strongly connects fertility drugs with increased risk. A multitude of studies conclude that prospective moms using any of the ovarian stimulation medications associated with IVF, including clomiphene citrate (Clomid), gonadotropin-releasing hormone (GnRH antagonist, Lupron), human chorionic gonadotropin (hCG), follicle stimulating hormone (FSH), luteinizing hormone (LH), and progesterone, do not have a higher risk of breast cancer.⁴³ In fact, works published since 2012 on the matter not only suggest a lack of interaction, but even a protective role of ovarian stimulation, as emphasized in two meta-analysis studies that pool the results of over 1.5 million infertile women who underwent IVF.⁴⁴ And for those of you who have endured over seven cycles of IVF, I have reassuring news: the largest, most comprehensive study to date followed over 25,000 infertile Dutch women for twenty-one years, and guess what? Your tenacity paid off (I hope with a baby too): breast cancer risk was significantly lower in women undergoing seven or more cycles compared to those receiving one to two cycles.⁴⁵ For all the twenty-one years they were followed, breast cancer risk among IVF-treated women was no different from that in the general Dutch population. There are exceptions, naturally, but they’re few. For example, one notable study from Australia did find an increased rate in women starting IVF under the age of twenty-four, but that’s an unusually young group to undergo IVF, СКАЧАТЬ