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BREAST AT MENOPAUSE: UNDERSTAND THE ROLE OF OESTROGEN
Oestrogen’s role in the body is as a ‘builder’, helping to build the lining of the womb ready to receive a fertilized egg during every menstrual cycle. You can see logically that increased cell growth could lead to cancer. The use of oestrogens and HRT has been linked to an increased risk of breast cancer in a number of studies. It has been estimated that the risk of breast cancer increases by 15 to 30 per cent after ten years of oestrogen therapy. It would also explain why women who have a surgical menopause seem to suffer less breast cancer (less oestrogen circulating) and why women who start their periods early and have a late menopause have a higher risk (more oestrogen present for a greater number of years).
A fascinating study reported in the September 1994 edition of the US Journal of the National Cancer Institute showed that women who exercised for around four hours a week had a 58 per cent lower risk of breast cancer and those who routinely exercised for between one and three hours a week had a 30 per cent lower risk. This investigation compared two groups of women under the age of forty and concluded that their activity patterns were a significant predictor of breast cancer risk. What the researchers did not know was precisely why. The thinking is that regular exercise modifies a woman’s hormonal activity in a beneficial way. We know that extremes of exercise alter the menstrual cycle dramatically – many women athletes, for instance, don’t have periods at all. So the suggestion is that moderate routine exercise suppresses the production (or overproduction) of hormones, reducing a woman’s exposure during her lifetime. As the researchers pointed out this highlighted one real way that women could protect themselves from adolescence onwards. And it supports the belief that oestrogen may be implicated in breast cancer. Establishing lifetime exercise routines is important before, through and after the menopause to reduce the risk of breast cancer.
Obviously we can choose not to take HRT (Hormone Replacement Therapy) if we think it poses an unacceptable risk. Unfortunately we are also bombarded from oestrogens in the environment. These are called xenoestrogens (foreign oestrogens). In an article in Environmental Health Perspectives entitled ‘Medical Hypothesis: Xenoestrogens, a preventable cause of breast cancer’ the authors put forward the theory that we are becoming engulfed in these foreign oestrogens from a number of different sources. Pesticides sprayed on crops are a major source of xenoestrogens and they are also found in plastics. One in particular is the chemical bisphenol A which is a by-product of the plastics industry. That bisphenol A produces oestrogenic effects in humans became alarmingly clear when some men working in the plastics industry developed breasts after inhaling the chemical in dust. We can absorb these chemicals into our bodies by putting our food in plastic containers or by buying sandwiches, fruit and vegetables etc. with plastic coverings. The same is true for drinks in plastic bottles or cooking food in the microwave.
Just how potent these xenoestrogens are was discovered by a group of scientists who found that alligators which had hatched in Lake Apopka, Florida, had abnormally small penises and altered hormone levels. They found that in 1980 there had been a massive spill of Kelthane, a pesticide, into the lake. The xenoestrogens from the pesticide were feminizing the alligators. The impact of xenoestrogen pollution has been seen elsewhere too. Fish-eating birds in the Great Lakes region which had been contaminated by chlorinated organic compounds had an abnormally high rate of embryo deaths and deformities and unusual nesting behaviour. Hundreds of these organo-chlorines have been shown to cause cancer in laboratory animals and humans. Some have been identified in breast cancers and have been banned or restricted, but many remain in everyday use. A few examples are the herbicide atrazine, vinyl chloride (used for making PVC) and methylene chloride (used in paint strippers). Women exposed to higher-than-normal levels of synthetic chemicals, through their jobs or living near hazardous waste sites, have significantly higher rates of breast cancer. Women with the highest concentration of certain organo-chlorine pesticides in their bodies are at a higher risk of breast cancer than women with lower levels.
It’s likely that these xenoestrogens get into the body to act on breast cells through fatty tissue. Synthetic oestrogens tend to accumulate in fatty tissue. And of course this problem runs right through the food chain. Food from animals is likely to contain larger doses of xenoestrogens than food from other organisms. So meat from animals that eat smaller animals or contaminated grass, grain or water is likely to give more exposure than a plate of vegetables which has been sprayed with pesticides.
Until recently women were officially advised to examine themselves for any changes in their breasts. Then in 1991, the medical officer at the Department of Health stated that self-examination had not resulted in a fall in mortality rates. This obviously caused a shock among health advisers and women themselves. To lessen the damage of this remark, the Government then changed its position to suggest that women should be ‘breast aware’, meaning aware of anything that seemed unusual in their breasts.
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