Breast cancer – from an integrative viewpoint

General Healthcare

  25 Minutes

A woman’s breast consists mainly of glandular, connective tissue and fat. The glands which produce milk are arranged in groups called lobes and drain into tiny tubes called milk ducts that lead from the glands to the nipple.

The breast develops when its cells are exposed to hormones. This happens significantly at puberty, during pregnancy and breastfeeding. After menopause, when hormone levels significantly drop, the breast tissue starts to degenerate.

In this article we provide an overview of breast cancer from an integrative medical point of view, we unpack the risk factors involved, as well as provide evidence-based preventative measures. For those who have been diagnosed with breast cancer, we briefly outline some of the possible integrative medical approaches that can assist.

Development of breast cancer

All body cells have a lifespan and inevitably die off at different stages. We are constantly replacing older cells with new ones through a process called cell division. Older cells also naturally die off when they reach the end of their lifespan and are replaced by new cells. This constant production of new cells to replace older or damaged cells is carefully controlled by our body. As in the case of most cancers, breast cancer can develop when certain breast cells display abnormal behaviour – instead of growing normally, dying off and being replaced by new cells, these renegade cells begin to behave uncontrollably, grow abnormally and change their genetic code, a process known as mutation. By not dying off naturally, these cells can build up and can form a lump known as a tumour. Not all tumours are cancerous (malignant) though, some, known as benign tumours, simply enlarge and take up space locally. Malignant tumours, however, are far more dangerous as they can invade surrounding cells or even spread to other parts of the body through the bloodstream or through the lymph.

Breast cancers most commonly start in the cells that line the milk ducts,ducts; this is known as ‘ductal carcinoma’. Cancers can also occur in the glands themselves, known as ‘lobular carcinoma.’ If these cancers are limited to one of these areas, they are called ‘in situ’, meaning occurring locally only. If they are undetected, they can spread into the surrounding tissues, when this occurs the cancers are known as invasive ductal or lobular carcinoma.

What causes breast cancer?

As to why some breast cells suddenly studently mutate and become cancerous, science is not yet able to give a full explanation. What we do know from the research available is that it appears that breast cancer can be triggered by a variety of both internal and external factors. These include genetic factors, lifestyle factors, diet and hormonal influences, all of which have been shown to play a role to a greater or lesser degree.

Genetic factors and family history

Women with a history of a first-degree relative (parent or sibling) who had breast cancer are reported to be twice at risk than women with no family history, with more than one relative having had breast cancer the risk increases to 3-4 times.

Although only affecting a small portion of breast cancer patients, mutations of the BRCA1 and BRCA2 genes which usually protect against breast cancer are typical examples of how genetics may significantly and directly increase the risk of breast cancer. In this case, the result is an increase in risk of 60-80%. There are other less serious gene mutations which may indirectly also add to overall risk by negatively influencing how our body metabolises and breaks down oestrogen and other hormones.

Hormonal influence

In terms of hormones, most breast cancers fall into a category known as ‘hormone receptive positive’ cancer, this means that the cancer cells are fueled by hormones such as oestrogen and progesterone i.e., ER+ and PR+ breast cancers respectively. It is this fact that makes the use of hormone-based medications such as the oral contraceptive pill (OCP) and hormone replacement therapy (HRT) a hotly debated topic with respect to their possible role in the development of this type of cancer. For both HRT and the OCP combinations of oestrogen and progesterone seem to pose the greatest risk. Hormone receptor-negative cancer of the breast is also possible, these cancers are not under the influence of hormones.


Diets high in fat, processed food and low in fibre, fruit and vegetables are well known to increase overall cancer risk. Typically, these eating patterns are also linked with obesity which is a known risk factor for developing breast cancer as well. Research also confirms a protective effect against breast cancer in those who eat sufficient fruit and vegetables (particularly non-starchy veg), as well as whole-grain foods and restricted saturated fat, and refined carbohydrates. The protective effects of this way of eating are thought to positively affect other cancer-promoting risk factors like insulin, sex hormones and other growth factors. There are also specific foods which offer protection that one should include in the diet, we will discuss these later.


Although obesity can be linked to up to 3-4% of all cancers, this figure is as high as 12% for breast cancer. This is specific for postmenopausal breast cancer, i.e., breast cancer in older patients. It seems to be overweight in adulthood or gaining significant weight as an adult specifically increases the risk of postmenopausal breast cancer. A study conducted by The World Cancer Research Fund study found a connection between body composition, body mass index (BMI), waist-hip ratio and body fat with 13 different types of cancer. Results from 56 studies including more than 80 000 cases confirm the link between the risk of breast cancer and abnormally high body mass index, with a 5% increase in risk for every 5kg of weight gain in adults! Why is this the case one may ask? Some research confirms that excess body fat can directly negatively impact hormone balance or even behave like an independent hormone-producing organ.

Lack of exercise

Not only does regular exercise reduce the overall risk of death but is reported to reduce the risk of breast cancer by up to 14%! The protective effects of exercise are applicable to both pre-menopausal and post-menopausal breast cancer. Those who are physically active are also less likely to be overweight which we know now is also an important risk factor when it comes to breast cancer. Some research also shows that in those with breast cancer, regular exercise improves survival and provides a reduction in risk of death of around 44%.


Research confirms that alcohol consumption can increase the risk of postmenopausal breast cancer, specifically having more than one alcoholic drink per day.

Menstrual history, pregnancy and breastfeeding

Women who start their first period quite early i.e., before age 12 or those who only go into menopause late i.e., after age 55 naturally have a longer exposure to oestrogen and progesterone. This longer exposure is thought to increase the risk of breast cancer, the reverse also possibly applies i.e. starting menstruation slightly later or entering menopause slightly earlier. InterestingInterestingly, pregnancy and giving birth before age 30 isare shown to reduce the risk of breast cancer as does breastfeeding.

Exposure to radiation

Although not the most common cause, exposure to ionizing radiation such as X-rays, especially during puberty increases risk of many cancers including breast cancer.

Other important factors which influence the risk of breast cancer

These are often factors which are given less attention or factors which are still being fully explored, however there is good emerging evidence which suggest these should be taken more seriously in the holistic prevention and management of breast cancer.

Impact of emotional trauma or stress

Stress is proven time and again to directly negatively impact our immune systems and increase our risk of many diseases and increase the risk of premature death. This is thought to be minimally due to higher levels of the stress hormone cortisol. Stressful life experiences and chronic stress have also been linked to the development and progression of breast cancer. Studies specifically show this increased risk in women who experience divorce, separation or death of a husband or death of a close relative or friend.

Sleep – quality and quantity

Sleep deprivation both in terms of the quality and quantity thereof goes hand in hand with stress. It also negatively impacts us emotionally and psychologically, so it’s difficult to determine the impact individually, but we know poor sleep is responsible for many forms of chronic disease. Short sleep duration was shown to increase cancer risk by 36% in one study. The combination of stress and sleep deprivation is also linked with unhealthy eating habits and lack of exercise which further increase overall risk.

A healthy gut microbiome

Research on the benefits of a healthy and balanced bacterial ecosystem in our gut known as the gut microbiome is emerging at an exponential rate, with whole medical journals now being formed just to cover this fascinating topic. We know that a healthy microbiome plays an important role with regulating our immune systems and our metabolism. Some studies have now show that the microbiome may affect how tumours respond to cancer therapy or even promote anti-tumour immunity. This type of research has sparked the formation of a possibly entire new treatment approach to cancer known as Oncobiotics.

Who’s at risk for getting breast cancer?

In summary, the following are known to increase the risk/be associated with increase in risk of breast cancer:

  • Women 55 years and older
  • Family history of breast cancer
  • Genetic mutations
  • Women with increased lifetime exposure to oestrogen
  • Obesity and/or sedentary lifestyle
  • Unhealthy diet
  • Alcohol in excess
  • Stress and psychological factors
  • Women who have not had children or breastfed.

The stages of breast cancer

When breast cancer is diagnosed, oncologists give the cancer an overall rating referred to as a ‘group staging.’ To calculate the staging of the cancer, various factors need to be taken into consideration. This can be done initially and again after treatment has taken place. Staging helps determine how to manage the cancer and the possible outcomes thereof.

The following factors are considered when calculating the staging:

  • T score relates to the size of the tumour and if it’s invaded any other tissue (in order of severity they are TX, T0, Tis, T1, T2, T3, T4).
  • N score relates to whether the cancer has spread to any lymph nodes (in order of severity they are NX, N0, N1, N2, N3).
  • M score relates to whether the cancer has spread to any other organs such as lung, liver, or bones (in order of severity they are M0, M1).
  • Hormone receptor status classifies what hormones (if any) the cancer is sensitive to, for examples oestrogen receptor positive (ER status) or progesterone receptor (PR status).
  • HER2 is another measurement which determines if the cancer makes a growth promoting protein called HER2.

Once all this is known, an overall stage grouping can be done. This usually is given a Roman numeral I-IV (1-4), simply the lower the number the less advanced the cancer and the better the general outlook. Higher stage cancers often require longer, often more intense therapy and carry higher risk.

Other terms one may come across relating to types of breast cancer include:

  • Tripple negative breast cancer – this is a type of breast cancer which is not oestrogen or progesterone receptor-positive (not hormone sensitive) nor does it have the extra HER2 proteins. It’s typically an aggressive form of invasive cancer.
  • Pagets disease – a rare form of breast cancer affecting the nipple.
  • Inflammatory breast cancer – a rare and aggressive form of breast cancer.

Breast cancer symptoms

Although breast cancer can present with no obvious symptoms at all, all women should be aware of the following possible signs and symptoms which warrant a checkup:

  • Swelling – of the whole breast or a part of the breast.
  • Pain – unexplained breast pain.
  • Nipple – pain, retraction, scaly skin.
  • Discharge – unexplained discharge from the nipple (other than breast milk).
  • Skin – an unusual irritation or dimpling of skin over the breast or scaly skin.
  • Lump – in the breast or under the arm.

The presence of these do not automatically imply the presence of breast cancer as there are other conditions which could be responsible for this, nevertheless a professional examination is necessary.

What age does breast cancer typically occur?

Although breast cancer in women can occur both before and after menopause, typically breast cancer risk increases with age. According to the American Cancer Society only one in 8 cases of invasive breast cancer are found in women younger than 45 years of age, with 2/3 of cases being found in women older than 55 years.

This makes sense for various reasons, firstly the older we are the longer we will have been exposed to hormones, secondly the older we are the higher likelihood and opportunity for genetic mutations to take place.

Does breast cancer only affect women?

Although rare, men can get breast cancer. Cases in men account for less than 1% of all cases of breast cancer and they are usually invasive ductal carcinomas. How is this possible you may ask? The fact is that men too have some breast tissue consisting of all the same structures women have but are less developed due to different hormones. The risk is much lower in men i.e., one in 1 000, compared to women where it is around 1 in 8 women. The problem in men with breast cancer is that it’s often missed and only diagnosed too late. This is largely due to lack of awareness of the risk and simply in terms of screening all the focus in men is on the prostate!

Breast cancer prognosis

Unfortunately, breast cancer has become the most common form of cancer in women. With more than 2 million cases diagnosed worldwide in 2020, it is reported to be the 5th leading cause of death in women worldwide.

Irrespective of this alarming statistic, a breast cancer diagnosis is NOT a life sentence. This will be attested to by the millions of breast cancer survivors worldwide.

The prognosis (outlook) in breast cancer is highly variable depending on a number of factors. Simply put, the earlier its detected and treated generally the better the prognosis. This is because the longer its present the greater the likelihood that it has spread. The group staging method mentioned before incorporates this and other factors which directly affect prognosis. When it comes to cancer, prognosis is expressed using a term called ‘average survival rate’ over 5 or 10 years, this calculates on average what percentage of patients with a certain type of cancer survive the cancer in 5 or 10 years from diagnosis.

The good news is that according to stats from the USA, the average 5- and 10-year survival rate of women with non-metastatic, invasive breast cancer is as high as 90% and 84% respectively. If the invasive cancer is only in the breast, the 5-year survival rate is as high as 99%! Unfortunately, the more the cancer has spread the greater the reduction in survival rates. Because of this, routine screening and early detection is key!

Breast cancer treatment

The aim of cancer therapy is to eliminate the cancer entirely or keep it under control long-term. With breast cancer therapy there isn’t a ‘one size fits all’ approach, treatment is highly variable and determined on a case-by-case basis depending on a variety of factors as every cancer is different and therefore responds differently to various procedures. For example, hormone sensitive cancers need different therapy to non-hormone sensitive ones.

Depending on the case before them, oncologists and surgeons have a variety of therapies and combinations thereof to choose from, these include various forms of:


This is often one of the first interventions used in breast cancer, there are different types of surgery determined by the specific type and location of the cancer. Common options include lumpectomy which is the removal of the lump from the breast tissue and some surrounding tissue but preserving the rest of breast. Mastectomy is removal of breast tissue, either the entire breast or in some cases parts of the breast are preserved, this could be used to remove cancer or prevent cancer by removing the tissue its likely to invade in future. Mastectomy can be done on one breast known as ‘single mastectomy’ or both breasts i.e., ‘double mastectomy,’ sometimes lymph nodes are also removed simultaneously.


Radiotherapy is used to directly kill or shrink tumours. Often it is done routinely after surgery as an additional line of treatment to ensure that possible remaining cancer cells are killed. In some cases where cancer cannot be operated on, radiotherapy is used to treat the tumor directly. Radiotherapy is also used if its spread elsewhere.


‘Chemo’ as it’s often referred to is the use of pharmaceutical drugs to stop the growth of cancer cells. Because these are given orally via injection or drips, they affect the entire body and in the process of treating the cancer they can also harm healthy cells. Chemotherapy targets cells which are growing quickly, which is a feature of most cancers but also healthy cells like hair follicles and bone marrow causing side effects like hair loss and abnormal blood cells. The benefit of chemotherapy is that they work both at the cancer site and elsewhere if the cancer has or is trying to spread.

Hormonal therapy

If the breast cancer is sensitive and fueled by hormones, then hormonal therapy which blocks these hormones could be effective. This accounts for 66-70% of all breast cancers. Hormone therapy can be used in different scenarios, for example to shrink the cancer before surgery, reduce the risk of it coming back, stop cancer from spreading further, or in some high-risk cases used preventively.

Targeted therapy

Targeted therapies are cleverly designed to specifically address one of the special characteristic features of the cancer cell. They are quite selective and because of this, are less likely to harm healthy cells. There are a wide variety of drugs used, each having their own unique way of working and therefore should be determined based on the specific type of cancer.


Immunotherapy harnesses the power of our own immune system to address cancer. Our immune system usually recognizes and deals with cancer cells. Cancer can cleverly find ways of hiding from the immune system thus evading it and sometimes cancer cells only become obviously foreign and recognisable too late. Immunotherapy uses drugs or substances which boost the immune system’s ability to recognize and target cancer cells. It’s used to slow down or stop the growth of cancer, prevent it from spreading, and to get the immune system more efficient at targeting cancer cells.

Evidence based complementary therapies

Cancer patients experience both symptoms of the cancer itself as well as additional side effects from therapy. These include diarrhoea, constipation, hot flushes, swelling, fatigue, insomnia, nausea, vomiting, nerve problems and skin rashes. In addition to these physical symptoms, emotional symptoms such as negative mood, anxiety and insomnia are common.

There have been extensive studies into various forms of complementary medicines and how they can assist and support breast cancer patients at various stages of therapy and recovery. We briefly summarise them in this section:

1. Acupuncture has been used extensively as a supportive tool in cancer patients. Key areas of benefit include chemo-induced nausea and vomiting, as well as depression, anxiety, fatigue, insomnia and even hot flushes and pain. Make sure you find a reputable, registered acupuncturist who can assist you with this type of treatment.

2. Homeopathy has no negative interactions when used in conjunction with conventional therapy for cancer, making it safe to use at any point. Homeopathy can assist with both common emotional symptoms such as anxiety, depression as well as physical ailments in cancer patients such as aftereffects of surgery, side effects of chemo and radiation and hot flushes. Click here to find a registered homeopathic doctor in your area.

3. Phytotherapy, which uses medicinal plants as medicine, also has much to offer cancer patients, specifically offering assistance with chemo-induced nausea and vomiting, skin rashes and other digestive problems which often occur. Herbal medicines can also provide relief from pain, support the nervous system and help with sleep. Contact the Phytotherapy Association of South Africa or click on this link to search.

Possible supportive products to consider

Bio-Strath contains plasmolysed herbal yeast with 61 of the 100 vital nutrients our bodies need daily, in a unique format that is highly absorbable by the human body. It supports healthy nutrition not only by providing these highly absorbable nutrients, but also by enhancing the absorption of nutrients in the intestine.

The nutritional effect of Bio-Strath has the following effect:

  • Contribute to normal mental performance.
  • Memory and concentration.
  • Assist with focus and attention.
  • Reduce fatigue and stress.
  • Strengthen the immune system.
  • Help restore and maintain natural energy.
  • Increase vitality.
  • Vitality during and after pregnancy.
  • Recover from illness (convalescence).
  • Recover from exercise.
  • Support and contribute to the healthy metabolism of nutrients.
  • Maintain good health.

Supporting nutritional status is so important not only in preventing illness but by supporting the body through it and to help it recover. Bio-Strath has been tested in cancer patients and shown to promote recovery and convalescence and quality of life. Cancer patients receiving radiotherapy experienced improved nutritional state, appetite, healthy weight and increased physical activity in response to Bio-Strath. Patients on chemo also experienced significant improvement in quality of life on Bio-Strath, including improved sleep, appetite, and fatigue as well as a reduction in nausea and vomiting.

A.Vogel Molkosan is a prebiotic food supplement made from fermented whey and contains L (+) lactic. Molkosan promotes healthy digestion and supports healthy gut bacteria and microbiome. We know that A.Vogel Molkosan increases levels of the short chainshort-chain fatty acid called butyrate which not only feeds but keeps colon cells healthy.

A healthy microbiome positively affects metabolic pathways and adaptive immunity and regulates inflammation. Research now confirms that healthy gut bacteria can directly impact on the microenvironment within tumours, how they react to cancer therapy and even possibly limit toxic side effects therefrom, even more reason supporting the microbiome is essential in any cancer patient!

Breast cancer prevention

We know so far that breast cancer prognosis is best when the cancer is detected as early as possible. This makes education, raising awareness and regular screening critical! There are also general dietary and lifestyle interventions that can help reduce the risk of breast cancer as well.

1. Screening

It’s generally recommended that all women have a professional breast physical examination with their doctor at least once a year, the frequency of these increase considerably in pre-diagnosed or high-risk patients. Self-examination is highly recommended, and it’s important to learn how to do this because this allows one to preform examinations much more regularly, and if something suspicious is picked up, a doctor’s visit can be arranged.

The breast self-examination consists of two parts:

  • Visual inspectionThe aim of visual inspection is to compare the size, contour and shape of each breast and nipple with the other one for symmetry. This is done by looking in the mirror and placing the arms in the various positions provided below. Also look at the skin, checking for any unusual marks, dimples, veins, or rashes over the breast, areola, and nipple. Check the nipple for any unusual discharges and make sure they look equal on both sides and are not sunken inward. It’s important to do this regularly so that you learn what is normal for you, knowing what’s normal will help you to pick up any deviation from the norm which could warrant a medical checkup.
  • Palpation (feeling the breast tissue)Lye Lie on your back with one arm on the side of the breast being examined resting over your head. Using the finger pads of the other hand, gently feel the breast tissue in an organized pattern, for example, a wedge shape moving from the nipple outwards in all directions, or in vertical lines, or in a clockwise spiral working your way from the nipple outward. You’re feeling for any unusual lumps, bumps, or nodules. Again, getting to know your normal is important, this means checking regularly and being self-aware. Remember to check the entire breast area right up into the armpits. Finally, repeat the process while sitting or standing. Just remember a lump doesn’t necessarily mean cancer! There are many other non-cancerous causes of lumps in the breast, ask your doctor if you are not sure.
2. Mammograms

A mammogram is like an x-ray of the breast and although a ‘clear’ mammogram doesn’t exclude the presence of cancer, it’s probably the most used specialized screening test. It’s recommended that from age 40, women have screening mammograms annually. These are done more frequently if you are considered higher risk.

3. General preventative measures

The World Cancer Research Fund recommends the following preventative measures:

  • Be a healthy weight
  • Move more (regular physical exercise)
  • Avoid high calorie foods and sugary drinks
  • Eat more wholegrains, fruit, vegetables, and beans
  • Limit red meat and avoid process meat
  • Avoid alcohol
  • Eat less salt
  • Breastfeed if you can.
4. Specific protective foods to include in your diet

Generally speaking, drinking at least 1.5 – 2 liters of good quality, filtered water daily and following an anti-inflammatory Mediterranean Diet is a good dietary foundation for all cancer patients and those wishing to prevent it. As far as possible, try eating organic which should be free from harmful chemicals, pesticides, and hormones.

In addition, there are also specific foods supported by scientific evidence to offer a potential protective effect.

Although originally thought to not be a good idea, research now confirms that breast cancer is less common in women who consume a diet rich in soya and soya products, and despite their phytoestrogen content, soy actually has a protective effect. These substances can compete with hormones to bind to receptors and thus have a protective effect. The research confirms that 2-3 servings of soy daily may in some cases have this protective effect.

Polyunsaturated fats, specifically omega-3 fatty acids from predatory fish, walnuts, flaxseed etc. have an anti-inflammatory effect. One study found a protective effect of these foods against ductal carcinoma of the breast. It also seems to offer a protective effect specifically in postmenopausal women. Interestingly, monounsaturated fats, specifically oleic acid (found in olive oil, avocados, hazelnuts and cashew nuts) have been shown to possibly combat breast cancer cells which make the growth protein HER2 mentioned earlier.

Cruciferous vegetables such as broccoli, cauliflower, brussels sprouts, and cabbage contain a plant chemical called indole-3-carbinol which is shown to reduce the growth of cancer cells. It does this by helping the body to break down and process oestrogen in a healthy manner, essentially ‘weakening’ it. Research suggests that by eating 1-2 servings daily of these anti-cancer foods, one could reduce risk by as much as 40%! Rather eat the food than take the supplement especially if you are on medication for breast cancer.

Fruit and vegetables contain antioxidants which have many healthy and protective effects on our bodies. Eating brightly coloured fruit and veg can possibly reduce the risk of breast cancer in postmenopausal women. Oncologists often don’t want their patients taking antioxidant supplements during chemotherapy, so check with your doctor before doing so. Generally speaking though, getting them through your diet is a better option during therapy. Try to get in 5-9 servings of fruit and veg daily as a preventative measure.

Green tea not only is rich in antioxidants known as polyphenols, but it also helps to modulate the excess production of oestrogen (something known as aromatization). A few studies have shown 3 or more cups per day to possibly reduce the risk of breast cancer.

Fermented foods are crucial for a healthy gut microbiome. These include kimchi, kombucha, sourcrout, and other pickled foods which contain high quantities of L (+) lactic acid which is beneficial for the gut and the bacterial ecosystem. Have a look at our previous article on this topic for more information.

5. Lifestyle measures

Try to prevent what you eat and drink from being contaminated by plastics which may contain harmful, cancer-promoting chemicals and xenoestrogens which disrupt your hormone balance. For example, don’t defrost food in plastic or polystyrene containers or covered with cling wrap – the heating of plastics may release these chemicals. Also, read labels and be more aware of products you apply to your skin, some of which contain harmful chemicals.

Try to exercise at least 5 days per week. Do a mixture of both strength exercises and cardio and consider adding specific types of exercise such as yoga, tai chi, and swimming which combine both relaxation and movement.

Make sure you get good quality and quantity sleep – refer to our previous article and podcast on this topic and how you can achieve this.

Actively manage stress levels. There are a variety of ways to do this – we have already mentioned regular exercise but consider other scientifically proven mind-body techniques like mindfulness, Qi gong, yoga, Thai-Chi and meditation. One of the other important ways to deal with stress is to support adrenal gland function and promote adrenal health, we have a whole article on this too.

  Listen to the podcast here: Cancer


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