Anna Cariza S.

Ayad

Nutrition and dietetics lecture

Jelly Ann A. Sanchez

Research Paper: BREAST CANCER

I.
A.
B.
C.
II.

III.

Introduction
Etiology
Pathology
Incidence
Medical nutrition therapy
Dietary prevention
Diatary modification
Rationale of the diet
Sample menu
Role of functional foods and current researches on the relationship of diet and the

IV.

disease.
References

A.
B.
C.
D.

A. Definition
Breast cancer is the cancer that forms in tissues of the breast. The most common type of
breast cancer is ductal carcinoma, which begins in the lining of the milk ducts (thin tubes that
carry milk from the lobules of the breast to the nipple). Another type of breast cancer is lobular
carcinoma, which begins in the lobules (milk glands) of the breast. Invasive breast cancer is

breast cancer that has spread from where it began in the breast ducts or lobules to surrounding
normal tissue. Breast cancer occurs in both men and women, although male breast cancer is rare.
B. Etiology
It's not clear what causes breast cancer. Doctors know that breast cancer occurs when
some breast cells begin growing abnormally. These cells divide more rapidly than healthy cells
do and continue to accumulate, forming a lump or mass. The cells may spread (metastasize)
through your breast to your lymph nodes or to other parts of your body.
Breast cancer most often begins with cells in the milk-producing ducts (invasive ductal
carcinoma). Breast cancer may also begin in the glandular tissue called lobules (invasive lobular
carcinoma) or in other cells or tissue within the breast.
Researchers have identified hormonal, lifestyle and environmental factors that may
increase your risk of breast cancer. But it's not clear why some people who have no risk factors
develop cancer, yet other people with risk factors never do. It's likely that breast cancer is caused
by a complex interaction of your genetic makeup and your environment.

Inherited breast cancer

Doctors estimate that only 5 to 10 percent of breast cancers are linked to gene mutations
passed through generations of a family. A number of inherited mutated genes that can increase
the likelihood of breast cancer have been identified. The most common are breast cancer gene 1

(BRCA1) and breast cancer gene 2 (BRCA2), both of which significantly increase the risk of
both breast and ovarian cancer.
If you have a strong family history of breast cancer or other cancers, your doctor may
recommend a blood test to help identify specific mutations in BRCA or other genes that are
being passed through your family.
Consider asking your doctor for a referral to a genetic counselor, who can review your
family health history. A genetic counselor can also discuss the benefits, risks and limitations of
genetic testing with you and guide you on appropriate genetic testing.
C. Pathology
Common Breast Cancer Pathology Terms
The following terms were developed by pathologists to describe the types and kinds of
breast cancers. These descriptions help the breast surgical oncologist, medical oncologist and
radiation oncologist design an individualized treatment plan for each patient.

HR-positive/negative (hormone receptor status) If breast cancer cells are stimulated

by hormones, then they are considered hormone receptor (HR) positive. This is a
favorable prognosis; your cancer will probably respond to hormonal therapies, which will
also be used as a part of your treatment. There are two types of female hormones the
tumor is tested with: estrogen and progesterone. When a tumor is positive for estrogen, or
positive for estrogen and progesterone, hormonal therapy (the opposite of hormone
replacement therapy) may be recommended as part of the treatment. It can greatly aid in

preventing recurrence of the disease and can help control breast cancer that has spread to
other organs.

HER-2/neu receptor The human epidermal growth factor receptor 2 (HER-2/neu) is a

prognostic factor used to measure how quickly a breast tumor is growing and how erratic
it is. Using an oncogene measurement, which measures cell growth, pathologists can
determine if the cells contain extra protein that makes them grow out of control. If the
HER-2 test is positive it means the cancer cells have too much HER-2 receptor protein on
the surface of the cell, or there are extra copies of the HER-2 gene that can lead to HER-2
overexpression.
If your tumor is found to have the HER-2/neu receptor, special recommendations for

targeted biological therapy might be recommended as part of your treatment. HER-2 negative is
a favorable prognostic factor; being positive is not favorable. Positivity is usually recorded as
being 3+ or +++. Negativity is recorded as 0, negative or +or++.
There is also something commonly referred to as triple negative breast cancer, which
refers to the prognostic factors of breast cancers whose cells have tested negative for hormone
epidermal growth factor receptor 2 (HER-2), estrogen receptors (ER) and progesterone receptors
(PR).

Grade This is a measurement of cell growth. Pathologists use a classification of 1, 2 or

3. If the cells are 1 they are slow growing; 2, average growing; and 3, rapidly growing.

Benign breast diseases Around 80 percent of suspicious masses found on

mammograms or breast exams are benign, meaning they are not cancerous and pose no

health risk. If our pathologists examine your slides and find no evidence of cancer, the
surgeon will determine if the benign tumor, usually a fibroadenoma, needs to be removed.
If they are large, increasing in size or causing pain, the surgeon will remove them.

Malignant tumors Malignant tumors are cancerous tumors and need to be treated as
such. Our pathologists will carefully evaluate all biopsies and slides to give the treating
surgical, medical and radiation oncologists information about the size, type and
prognostic factors of the tumor. Armed with these precise facts, our team can create an
individualized treatment plan that targets the exact nature of your breast cancer.

D. Incidence
Breast cancer has been the most common cancer in the UK since 1997, despite the fact
that it is rare in men. It is by far the most common cancer among women in the UK (2011),
accounting for 30% of all new cases of cancer in females.
In 2011, there were 50,285 new cases of breast cancer in the UK (Table 1.1): 49,936
(99%) in women and 349 (less than 1%) in men, giving a female: male ratio of 143 The crude
incidence rate shows that there are 155 new breast cancer cases for every 100,000 females in the
UK, and 1 for every 100,000 males.
Incidence statistics for breast cancer by country in the UK, age and trends over time are
presented here. There are also data on lifetime risk, the distribution of cases, stage at diagnosis,
geography, socio-economic variation, and prevalence.

The statistics on this page are for invasive breast cancer only. Statistics for in situ breast
carcinoma (a non-invasive tumour of the breast) are also available.

II. Medical Nutrition therapy

A. Dietary prevention
Lower your risk with these breast cancer diet suggestions.

You can lower your risk for breast cancer by reaching for the right foods, according to
recent research. A woman can cut her chance of cancer by as much as two-thirds with good
nutrition and weight management, says Cheryl L. Rock, Ph.D., R.D., professor of family and
preventive medicine at the University of California, San Diego, School of Medicine. Even a
woman who carries the BRCA1 or 2 gene [two genetic mutations that up a womans risk] can
reduce her risk. Fill your diet with lean protein and plentiful produceto help keep your weight
in check and provide cancer-fighting compounds.

Broccoli

Sulforaphanea compound in broccolireduced the number of breast cancer stem cells

(which cause cancer spread and recurrence) in mice, according to research from the University of
Michigan. Eating broccoli may not deliver enough sulforaphane to achieve the same effect, but
to get the most you can, eat your broccoli raw or briefly steam or stir-fry the green florets.
(Boiling destroys some of the sulforaphane.)

Salmon

Taking fish-oil supplements for at least 10 years can shrink your risk of ductal carcinoma,
the most common type of breast cancer, according to a study in Cancer Epidemiology,
Biomarkers & Prevention. Its thought that the omega-3 fats in fish oil reduce inflammation,
which may contribute to breast cancer. But you can skip the supplement aisle, say the studys
researchers, and eat about 8 ounces of oily fish (salmon, sardines, tuna) a week.

Olive Oil

Another reason to reach for extra-virgin olive oil: when researchers in Barcelona gave
rats with breast cancer a diet in which fat came predominantly from extra-virgin olive oil (versus
corn oil), they found that the olive oils antioxidants and oleic acid (a mono-unsaturated fat)
quelled growth of malignant cells
Parsley

University of Missouri scientists found that this herb can actually inhibit cancer-cell
growth. Animals that were given apigenin, a compound abundant in parsley (and in celery),
boosted their resistance to developing cancerous tumors. Experts recommend adding a couple
pinches of minced fresh parsley to your dishes daily.

Coffee

Drinking about two 12-ounce coffees a day may lower your risk of an aggressive form of
breast cancer, says a May 2011 study in Breast Cancer Research. One possibility is that coffees
antioxidants protect cells from damage that can lead to cancer, says study author Jingmei Li,
Ph.D. More research is needed, so dont up your intake based on these findings just yet.

B. Dietary modification
There are no food or dietary supplements that will act as magic bullets to prevent breast
cancer from returning. National Cancer Institute guidelines for cancer prevention can be used to
decrease the chance of a breast cancer recurrence. These guidelines include:

Increase intake of fruits, vegetables and whole grains

Decrease fat intake to < 30 percent of calories

Minimize intake of cured, pickled and smoked foods

Achieve and maintain a healthy weight

Alcohol consumption should be done in moderation, if at all

C. Rationale of the diet

Animal studies show a cancer promoting role for dietary fat.

After receiving a carcinogen (a known cancer causing agent), rats fed a high fat diet had more
mammary tumours that rats fed a low fat diet. While these findings are well established, we cannot
assume that they will apply to the development of human breast cancer.

D. Sample menu
The following is a sample menu. If you need extra calories or protein in your diet, add
more servings.
Breakfast:

cup cooked cereal

cup milk

cup fruit or fruit juice

1 hard-boiled egg

Beverage (coffee, tea or water)

Snack:

cup granola

cup low-fat yogurt

Lunch:

Sandwich: 2 slices whole-grain bread

4 oz lean meat, fish, or poultry

1 tsp mayonnaise, lettuce, tomato slices

1 piece of fruit

cup carrot sticks

Beverage

Snack:

cup raw vegetables

2 Tbsp of peanut butter

Dinner:

4 oz lean meat, fish or poultry

1 cup steamed vegetables

cup grain product (pasta, brown rice)

1 tsp of butter

1 cup of milk

Beverage

Snack:

4 whole-wheat crackers

2 Tbsp of peanut butter

Beverage

III. Role of functional food and current researches on the relationships of diet and the
disease.

Role of multi-component functional foods in the complex treatment of patients with

advanced breast cancer.
Drgan S1, Nicola T, Ilina R, Ursoniu S, Kimar A, Nimade S, Nicola T.Author info
Abstract

Cancer increases free radicals and that certain diets can influence oxidative stress. There
is little evidence about the functional effect of multi-component functional foods on oxidative
stress in
MATERIAL AND METHODS:
With histologically confirmed breast cancer, stages IIIB and IV were enrolled in a
randomised controlled trial. All patients filled out the Quality of Life questionnaire FACT-B
version 4, translated in Romanian and validated, obtained from Evanston North-Western Health
Care, Illinois, USA. Seventeen patients, mean age 57.84 +/- 11.2, were put on a special diet
consisting of 15 ml/day balsamic vinegar from apples and honey, with seabuckthorn berry rich in
carotenoids, rosemary, sage and basil extracts, to be used in salads and vegetable soups, 150
g/day whole wheat bread with 2.5% of the nutraceutic mixture VITAPAN, 15 ml/day grape seed
extract rich in polyphenols (gr. 1). Seventeen patients served as control (gr. 2). Parameters of the
metabolic syndrome were measured: serum lipids, IR-HOMA insulin resistance index. Oxidative
stress was measured by the FORT (free oxygen radical) test. Total hydro- and liposoluble

antioxidants (ACW, ACL) in serum were measured by chemo-luminometry. All investigations

were done at entry and after 3 months.
RESULTS:
Student's t test was applied to compare the means within group and between the 2 groups.
The Physical well being subscale score of the QOL FACT-B version 4 questionnaire showed a
significant difference between the 2 groups (p = 0.001). Also, functional well being subscale (p =
0.004), FACT-G (p = 0.003) and FACT-B (p = 0.002) showed significant differences on
comparison. Breast Cancer Score (Additional Concerns) had a borderline significant difference
(p = 0.057). Social/Family Well being subscale and Emotional well being subscale scores
showed no significant difference. At inclusion, radical activity > 310 FORT units, relevant for
increased oxidative stress were present in 95.1% cases. After 3 months radical activity > 310
FORT units were present in 52.8% cases in gr. 1.
CONCLUSION:
A proper design of foods enriched with bioactive compounds that can lead to significant
effects on health represents a promising adjuvant treatment in patients with advanced breast
cancer, due to its contribution in lowering the high oxidative stress present in these patients.