November 11, 2016
By Virender Sodhi, MD (Ayurved), ND & Priya Walia, ND, MS (Ayurveda)
A Healthy Breast
“Swasthyavrit: Circle of Health”
In continuation of this series on “Swasthyavrit,” we are going to take a look at what the ancient wisdom of Ayurveda has to offer regarding maintaining healthy breasts.
Ayurveda and the Breast
Ayurveda recognizes the female reproductive system, known as Artava vaha srotas. This includes all reproductive organs, including the breasts. Artava vaha srotas is a very intricate system that works in sync with the endocrine system, influencing hormones, thought processes, digestion, immunity and many more.
The shape of the breast is determined by the amount of fatty tissue and the tone of supporting structures including muscles, ligaments, and connective tissue. Breasts come in all shapes and sizes. Vata breasts tend to be small and dry with thin overlying skin. Pitta breasts are medium in size with slightly oily skin. Kapha type breasts are large, moisture-rich, and with thick skin. Often, there is a mixture of these doshic types that make up the variable sizes and shapes of the breast.
Of note, breast tissue is made primarily of fatty tissue, known as medha dhatu, which is where toxins like to settle. Breasts are considered to be glandular structures that allow for significant lymphatic flow and drainage, as well as other secretions including milk. There is a dominance of lymph circulation with nearby lymph nodes in the armpits and behind the collarbone. Therefore it becomes much more imperative to establish a routine to enable proper functioning of the channel and allow proper release of toxins, or ama, as toxic buildup leads to dis-ease.
Breast Health Today
While it is easy for toxins to stagnate in breast tissue, it has become more common to see breast cancer in our present day society. Today, about 12% of females are diagnosed with breast cancer. In other words, one in eight females will be diagnosed with breast cancer. This is a scary thought. This number isn’t the same around the world. Interestingly, cultures have varying rates of breast cancer diagnosis. For example, the Japanese culture has low occurrence and numbers of cancers, including breast cancer. This has been attributed to the rich culture of consuming more fresh vegetables, fruits, and fish with less consumption of red meat. Breast health has become especially important for prevention of breast cancer.
Let’s take a look at how we can take care of our breasts.
Strategies for Promoting Breast Health
The Breast Exam
Self-Breast Exam (SBE)
The best person that knows your body, is you. You know what feels normal versus abnormal. Most breast masses are found by the woman herself. Therefore, breast self-awareness, or a woman's awareness of the normal appearance and feel of her breasts, is important in early detection of disease.
Ideally, the exam is done monthly in mid-cycle. Breast tissue changes throughout the menstrual cycle and you may notice differences when you examine your breasts at varying times. Women who are pregnant, nursing or who have breast implants should also perform regular SBE.
Self-Breast Exam Procedure:
- This exam is usually performed lying down but can also be performed standing or even in the shower after the skin is wet and soapy, as some breast changes can be more easily felt this way.
- Using the pads (not tips) of your three middle fingers press firmly over the breast tissue to feel for lumps in each breast. Feel completely through the tissue all the way down to your chest wall.
- Move around the entire breast in an up/down pattern. Check the tissue all the way into the armpit. Check for lumps, knots or thickenings.
- As one more check, look at your breasts while standing in front of a mirror, looking for dimpling of the skin, redness, swelling, or other changes in the nipple
- Remember how the breast feels from month to month. The most important part is knowing what YOUR breasts feel like. Write down any changes to help keep track of changes.
See your physician for evaluation if you notice any changes or concerning findings.
Yearly Breast Exam by Your PCP/Gynecologist
Clinical breast exams can be useful in detecting breast masses. Current recommendations are to have a yearly clinical breast exam. This is usually incorporated into an annual exam with pelvic exam and PAP smear if indicated. Clinical breast exams are recommended starting at age 19 (according to ACOG). It is also the only breast cancer screening recommended for women under 50 years of age.
The procedure of the exam is similar to the SBE. The doctor will exam each breast as well as the associated lymph nodes (located in the armpit) while the patient lays on her back. If anything concerning is found upon examination, imaging is usually the next step.
Mammogram, according the USPFTF (U.S. Preventive Services Task Force) guidelines.
The USPSTF recommends screening mammography for women 50-74 years every 2 years.
A recent meta-analysis of clinical trials taking place over a 10-year period found that screening 10,000 women aged 60 to 69 years will result in 21 fewer breast cancer deaths. The benefit is even smaller in younger women: for women aged 50 to 59 years, 8 fewer breast cancer deaths in 10,000 screenings, and screening 40 to 49 year olds will result in 3 fewer breast cancer deaths in 10,000 screenings. Evidence has been increasing towards efficacy of mammography in preventing breast cancer.
Many reports and studies have suggested that mammography has led to over diagnosis, not early detection. For example, the Swiss Medical Board has found that 21.9% of breast cancers found through mammography screening represented over-diagnosis; or, one in five women received unnecessary treatment after screening.
In the U.S., thousands of women undergo surgery, radiation and chemotherapy for non-life threatening cancers yearly. In the last 30 years, there has been overtreatment and over diagnosis in about 1.3 million U.S. women. A study published in the Journal of the Royal Society of Medicine, titled "Mammography screening is harmful and should be abandoned," states that the effect of decades of screening has not been to reduce breast cancer associated mortality, even with the new staging and diagnosis classifications, such as "early stage" or "stage zero" breast cancer.
There is also a risk for false positive results leading to unnecessary procedures, psychological harms, and inconvenience. Other possible harms from screening includes radiation exposure, pain from breast compression, under diagnosis, and costs associated with over diagnosis. Clearly, the evidence is lacking effectiveness, yet, we still have such guidelines in place.
Correct Fitting Bras or No Bra Use?
“Experts”, doctors, fashion experts, and bra designers, like to weigh in on the topic and the general consensus is that bras are not medically necessary and each woman should decide for herself. A French study that followed about 300 participants from ages 18-35 for 15 years, found cosmetic differences – higher nipples, reduced stretched marks and firmer breasts at the end of the study for women who did not wear bras. Also, no reduction in back pain for those who wore bras was found.
An area of concern with bras is the limited movement of the breasts when held in a bra. The thought is that this could affect lymph movement. Lymph helps clear toxins and waste away from cells. Since lymph is not pumped like blood it needs muscle movement to move the fluid. Therefore, exercise (and the resulting breast movement) helps to prevent breast-health problems. Although not proven, the concern is that a bra might limit some of this movement. A study in 2014 from Seattle-Puget Sound metropolitan area found no association between bra wearing and breast cancer risk.
When wearing a bra:
- Avoid thin straps – this can cause headaches, neck pain, and even nerve damage
- Wear the right size – Get properly measured and fitted. A bra that is too small can affect breathing, cause headaches, neck pain, and skin issues and affect blood and lymph flow.
Stimulating Lymphatic Flow
Dry brushing is one technique that enables flow and drainage of lymph fluid and blood circulation, and toxin removal. This is done ideally before a massage and shower. Gentle circular strokes in an outward motion are used on the breasts, while vertical strokes are made over the breastbone and solar plexus.
Our breasts are made primarily of fat and can accumulate toxins. A daily self-massage with warm oils (sesame oil, castor oil, coconut oil or olive oil) ensures flow of lymph and blood, removal of toxins, excessive hormones, and also maintain good tone of the breast tissue. It is best to massage the upper chest and breasts similar to how one would dry brush: in a circular outward motion, allowing for the internal fluid/lymphatics to flow in the direction of drainage. Vertical strokes should be made over the breastbone and solar plexus.
Diet forms one of the foundations for overall health. Today, environmental toxins are hard to break away from, as they linger in our food crops, as fertilizer or added preservatives, and even in household products such as detergents and cleaning products. Since the breast is made of fatty tissue, such toxins can deposit. In particular, bisphenol A, BPA, is a lipophilic and estrogenic toxin that promotes cancer. Other harmful chemical substances include: polychlorinated biphenyls (PCBs), DDT and its metabolites, dioxins, dibenzofurans, polybrominated diphenyl ethers (PBDEs), and heavy metals. Such substances are now being found in breast milk and breast tissue. Therefore, it is ideal to eat fresh, seasonal, and organic food in its purest form. Packaged and processed or refined food should be avoided.
With healthy nutritional practices, we are able to help nourish all tissues and support healthy detoxification, thereby reducing the toxic load. A healthy diet consists of:
- Consuming fresh, seasonal vegetables (especially bitter greens), mustard-family greens like kale, chard, mustard greens, radishes, turnips, bok choy, and other leafy greens, carrots, beets. Try to add as much as color in your diet.
- Eating fresh, seasonal fruits (2 a day)
- Energetically cooling foods
- Consuming healthy oils in raw form (ie. ghee or clarified butter, olive oil, avocado oil, sesame oil, coconut oil, etc.)
- Avoiding stimulants like coffee and alcohol
- Add spices like turmeric, black seeds, coriander, cumin, black pepper, and ginger in your diet.Do not cook your spices, as cooking decreases the potency and effect of the spices.Add freshly grinded spices in your meals.
Mother Nature never ceases to educate us. Pomegranates, while in season currently, also offer breast support. If you take a look at a pomegranate, you will notice that it resembles the appearance of a breast. Its astringent quality helps to tonify the breast tissue. Pomegranate has firming actions on the breast and also anti-cancer properties. Its active phytochemicals (ellagic acid, luteolin, pucinic acid) have been found to fight against cancer cells.
Soy, is another food that has been debated about in regards to breast cancer in particular. This is due to its phytoestrogenic properties — are phytoestrogens cancer promoting or cancer protecting? Phytoestrogenic foods and compounds, including grains, sprouts, and legumes, bind to estrogen receptors in the body. They compete with estrogen (estradiol, a form of estrogen) to bind to estrogen receptors. When bound, the effect is a weak effect, as estradiol is about 300x stronger than phytoestrogens. However, once bound, they make it unable for the potent estrogen to bind and cause potential “problems,” such as causing hormone sensitive breast cancer. All in all, soy and other phytoestrogenic compounds are actually protective in terms of cancer.
- To promote hydration and release of toxins, drinking 8-10 glasses of lukewarm water daily is key.
It is common for young women to stand or sit with rolled shoulders as they are developing into their full-figure, during breast growth. As a result, there is often an associated shyness about their change in shape and want to “hide” or distract attention from the area, thus, enabling a posture that is not supportive for breast growth or promoting optimal health. It is imperative to talk to young developing women about a healthy posture – keep the shoulders pulled back and spine straight – to support the health of healthy breasts.
To move is the simplest way to prevent dis-ease overall. When we move, we allow for not only increase in strength and tone of muscles but of the fluid circulating in our body. By providing support to the muscles, ligament and tendons surrounding the breast tissue, we enable free movement of lymph and blood, thereby reducing stagnation and toxin buildup. Exercise includes: a form of cardio, strength training, and stretching. Yoga can be a form of strength building and stretching. Walking, or interval walking, for 45 minutes daily, plus 20 minutes of strength training at least 3x a week is enough for overall maintenance. The breast tissue, in particular, can be supported by the surrounding muscles, ligaments, and tendons in the chest. Examples include: pushups, bench press, dumbbell press, etc. To stimulate lymph flow, simple jumping jacks or even jumping on a trampoline is very helpful.
Yoga is an excellent way to incorporate movement to help the movement of fluid and prevent stagnation, as well as work on a deeper spiritual level. Generally chest opening and backbend poses help stimulate movement and prevent stagnation in the chest. Examples include:
- Upward facing dog
- Extended side angle
- Legs up the wall
- Triangle pose
Alternate nostril breathing or Anulom Vilom. This form of breath-work cleanses the prana channels while balancing the activity of the sympathetic and parasympathetic nervous systems, the opposing and balancing aspects of body’s nerve activity, while ultimately bringing balance to our hormones.
Description: In the first half of the breath cycle, breath is taken from the left nostril, while blocking the opening of the right nostril. Exhale through the right nostril, while blocking the opening of the left nostril. Then, breath is taken in through the right nostril and exhaled through the left. This is done repeatedly for 15 minutes, twice daily.
Just a simple technique of sitting in a quiet room while focusing on the breath can help bring about mental clarity and removal of stagnated emotions. Stagnated emotions also affect the chest and heart, giving way to health or illness. Breasts are a part of the emotional intelligence in our body, as they are regarded as nurturing and caring.
- Aloe vera, Kumari, has been regarded as an herb that strengthens and supports the female reproductive system, while also providing cleansing properties. With its cooling property, it supports excess pitta.
- Herbs that stimulate lymphatic flow include: licorice, tulsi (holy basil), and fennel.
- Shatavari, has been regarded in Ayurveda as the ultimate vitality supporting her for females. It supports a women in all aspects, providing nourishing, supporting, and cleansing properties. Shatavari also has phytoestrogenic properties, which can be protective towards estrogen positive breast cancer.
The vast knowledge of Ayurveda lends way to keeping our breasts healthy and disease free which is critical in a society where illnesses such as breast cancer loom over more than ever. Of importance, it is key to listen and be aware of your body’s changes, as you know it best. By keeping up with the simple daily, monthly, or even yearly techniques outlined above, one will be able to better sustain optimal health and prevent disease of the breast.
-  Bastyr Center for Natural Health Patient Handout. (2010). Self Breast Exam. Personal archive.
-  Castillo, M. (2013). French study suggests younger women should stop wearing bras. CBC News.
-  Chen, L., Malone, K. E., Li. C. L. (2014). Bra wearing not associated with breast cancer risk: a population-based case-control study. Cancer Epidemiology, Biomarkers & Prevention, 23(10), 2181-2185.
-  Jaggar, K. (2014). Breast cancer mammograms: overrated and over-diagnosing women. The Guardian.
-  Ji, S. (2015). Mammography is harmful & should be abandoned, review concludes. GreenMedinfo.
-  Nelson, H. D., Fu, R., Cantor, A., Pappas, M., Daeges, M., & Humphrey, L. (2016). Effectiveness of breast cancer screening: Systematic review and meta-analysis to update the 2009 U.S. Preventive Services Task Force recommendation. Annals of Internal Medicine. 2016. Doi: 10.7326/M15-0969
-  Siu, R. L. (2016). Screening for Breast Cancer: U.S. Preventive Services Task Force
-  Recommendation Statement. Annals of Internal Medicine, 164(4), 279-297.
-  Smith, B. (2013). 10 Bra Mistakes You’re Probably Making (And How To Fix Them). The Huffington Post.
-  Smith, K. The ‘Purpose’ of Bras. Breastnotes.com.