Breast Health: Prevention, Empowerment, and Wellness

Breast health is a vital aspect of overall well-being for women of all ages. Did you know that breast cancer is the second-most diagnosed cancer in Canada and is the second leading cause of death among Canadian women over 50?[i] This October, as we honor Breast Cancer Awareness Month, we want to empower you to take proactive steps towards your breast health – because it’s never too early to start.

At Saskatoon Naturopathic Medicine, we believe in supporting you with an individualized approach looking at the body’s weaknesses and vulnerabilities that may make you susceptible to disease. Through optimizing nutrition, addressing environmental factors, or supporting your body’s natural defenses, we are committed to providing comprehensive care that treats the whole person.

Know the Risk Factors

Several factors can influence your risk of developing breast cancer. Some are within your control, while others – like family history or genetics – are not. Here are some key considerations:

• Nutrition : A balanced diet plays an essential role in reducing risks. Not only can a healthy diet directly improve our health, but it can also positively interact with many other factors involved in health like inflammation, body weight, hormone levels, and our gut microbiome. It is estimated that 30%-50% of cancers can be prevented through dietary changes.[ii] [iii] [iv]

• Exercise and healthy lifestyle: Lack of exercise contributes to obesity, which in itself is a risk factor for breast cancer. In breast cancer patients, physical activity - both before and after the cancer diagnosis - has been associated with a lower risk of disease recurrence and reduced overall cancer-specific mortality compared to their sedentary counterparts. [v]

• Family history and genetics: Understanding your genetic predispositions can guide proactive prevention.

• Environmental toxins: Exposure to harmful chemicals (including alcohol and tobacco) can contribute to increased risk.

• Dense breast tissue: Dense breasts not only elevate cancer risk but also make it difficult for cancerous lesions to be seen on a mammogram.

Being informed about these factors helps you take charge of your health, empowering you to make choices that align with your long-term wellness goals. Naturopathic doctors can break down these risk factors further to help you understand your vulnerabilities and strategize an individualized prevention plan.

Symptoms to Watch For

Breast cancer can manifest in various ways, some of which may be subtle. If you notice any of the following symptoms, it’s important to reach out to your healthcare provider for further evaluation:

• Changes in breast size, shape, or appearance

• New lumps, nodules, or cysts

• Nipple discharge when not breastfeeding

• Redness, pitting, or dimpling of the skin

• Peeling or flaking of the nipple

• Inverted nipples

Understanding Dense Breasts

Breast density[vi] is not about how your breasts look or feel – it is about tissue. Dense breasts have more glandular and fibrous tissue, making it harder for mammograms to detect cancer. However, having dense breasts is quite common, particularly in younger women. As women get older, their breasts typically become fattier and less dense (but this isn’t always the case). It is important to know your breast density so you can understand the risks and complications and make informed screening decisions.[vii]

You can learn more at www.densebreastscanada.ca.       

Screening: Early Detection Saves Lives

Early detection is crucial, and regular screening is an important part of taking care of your breast health. As of January 2025, you will be able to self-refer for a mammogram in Saskatchewan beginning at the age of 40 (currently, the minimum screening age is 50).[viii]

Read that again – you do not need a doctor’s referral to make an appointment for a screening mammogram!

Just call 1-855-584-8228 to book your screening through the Screening Program for Breast Cancer. With screening centres throughout Saskatchewan (including a mobile unit that serves rural and northern Saskatchewan) accessing this potentially life-saving service is available to you.

How We Can Help

We are dedicated to helping you navigate these complex factors, providing tailored recommendations that fit your unique situation. Whether you are seeking prevention or already managing a diagnosis, our collaborative model works alongside conventional approaches to give you the best outcomes. From optimizing your nutrition and lifestyle to helping you understand your risks, we’re here to empower you at every step of your health journey, You deserve to feel confident, supported, and in control of your health.

[i] https://cancer.ca/en/cancer-information/cancer-types/breast/statistics

[ii] Mentella MC, Scaldaferri F, Ricci C, Gasbarrini A, Miggiano GAD. Cancer and Mediterranean Diet: A Review. Nutrients. 2019; 11(9):2059. https://doi.org/10.3390/nu11092059

[iii] Monllor-Tormos A, García-Vigara A, Morgan O, García-Pérez MÁ, Mendoza N, Tarín JJ, Cano A. Mediterranean diet for cancer prevention and survivorship. Maturitas. 2023 Dec;178:107841. doi: 10.1016/j.maturitas.2023.107841. Epub 2023 Aug 24. PMID: 37660598.

[iv] Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74. doi: 10.3322/caac.21142. Epub 2012 Apr 26. Erratum in: CA Cancer J Clin. 2013 May;63(3):215. PMID: 22539238.

[v] Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016 Jun 1;176(6):816-25. doi: 10.1001/jamainternmed.2016.1548. PMID: 27183032; PMCID: PMC5812009.

[vi] https://cancer.ca/en/treatments/tests-and-procedures/mammography/breast-density

[vii] https://densebreastscanada.ca/faq/

[viii] https://densebreastscanada.ca/breast-cancer-screening-in-saskatchewan/

Love the Skin You're In

Your skin is the largest organ in your body. It protects and gives you signals from the environment, and regulates temperature and water. We often don’t think about the functions of our skin until it starts to cause us problems – itching, rashes, acne, discoloration, premature aging, etc – all of which can be a signal of something deeper going on in our body. The skin is also a great absorptive surface, for better or for worse. We can use this effect to our benefit for absorbing certain medications or nutrients applied topically (eg. estrogen, testosterone, magnesium), though the absorptive nature of skin also makes us susceptible to adverse effects from environmental exposures that may be allergic or irritant in nature.

ouTSIDE IN VS AND INSIDE OUT

Whether it’s limiting exposures to harmful substances, or increasing exposure to therapeutic agents, both internal and external approaches can, and should, be used in conjunction to promote optimal skin health.

outside in

Skin & The Immune System —> Allergies

An allergic response occurs when the immune system reacts abnormally to a substance found in the environment. The substance that provokes the reaction is called an allergen.

3 Categories of Allergens:

• Ingested allergens - reactions to food or things consumed orally

• Inhaled allergens - reactions to substances we breathe in

• Contact allergens - reactions to substances applied on skin or mucus membranes (lips, mouth, groin)

Skin Allergies

1. Allergic reactions tend to happen after repeated exposure to a substance. The reaction never happens to the first exposure because the immune system must first become sensitized to the chemical.

2. Once you have been sensitizes, you will always be allergic to it.

3. Sudden development of allergies is possible.

4. Even small amounts of allergen can trigger a reaction that can last for several weeks.

5. With each new exposure, the reaction becomes stronger.

6. The reaction can spread beyond the exposure site.

7. A reaction need not happen immediately - it can take hours or days to present.

Allergy Testing

• Prick testing - for allergens ingested or inhaled

• Patch testing - for contact allergens

Top Allergens in Personal Care Products

1. Fragrances

2. Preservatives

3. Hair dyes

4. Lanolin

5. Synthetic detergents

6. Botanicals

7. Nail cosmetics

8. Sunscreens

Skin and The Immune System —> Irritants & Intolerances

Skin irritants elicit non-allergy reactions, that may be immediate, dose-dependent, and/or cumulative.

Irritant Reactions

• Irritation is dose-dependent - the more you are exposed, the more severe the reaction.

• Irritation is cumulative - multiple exposures, multiple chemicals.

• Irritation can happen after a single exposure.

• Irritation does not necessarily happen after every exposure (cumulative exposures impact the outcome).

• An irritant reaction can happen immediately after exposures and can resolve quickly after exposure ends.

Top Irritants in Personal Care Products

1. Water

2. Soap and detergents

3. Fragrances

4. Botanicals

5. Alcohol

6. Abrasive scrubs

7. Vitamin A derivatives and Alpha-Hydroxy Acid (AHA)

8. Shampoos and conditioners

inside out

Your skin is also reflective of what is going on within your body. We see this often with certain conditions that have dermatologic manifestations, such as Celiac disease (dermatitis herpetiformis), systemic lupus erythematosus (malar erythema), PCOS (acne) and many others. Aside from diagnosable pathologies, functional imbalances and other factors can also impact the quality and health of our skin. These may include:

• Inflammation

• Hormonal imbalances

• Diet

• Digestive issues

• Food sensitivities

• Sun exposure

• Stress

• Nutrient deficiencies

• Immune dysfunction

• Medications or supplements

• Smoking

• Infections

Skin problems are often multifactorial, and as such often require a multi-factorial approach. Whether you are addressing the symptoms of chronic disease or looking to improve the appearance and health of your skin overall, optimizing and correcting any one or several of these factors may be necessary to achieve desired results.

THE FIRST STEP TO TREATMENT IS A PROPER ASSESSMENT.

Deciding where to start can be overwhelming. With no shortage of information online, many times patients are confronted with information and option overload. A detailed history taking with a health professional can help to narrow down areas to focus on and get you started on a treatment plan tailored to your individual needs to help you love the skin you’re in.

In health,

Dr. Jacalyn Sieben, ND

PS - for more information about a holistic Outside-In approach I highly recommend the book referenced below.

Reference:

Skotnicki, S. (2018). Beyond soap: The real truth about what you are doing to your skin and how to fix it for a beautiful, healthy glow. Penguin Random House.

Probiotics, Your Microbiome and Your Mood

Have you ever noticed that what you eat impacts your mood? Have you felt worse after binging on junk food or after a night of drinking? There is compelling research suggesting that it may not be just the guilt talking - your microbiome may be contributing in a large way to the conversation.  

What is the microbiome?  

There are 10- to 100-trillion symbiotic microbes of various species existing in and around the human body, collectively referred to as the microbiome [1]. These friendly microbes outnumber your own human cells and have recently become popularized for the growing body of evidence detailing the vast impacts they have on human physiology and behaviour. 

The microbes in your intestines make vitamins, amino acids, hormones, neurotransmitters and other signaling molecules that impact the way your brain and body function [2], [3]. They also produce short-chain fatty acids as byproducts that your intestinal cells use for energy, which contributes to healthy gut function [3].  

These microbes live in our digestive tract and survive off the foods that we eat. Just like any other living organism, their health (and therefore ours) depends on consuming a healthy diet. It has been shown that dietary changes (e.g. from animal-based to plant-based), as well as any significant systemic stress and inflammation can alter the composition (i.e. diversity and abundance of species) of your microbiome within just 24 hours [3].  

Altered microbiome composition has been associated with many conditions, such as inflammatory bowel disease (IBD), psoriasis, atopic dermatitis, autoimmune arthritis, type 2 diabetes, obesity, and atherosclerosis [3]. This is not surprising given the significant role these organisms have in regulating metabolism and immunity. In fact, researchers are finding that the microbiome composition in a given disease seem to have a different complement of microbes associated with it. For example, an IBD microbiome has less diversity (fewer species of healthy microbes), and lower numbers of good bacterial species. Therefore, it has lower short-chain fatty acid production [3]. Short-chain fatty acids (SCFAs) are essential to the health of your intestinal cells and are also thought to be anti-inflammatory in the gut [3]. 

The Microbiome’s Effect on Mood & Behaviour  

Gut microbes relay messages to the brain via various direct and indirect mechanisms - bacterial metabolites, metabolic precursors, immune signalling, vagus nerve signalling, and Hypothalamic Pituitary-Adrenal axis activation [4], [5]. It is through these mechanisms that neurodevelopment or neurodegeneration are influenced [5]. A significant portion of the microbiome influence on the brain comes via the gut-brain axis: a bi-directional pathway connecting the nervous system in your digestive tract to the central nervous system (your brain) [4], [5]. As shown in the graphic below, your gut and your brain communicate directly via nerves that transmit different signals and molecules, which can have a profound effect both ways to both systems [6].

Photo credit: https://fhs.mcmaster.ca/forsythe-lab/microbiota_gut_brain_axis.html 

Considering the gut-brain axis and the physical manifestations that different microbiome composition can produce, it should be no surprise that there are mental/emotional implications as well. Many psychiatric and neurological pathologies have gastrointestinal co-morbidities, including schizophrenia, autism, neurodegenerative diseases, anxiety, and depression [7]. As noted above, different pathologies have different microbiome composition. This extends to mood and neurodegenerative disorders, such as major depressive disorder, schizophrenia, Parkinson’s disease, and autism spectrum disorder [2], [5], [8]. There is also data suggesting that alterations in the microbiome from addictions (e.g. alcohol, cocaine) may be associated with substance cravings and increased risk of developing associated psychiatric disorders, such as anxiety and depression [9], [10]. 

Probiotics & Your Mood 

Probiotics are supplements that contain healthy microbes that ,when ingested, influence the health of your microbiome. Probiotics used to benefit mood and cognition have been coined “psychobiotics,” and are a burgeoning new area of interest in research. A study by Tillisch et al. used brain scans (functional magnetic resonance imaging) to demonstrate the ability of probiotics to alter brain activity in areas associated with processing emotion and sensation, and to reduce negative thinking associated with sad mood [4], [7], [11], [12]. While most studies indicate that further research in this area is needed, associations between specific strains of microbial species and their benefits on various conditions are rapidly emerging [7], [13][14]. A recent human clinical trial of adjunctive probiotic intervention for Major Depressive Disorder (MDD) showed that compared with placebo, probiotic intervention exhibited greater improvement in depressive symptoms [15]. Participants who received the probiotic intervention experienced reductions in both depression and anxiety, and the probiotics were well-tolerated, prompting the authors to suggest probiotics as an acceptable adjunctive intervention for adults with MDD [15]. 

How Can I Support My Microbiome? 

Lifestyle 

A healthy lifestyle goes a long way in supporting your microbiome, and healthy eating is just one part of it. As mentioned earlier, dietary changes, significant systemic stress, and inflammation can alter your microbiome within just 24 hours. There are many different types of stress - physical, mental and emotional - that can lead to physiologic changes that can alter the microbiome. Practicing stress management through self-care, meditation, social connection, thoughtful schedule planning, getting adequate sleep, and setting appropriate boundaries with people and responsibilities will help you be more resilient in dealing with stress. The better you are at managing stress, the less likely it will spill over into added physical or mood-related symptoms.  

Digestive Supports 

Probiotics are a great start to improving your gut health and mood, though quality and potency matter!  Our naturopathic doctors are here to assess if and which type of probiotics are most suitable for you, as well as to review if any further testing or treatments are indicated to optimize your digestive and mental health.  

We are here to help, so reach out if you are looking for professional guidance! 

In Health,  

Dr. Jacalyn Sieben, ND 

[1] Ursell, L.K. et al. (2012). Defining the human microbiome. Nutrition Reviews. Vol. 70 (Suppl. 1):S38- S44. doi:10.1111/j.1753-4887.2012.00493.x

[2] Dinan, T.G. & Cryan, J.F. Mood by microbe: Towards clinical translation. Genome Medicine. 8:36. DOI  10.1186/s13073-016-0292-1

[3] Corfe, B.M. et al. (2015). The multifactorial interplay of diet, the microbiome, and appetite control:  current knowledge and future challenges. Proceedings of the Nutrition Society. 74, 235-244.  doi:10.1017/S0029665114001670

[4] Dinan, T.G., Stilling, R.M., Stanton, C., Cryan, J.F. (2015). Collective unconscious: How gut microbes shape human behavior. Journal of Psychiatric Research. 63:1-9. http://dx.doi.org/10.1016/ j.jpsychires.2015.02.021

[5] Sharon, G. et al. (2016). The central nervous system and the gut microbiome. Cell. 167. http:// dx.doi.org/10.1016/j.cell.2016.10.027

[6] McMaster University. (2019). The microbiota-gut-brain axis. [Digital Image] Retrieved from: https:// fhs.mcmaster.ca/forsythe-lab/microbiota_gut_brain_axis.html

[7] Sampson, T.R. & Mazmanian, S.K. (2015). Control of brain development, function, and behavior by the microbiome. Cell Host & Microbe. http://dx.doi.org/10.1016/j.chom.2015.04.011

[8] Jiang, H. et al. (2015). Altered fecal microbiota composition in patients with major depressive disorder. Brain, Behavior, and Immunity. 48:186-194. http://dx.doi.org/10.1016/j.bbi.2015.03.016

[9] Hillemacher, T., et al. (2018). Alcohol, microbiome, and their effect on psychiatric disorders. Progress in Neuro-Psychopharmacology and Biological Psychiatry. Volume 85, Pages 105-115. https://doi.org/ 10.1016/j.pnpbp.2018.04.015

[10] Kiraly, D.D. et al. (2016). Alterations of the host microbiome affect behavioral responses to cocaine. Scientific Reports. 6:35455. DOI: 10.1038/srep35455

[11] Rea, K., Dinan, T.G., Cryan, J.F. (2016). The microbiome: A key regulator of stress and neuroinflammation. Neurobiology of Stress. 23-33. http://dx.doi.org/10.1016/j.ynstr.2016.03.001

[12] Tillisch, K., Labus, J., Kilpatrick, L., Jiang, Z., Stains, J., Ebrat, B., Guyonnet, D., Legrain-Raspaud, S., Trotin, B., Naliboff, B., et al. (2013). Consumption of fermented milk product with probiotic modulates brain activity. Gastroenter- ology 144, 1394–1401. DOI: https://doi.org/10.1053/j.gastro.2013.02.043

[13] Foster, J.A., Rinaman, L., & Cryan, J.F. (2017). Stress & the gut-brain axis: Regulation by the microbiome. Neurobiology of Stress. 124-136. http://dx.doi.org/10.1016/j.ynstr.2017.03.0 01

[14] Sarkar, A. et al. (2016). Psychobiotics and the manipulation of bacteria-gut-brain signals. Trends in Neurosciences. Vol 39, No. 11. http://dx.doi.org/10.1016/j.tins.2016.09.002

[15] Nikolova VL, Cleare AJ, Young AH, Stone JM. (2023). Acceptability, Tolerability, and Estimates of Putative Treatment Effects of Probiotics as Adjunctive Treatment in Patients with Depression: A Randomized Clinical Trial. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2023.1817