by Anna Marie Trotman, Integrative Nutrition and Health Coach

When my mom was diagnosed with HER2-positive breast cancer, it was a shock. Surgery, chemo and radiation were not easy for an 86 year old women, but my mom, being my mom, took it in stride and was compliant with her treatments. However, she also took a holistic approach to her health care with diet, exercise, a good mental attitude, and with the support of her health care provider, her family and friends, she was cancer free within a year.  


One out of every eight women in the US will be diagnosed with breast cancer during their lifetime, a number that has been increasing steadily over the past decade. The prevalence of breast cancer in men is also on the rise. Given the number of breast cancer diagnoses, practitioners, such as our certified nurse midwives and partners, are equipped with up-to-date, comprehensive information about prevention, treatment, and survivorship.

Research shows that integrative interventions can impact not only quality of life, but also cancer-specific outcomes. These powerful complementary treatments include stress management, exercise, sleep, and diet.

Breast Cancer Risk Reduction

As practitioners it is our responsibility to help you identify key risk factors for breast cancer and identify those which can be modified. It is your responsibility to follow through on recommendations. Your certified nurse midwife and/or integrative practitioner can define strategies to help you address modifiable risk factors like diet, exercise, and stress reduction.

Nutrition plays a key role in breast cancer risk and the reduction of risk. By recognizing the roles of insulin resistance and environmental toxins in breast cancer the practitioner can support you in making significant changes which may lower your risk. 

Risk Factors

Let’s look at some of the risk factors realizing that this knowledge can give you the power and the courage to make the decisions necessary to improve your health and wellbeing. 


Obesity: After menopause, fat tissue may contribute to increases in estrogen levels, and high levels of estrogen may increase the risk of breast cancer. Weight gain during adulthood and excess body fat around the waist may also play a role. 

High breast density: Women with less fatty tissue and more glandular and fibrous tissue may be at higher risk for developing breast cancer than women with less dense breasts.

Menstrual history: Women who started menstruation at an early age (before age 12) and/or menopause at an older age (after age 55) have a slightly higher risk of breast cancer. The increase in risk may be due to a longer lifetime exposure to the hormones estrogen and progesterone.


A sedentary lifestyle: Physical activity in the form of regular exercise for four to seven hours a week may help to reduce breast cancer risk. 

Heavy drinking: The use of alcohol is linked to an increased risk of developing breast cancer. The risk increases with the amount of alcohol consumed.

When my mother was asked, she didn’t have any real risk factors. It was then recommended that she be tested for the BRCA genes. The most common cause of hereditary breast cancer is an inherited mutation in the BRCA1 and BRCA2 genes. At 86 she was unsure about getting tested, but decided to move forward just in case she might be a carrier. The test came back negative. 

Should You Get Genetic Testing?

It’s important to do genetic testing correctly. You can easily get the wrong test, or have the results misinterpreted.

Don’t go online or go to your family provider. Go to a genetic counselor.

Your family doctor or nurse practitioner does not have the necessary training in genetics as a genetic counselor does. A genetic counselor will spend an hour or more with you on the initial consultation; she will explain everything to you and give you a clear picture of your next steps. 

Make Sure You Really Need Genetic Testing 

It is not advisable to get tested just because you’re curious about your genes. Tests can be inconclusive or meaningless sending you into a mental spin where you spend the rest of your life being apprehensive and filled with anxiety. The Birth Center recommends getting tested when you have a family history of a certain disease. Discuss your concerns with your midwife. We are here to support you. 

Some women, because of their family history, genetic tendency, or certain other factors, should be screened with MRI in addition to a thermogram or mammogram. (The number of women who fall into this category is small: less than 2% of all the women in the US.) Talk with your midwife about your history and whether you should have additional tests at an earlier age. Reference.

Annual Gynecological and Breast Exams Are a Part Of Your Well Women Visits 

Screening Guidelines

Breast and gynecological exam yearly all ages. Not just when you need a PAP.

Baseline mammogram or Thermogram (reference), if you are declining a mammogram at 40.

Mammograms or Thermograms (reference): Every 1-2 between 41 and 50 and yearly after age 51.

Self breast exam monthly.

If you have a family history of breast cancer, a genetic tendency, or certain other factors a baseline mammogram is recommended starting at age 30. 

If you are due for your Well Women Exam call us at 302-658-2229.


American Cancer Society

National Cancer Institute

Dr. Andrew Weil