Most women are aware of the risk of breast cancer; we have learned to perform monthly self-exams and visit the doctor for regular mammograms. While these are important tools for early detection of breast cancer, are we doing enough to optimize the health of our breasts?
According to the American Cancer Society, breast cancer kills more than 40,000 women in the U.S. every year. For women between 40 and 54, it is the second leading cause of death, trailing only heart disease. If a woman lives to age 85, she has a one in eight chance of developing breast cancer over the course of her life. To remind us of the prevalence of this disease, October is Breast Cancer Awareness Month. But what the promotional billboards and posters may not tell us is that our yoga practice can help create a broad lifestyle program to minimize the risk of breast cancer.
Understand Your Breasts
To understand how yoga can help, let's first do a quick primer on breasts and on what goes wrong when breast cancer develops. The tissues of the breasts—glands, ducts, connective tissue, and fat cells—begin to grow rapidly in response to the hormonal changes that happen at puberty. Throughout a woman's life, the complex hormonal balance regulated by the endocrine system—including the pineal, pituitary, thyroid, parathyroid, and adrenal glands; the thymus, pancreas, and ovaries; and other scattered tissues—has an enormous impact on the development and health of her breasts.
The hormone that plays the largest role in breast health and disease is estrogen. Each month after she stops menstruating, a woman's ovaries begin to step up their production of estrogen. In response, the lining on the inner uterine wall begins to build, preparing the body for the possibility of pregnancy. Estrogen also encourages the breast cells to swell and retain fluid. If a fertilized egg doesn't implant in the uterine wall, the newly built lining is shed in menstruation and the breast cells become smaller again.
If you examine your breasts regularly, you may have found that the tissues change in a predictable rhythm that follows your menstrual cycle. Many women experience some swelling and tenderness before their period. Although these changes can range from barely noticeable to extremely uncomfortable, they aren't usually cause for alarm about cancer. Neither are some other alterations, including fibroadenomas (lumps common among teenagers and women in their 20s) and cysts (most common in 35- to 55-year-old women).
But occasionally changes in breast tissue stray beyond these variations into the realm of cancer. Instead of reproducing normally, cells mutate. Even then, most of the time the immune system destroys the abnormal cells. If the immune system doesn't check them, however, cancerous cells can begin to multiply.
What causes the normal reproduction of healthy breast cells to go awry, the immune system to fail in its surveillance, and cancer to develop? The factors involved are so numerous and their interactions so complex that we may never have a final, definitive answer to that question. But researchers have identified a number of factors definitely correlated with increased risk of breast cancer, and future research may discover others.
Know Your Risk Factors
Gender is the single biggest risk factor: Women account for more than 99 percent of breast cancers. A documented family history of breast cancer is also important: If your mother and sister both have had breast cancer, you're four to six times more likely than average to develop it yourself.
Alcohol consumption is risky too. As little as one drink per day increases your risk by 40 percent, and higher consumption brings more risk. High exposure to radiation—from radioactive fallout, radiation accidents, or a large number of chest X-rays—also increases breast cancer risk. One recent study (Spine vol. 25, August 15, 2000) showed that women with scoliosis who were given multiple chest X-rays during puberty are 70 percent more likely to die of breast cancer than other women.
For most women, though, by far the most important risk factor for breast cancer is their lifetime exposure to estrogen. In other words, the more menstrual cycles a woman goes through in her life, the greater her breast cancer risk. The fewer cycles, the less risk: Late onset of menstruation, pregnancies (especially pregnancies before age 30), breastfeeding, and early menopause all decrease the risk of breast cancer.
Of course, it's not as if estrogen were some foreign, toxic substance. Your body is designed to make and use estrogen. But in today's industrialized world, women probably both produce and are otherwise exposed to more estrogen than ever before. We start menstruation earlier, we have smaller families later in life, we breastfeed for shorter periods of time, and we're exposed to many more estrogenlike, human-made chemicals in our food, water, and environment.
In addition, stress—the far-too-frequent stimulation of the body's fight-or-flight response—can disrupt the glandular system. Also, for proper estrogen levels to be maintained, your body's liver and kidneys must be healthy. If too much estrogen is produced or if the body isn't utilizing estrogen efficiently, the liver must break down the excess and send it to the kidneys to be flushed from the system. If the liver is overworked, sluggish from dealing with too many toxins, the excess estrogen gets reabsorbed back into the bloodstream and the body has more of the hormone than it can use.
Practice for Health
Given that many of the risk factors for breast cancer seem largely beyond our control—we may choose to have babies and breastfeed, but we didn't choose our gender and we can't choose when we begin and stop menstruating or, for the most part, how much radiation we absorb—it might not be apparent how yoga can help. But your yoga practice can make a contribution in three major ways: regulating the endocrine system and thus the balance of hormones to which you're exposed; strengthening the immune system, especially by stimulating the flow of lymph; and providing both a philosophy and practice for creating a healthy relationship with our bodies and with the world around us.
Many yogis believe that both a well-rounded yoga practice and specific asanas support the endocrine glands in maintaining an optimal balance of hormones in the body. According to the teachings of yoga master B.K.S. Iyengar, inversions are the body's best friend. A number of critical glands—the pineal, thyroid, parathyroid, and thymus—are all located in the head, neck, and chest. Simply getting your feet over your head is thought to improve circulation to these glands, which can then work better.
Sarvangasana (Shoulderstand), Halasana (Plow Pose), and Setu Bandha Sarvangasana (Bridge Pose) all work to improve thyroid-parathyroid function by employing a gentle chinlock. According to yogis, the chinlock squeezes blood from the area; then, as you release the lock, fresh, oxygenated blood circulates more freely in and around these organs.
Yogis also believe that forward bends tend to lower blood pressure and pacify the adrenals and other components of the sympathetic nervous system that are engaged in the fight-or-flight response. Iyengar yogis teach that you must calm overactive adrenals before you can activate them healthily, so it's good to do some forward bends before practicing twists and backbends. Twists like Ardha Matsyendrasana I (Half Lord of the Fishes Pose) provide the ovaries, pancreas, and adrenals with the same squeezing and soaking action the chinlock provides for the thyroid and parathyroid. Backbends like Dhanurasana (Bow Pose) are also thought to energize these abdominal organs. While medical science has yet to conclusively document most of these effects, there's certainly no harm in hedging your bets until more evidence is in.
The immune system also plays a major role in protecting us from breast cancer. Just as predatory insects maintain the delicate balance on an organic farm by feeding on crop-eating pests, the immune system keeps the body healthy and strong by sensing and devouring mutated cells. Yoga therapeutics holds that inverted poses are especially beneficial for immune function. Poses like Sirsasansa (Headstand) and Sarvangasana (Shoulderstand) are very potent but off-limits to some students due to neck injuries or lack of strength or experience. But a simple Viparita Karani (Legs-Up-the-Wall Pose) is accessible to everyone, as well as comfortable and deeply nourishing. In general, since stress taxes the immune system, restorative poses and Savasana (Corpse Pose) can play an important role in immune system health.
Yoga can also contribute to strengthening one particular component of our immune network, the lymphatic system. Lymph is the fluid that surrounds all of our cells. Just like our bodies, our cells take in nutrients and excrete wastes. If lymphatic fluid doesn't flow, cells are surrounded by their own waste. Bathed in cellular debris and toxins, they're unable to receive proper nutrition.
Unlike the blood, which is pumped through the body by the heart, lymph depends on body movement to keep it flowing. Many kinds of movement can help circulate lymph: massage, deep breathing, even the flow of blood in a nearby vein. But exercise is one of the best methods for circulating lymph, and yoga excels at encouraging lymph flow.
Along with supporting lymph flow throughout the body, yoga can help stimulate the lymph nodes. These specialized glands, central to the prevention of disease, manufacture lymphocytes (a type of white blood cell) and filter wastes and other unwanted matter from lymph fluid. The largest clusters of lymph nodes in the body are located in the armpits, adjacent to the breasts.
One great way to stimulate lymph flow all through the body is with a vigorous vinyasa practice. A sweaty round of Suryanamaskar (Sun Salutations) is an excellent way to do this. This sequence can be modified to provide an appropriate level of challenge for almost any student.
More specifically, many yoga poses directly contract and stretch the muscles of the chest, arms, and shoulders, massaging the nearby lymph nodes and encouraging lymph flow through the area. Poses like Adho Mukha Svanasana (Downward-Facing Dog Pose) and Pincha Mayurasana (Elbow Balance) work and stretch the chest, as do backbends. Gomukhasana (Cow Face Pose) especially stretches the armpit. Even simple poses and actions, like backbending over a bolster and stretching an arm overhead, can be very effective at loosening and stimulating this area. Shifting the hips from side to side in Balasana (Child's Pose) and rocking back and forth along the spine in Padangustha Halasana can actually massage breast tissue to stimulate lymph flow.
Change Your Attitude
The most subtle but far-reaching effects of yoga on the health of your breasts may be the way it can change your attitude toward your body and the world around you. Although the physiological function of breasts is simply to provide milk to babies, it's obvious that our culture focuses much more on how breasts look than on how well they work. As a result, many women end up with complex and ambivalent or even strongly negative feelings about their breasts. Such feelings can interfere with regular breast self-examinations, a simple and powerful tool for decreasing risk from breast cancer—a tool that's literally right at your fingertips.
Despite decades of encouragement from public health officials, providers, and educators, some polls indicate that as many as nine out of 10 women still don't perform regular breast self-exams. Kami McBride, director of the Living Awareness Institute in Vacaville, California, has devoted her life to helping women heal their relationship with their bodies. "One of the most important things a woman can do is to shift her perspective on her breasts away from wishing they were different," says McBride. She encourages her clients to use nonsexual touch and herbal pampering to improve their relationship with their breasts. She contends, "It is so important for girls and women to learn to discern how they feel based on their inner experience. Instead of looking at ourselves in a mirror and comparing ourselves to the latest magazine image of how breasts 'should' look, we need to feel the inherent joy of being alive in a female body."
With its focus on concentration, presence, and fully conscious activity, yoga can be a crucial tool in connecting with what your body feels and what it can do. Many women find that yoga helps them experience a new appreciation for their body as they experience the sweetness of a deep stretch or the contentment that can follow a vigorous practice. This increased awareness of and comfort with the body can in turn make it easier for a woman to familiarize herself with the ways her breast tissue changes as she moves through her monthly cycle, establishing a clear baseline understanding that increases the value of regular breast self-exams.
While yoga asanas can be an important part of your breast health regime, it's important to remember that yoga doesn't operate on a magic bullet, "take three poses and call me in the morning" basis. Yoga encourages a holistic approach to life, so it's sensible to incorporate other preventative measures into your breast health regime. You may want to limit your exposure to estrogen-mimicking chemicals, including those in many pesticides: Buying and eating organic food (especially meat and dairy products, if you include these in your diet) and drinking filtered water can be powerful steps toward a more holistic approach to wellness.
More studies will be needed before science can firmly weigh in on the value of yoga and other holistic strategies for preventing breast cancer. But even though research so far has provided far more answers about early detection of breast cancer than about actual prevention, many people believe enough evidence already exists to encourage us to adopt such measures. At the same time, we need to keep in mind that there's a difference between advocating personal responsibility and ascribing blame. Saying that "eating a plant-based diet may help to prevent cancer" is a very different statement than saying "She developed cancer because she ate too much meat." For one thing, there's just not enough evidence to indicate the latter claim. Perhaps even more important, blame—and that includes blaming yourself—can only add to stress and interfere with healing.
It would be wonderful if we could be assured that by practicing yoga and otherwise following a breast-healthy lifestyle, we will never develop breast cancer. But we know all too well that many otherwise strong, healthy women have been diagnosed with this disease. Young, incredibly fit athletes have developed breast cancer, as have vegetarian yoginis.
Obviously, the steps suggested in this article don't provide you with an ironclad guarantee of health. But such a program may significantly increase your odds of remaining free of breast cancer, and it will certainly provide you with all the general health benefits of practicing yoga while it deepens your awareness of your body and of the connections between your personal health and the health of the world around you.
Joanna Colwell lives in Middlebury, Vermont, and teaches Iyengar-style yoga and breast health workshops around the U.S. She can be reached at firstname.lastname@example.org.