Breast Pain and Birth Control Pills Art © Pam Stephan

Breasts don't stay the same all your life.  Hormonal cycles, weight gain, and pregnancy may affect the shape, size, and texture of your breasts.  Even your contraception choices may affect your breasts.  If you use hormonal contraception - more simply called "The Pill" then you may have noticed how it affects your menstrual cycles.  But did you know that the hormones in birth control pills also affect your breast health?

This month, About.com is having a blog carnival on the topic of Contraception and Your Overall Health.  Many women in their fertile years are juggling careers, education, relationships, and motherhood.  Birth control pills are often a part of that picture, while they might not be for others.  The synthetic hormones - estrogen and progestin - in combination birth control pills and minipills effect not just your reproductive health, but your overall health.  So when making a decision about taking The Pill, consider the big picture.

Birth control pills may be prescribed to help with breast pain or irregular menstrual periods.  In some cases, the use of birth control pills helps regulate hormonal cycles and prepares the way for conception - once they are discontinued.  But there are other health benefits and risks associated with The Pill.

According to the National Cancer Institute (NCI), using the synthetic hormones in oral contraceptives lowers your risk for endometrial and ovarian cancers.  NCI also studied the effect of The Pill on risk for breast cancer.  Most breast tumors are fueled by estrogen, and many tumors also use progesterone to grow.  For young women, particularly those who began using The Pill as teenagers, the lifetime risk for developing breast cancer was greater than average. Condoms and spermicides or abstinence might be safer contraception options for women in their teens and twenties.  Family history of breast cancer, race, location, and economic status didn't affect their breast cancer risk - only the addition of synthetic hormones appeared to raise these young women's risk.  Women over 20 who used The Pill had a slightly increased risk for breast cancer, but the study found that 5 to 10 years after stopping The Pill, their risk returned to the lifetime average for their age group.

So while hormonal contraception can be good for cyclical breast pain and prevention of endometrial and ovarian cancers, The Pill does comes with some risk.  If you're considering using birth control pills, discuss your risks and benefits with your doctor before requesting a prescription.  Be sure to do your breast self-exam monthly, and stay current on your screening mammograms.  If you are diagnosed with breast cancer while taking The Pill, stop using it right away.

Metformin, a drug prescribed for type 2 diabetes, appears to starve breast cancer cells by denying them access to high-energy nutrients.  The relationship between metformin and breast cancer treatment has been studied for several years, and has been tested in the lab along with Adriamycin on breast cancer stem cells.  It appears to boost the effectiveness of Adriamycin treatment for hormone-sensitive breast cancer, as well as HER2-positive and triple-negative breast tumors.

A new study supported by Breakthrough Breast Cancer has been aimed at developing a test to determine which patients with breast cancer would benefit most from a treatment plan using metformin.  The study was led by Dr. Michael Lisanti of Thomas Jefferson University and Dr. Anthony Howell of the University of Manchester.  Dr Howell explained that, "Some cancer cells are fed by healthy cells.  We discovered an agent that would block that.  It is Metformin, a common drug used to treat diabetes."  When asked how this will help breast cancer patients, he replied, ""The potential benefit is that it will stop the cancer cell being fed by the normal cell and then the cancer cell won't grow."  Dr. Howell also noted that Metformin is relatively inexpensive, especially compared to standard chemotherapy drugs.

Women who are diagnosed with aggressive forms of breast cancer may someday be tested to see if Metformin will stop the growth and recurrence of their cancer.  If their tumor responds to the diabetes drug, then they may take personalized treatment, based specifically on the type of tumor and the fuel it requires to grow.  Dr. Howell said, "This is terrifically exciting. It is a step towards having each patient get the right treatment for them - what we call personalized medicine. We are looking at a new way to separate patients based on who should respond well to the treatments we have, and who might need something different."

Metformin is readily available and each pill costs about 10 pence in the United Kingdom or roughly 16 cents in the United States.  The results of Lisanti and Howell's study was published in the journal Cell Cycle.

In our super-sized western society, with lots of fast, fat-loaded food available on every corner, obesity has become an established problem.  We know that obesity affects our health - and our children's health - in terms of quality of life and risk for many diseases.  Extra weight overloads the body and all its systems, leading to diabetes, high blood pressure, back pain, higher levels of estrogen, and increased risk for cancer.  The Cancer Advocacy Coalition of Canada believes that many thousand cases of newly diagnosed breast cancer may be prevented if better diets and regular exercise were promoted across the country.

Many of us eat too much animal fat, processed grains and refined sugars.  We avoid vegetables and fruits except as incidental side dishes.  We line up for fried foods and guzzle down sweet drinks so often that it seems normal.  Once we're loaded down with calories from this kind of diet, we don't burn it off, or use our bodies with healthy exercise.  Instead, we watch television and stare at computers or other small screens.  We drink more alcohol that we should and probably don't keep count of how many ounces of alcoholic calories we consume in a week or a month.  All this adds up to lack of good health awareness and increased risk for breast, colon, uterus, kidney and esophageal cancers.

What would it take - short of being diagnosed with breast cancer (or any cancer) for us to come to grips with our hazardous health habits?  What would it take for us to demand better education of our families and society about the effect of diet and inactivity on health?  The national and personal cost of cancer - any type of cancer - is very high.  What is needed, to get the simple message out?

If you are slim, stay that way, and keep active.  Eat carefully - your food and drink choices shape your health.  If you are carrying extra pounds, get help from your doctor to lose weight and consult a nutritionist to get a proper diet plan.  Every extra pound on your body stores hormones that can fuel breast tumors.  Even after menopause, when hormone levels fall - your extra fat tissue holds enough estrogen to cause concern.

So drop it. Drop the extra weight.  Get off the couch, out of the easy chair, hit the jogging trail or gym, and learn how to eat the anticancer diet.  Prevention is worth the work it takes to spare yourself a cancer journey.

Painful Breast Art © Sebastian Kaulitzki

Breast pain in the era of Pink Ribbon Awareness campaigns is really disturbing.  Most of us instantly worry, "Is my breast pain a symptom of breast cancer?"  Even men with breast pain may get worried about their own breast health.  Pain in both breasts or a sharp pain in just one breast may send us scurrying to the bathroom to do a quick breast self exam.  Suddenly every little bump, bruise, and hair follicle on your breast skin seems ominous and important.

Even when we've heard the statistics about 80% of all breast lumps being benign, when a lump or bump or odd rash is bothering our own breasts, its very hard to remain calm.  So take a deep breath and slow down, because I have good news for you.  Most breast pain is not related to breast cancer.   There are many benign breast conditions - many of which can cause breast tenderness, aching, swelling,  lumps, shooting pain, and even nipple discharge.  Once you figure out if your breast pain may be hormonal or non cyclical, you can use some home care to alleviate the pain - or you can call your doctor for help.

But the flip side of the good news is the bad news:  since breast cancer rarely causes pain, it can sneak up on you, if you aren't aware of your breast health, or you aren't being regular about your self-exams and annual screenings.  That is why you need to know about your family health history, your personal risk factors, and what healthy choices you can make to reduce your risk.  So its okay to have breast pain, if you take care to treat your breasts right.  Get your doctor's help when home care doesn't reduce your breast pain, and remember that those twinges and tenderness most likely are not breast cancer.

• Breast Pain And Breast Cancer Risk
• Breast Pain, Periods, and The Pill

Discuss: What is the worst thing about breast pain?