October is Breast Cancer Awareness Month
Updated: 13 hours ago
October is Breast Cancer Awareness Month,
but breast health deserves our attention throughout the year.
Every October, we're reminded of the importance of mammograms, early detection, and breast cancer awareness. These are important conversations, but I believe we should also be asking a broader question:
What can we do to support breast health before a problem develops?
At Boulder Integrative Health, my approach has always been to look at the whole person. That includes hormones, nutrition, metabolic health, environmental exposures, lifestyle, and individual risk factors.
Breast health is no different.
And although breast cancer is most often associated with women, approximately 1% of breast cancer diagnoses occur in men. Breast awareness matters for them, too.
Breast Cancer Screening Is Not One-Size-Fits-All
I've been following the work of Dr. Laura Esserman, a breast surgeon and researcher at UCSF who has challenged the traditional one-size-fits-all approach to breast cancer screening.
Her work, including the WISDOM study, emphasizes understanding a woman's individual risk rather than assuming every woman needs exactly the same screening strategy.
Factors such as age, breast density, family history, genetics, and previous breast biopsies can influence screening recommendations. I appreciate this perspective because it aligns with how I practice medicine. Individualized care matters.
Mammography remains an important screening tool, but it is not the entire picture. Depending on a woman's risk, additional imaging or a different screening schedule may be appropriate.
The goal is to make informed decisions with your healthcare team, not simply follow the same plan as everyone else. I recently enjoyed Dr. Esserman's conversation with Maria Shriver in The Sunday Paper. It's an excellent discussion about the future of personalized breast cancer screening and why understanding individual risk is so important.
Read the interview: Breast Cancer Care Isn't One-Size-Fits-All
Hormones and Breast Health: Understanding Estrogen Metabolism
One area I pay particular attention to, especially in women using bio-identical hormone replacement therapy (BHRT), is how the body metabolizes estrogen.
Estrogen doesn't simply circulate in the bloodstream. It is metabolized through several pathways, and some of the resulting compounds have different biological activities and implications for cellular health.
This is one reason I incorporate comprehensive urinary hormone metabolite testing into my practice. These tests provide information about estrogen metabolism that standard blood hormone levels cannot tell us.
For women receiving BHRT, understanding these pathways can help guide a more individualized discussion about hormone therapy, metabolism, and overall health.
While hormone metabolite testing is not a breast cancer screening test, I believe understanding how the body processes hormones is an important part of comprehensive hormone care.
For those interested in learning more: I explore estrogen metabolism in greater detail in my contributed chapter, “Precision Hormone Care for Men and Women: Feeling Better, Staying Safe, and Building Healthspan,” featured in the fourth edition of Tirza Derflinger's book, Take Back Control of Your Health.
In the chapter, I explain the 2-OH, 4-OH, and 16-OH estrogen metabolism pathways, why hormone delivery routes matter, and how thoughtful monitoring can support individualized hormone care.
Food Matters, Too
We often think of nutrition in terms of weight management or cardiovascular health, but what we eat also influences metabolic health, inflammation, insulin regulation, and the way our bodies process hormones.
I encourage women to focus on a colorful variety of whole foods, particularly:
Cruciferous vegetables such as broccoli, broccoli sprouts, cauliflower, Brussels sprouts, and arugula
Fiber-rich foods including vegetables, legumes, nuts, and seeds
Berries and other colorful fruits rich in polyphenols
Healthy fats from foods such as olive oil, avocado, and walnuts
Adequate protein to support muscle and metabolic health
Cruciferous vegetables are particularly interesting because they contain natural compounds called glucosinolates. One of these, glucoraphanin, found especially in broccoli and broccoli sprouts, can be converted into sulforaphane. Research suggests that sulforaphane may support the body's natural cellular defense systems, including antioxidant activity and enzymes involved in detoxification.
Fiber also supports healthy digestion and the elimination of metabolized hormones.
These foods are not a guarantee against cancer, and no single food or supplement can prevent breast cancer. But a dietary pattern rich in plant foods is an important part of long-term health. Most importantly, healthy eating doesn't need to be complicated. Consistency matters far more than perfection.
Environmental Exposures: Small Changes Can Add Up
Another consideration is our daily exposure to endocrine-disrupting chemicals.
Certain chemicals found in plastics, food packaging, personal care products, and household materials can interfere with normal hormone signaling.
We cannot eliminate every environmental exposure, nor do we need to become fearful of everything around us.
Instead, I encourage practical changes:
Use glass or stainless steel for food storage when possible.
Avoid heating food in plastic containers.
Choose fragrance-free personal care and household products when practical.
Wash fresh produce and prioritize a varied, nutrient-dense diet.
Reduce unnecessary exposure to pesticides and other chemicals where feasible.
The research connecting individual environmental exposures to breast cancer risk is complex and still evolving. Nevertheless, reducing avoidable exposures is a reasonable part of a broader approach to health.
My philosophy is to focus on changes that are realistic and sustainable.
Thermography and a Broader Conversation About Breast Wellness
Some women are also interested in thermography as an additional way to observe patterns of temperature and vascular activity at the skin's surface.
Thermography uses infrared imaging to display temperature patterns. It does not visualize breast tissue the way mammography, ultrasound, or MRI can, and it cannot determine whether a woman or man has breast cancer.
For that reason, thermography should never replace recommended breast cancer screening or evaluation of a concerning breast symptom.
I'm also pleased to share a new offering from our colleague Tirza Derflinger. Tirza is now offering her ThermoEstrogen Assessment for $125 to women currently receiving bio-identical hormone replacement therapy OR hormonal birth control under the care of a healthcare provider. *This is a specially priced assessment for women already being medically managed on BHRT. Her standard assessment is priced separately.
The assessment uses thermographic imaging as part of a broader discussion about hormonal wellness. It is not a breast cancer screening test and does not measure estrogen metabolites, but it may appeal to women who want to explore additional aspects of their health alongside their existing hormone care.
Appointments are available in Boulder, Centennial, Fort Collins, and Lakewood.
Don't Forget About Gynecologic Cancer Awareness
While October brings tremendous attention to breast cancer, September was Gynecologic Cancer Awareness Month, recognizing cancers of the uterus, ovaries, cervix, vagina, and vulva.
These cancers deserve awareness throughout the year as well.
Symptoms such as unexpected vaginal bleeding, persistent pelvic pressure, unusual bloating, or unexplained changes in bowel or bladder habits should not be dismissed.
Knowing your body, recognizing changes, and seeking appropriate evaluation are important parts of preventive care.
Bringing It All Together
My hope is that women come away from Breast Cancer Awareness Month thinking about more than scheduling a mammogram.
Yes, stay current with recommended screening. Understand your personal risk factors. Ask questions about breast density and whether additional imaging is appropriate.
But also consider the everyday factors that contribute to your overall health.
How are you nourishing your body? Are you maintaining muscle and supporting metabolic health? What environmental exposures can you reasonably reduce? If you're using hormone therapy, is your treatment being individualized and regularly reassessed?
There is no single test, supplement, diet, or screening strategy that addresses every aspect of breast health.
The most meaningful approach combines appropriate screening, informed medical care, and healthy choices we can make throughout our lives.
At Boulder Integrative Health, that's the kind of thoughtful, individualized care we strive to provide.
Yours in health,
Carrie Ballas, BSN, MS, FNP-C, ABAAHP
Founder, Boulder Integrative Health
