Hot Flashes Linked to Lower Breast Cancer Risk...Hmmm, Maybe

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Rush Hour Thinking....The following reprinted article came from one of the institutional e-newsletters I receive. I initially read it off of my Blackberry while sitting in wall-to-wall traffic on a highway. (And no, the car was not moving, I assure you. But it sure got my mind moving in wild directions.) I know that these snip-its don't provide a reader with the whole back-story. I do plan to scrutinize the original publication. I must say, however, upon reading this I felt like I had been punched in the gut. It highlighted a conundrum for me. Specifically, the incongruity of breast cancer in pre-menopausal women.

I was not menopausal when I discovered the cancer growing within me. I have no experience with hot flashes. That said, my last cycle was three months ago. Since my bout with pneumonia in December, nothing is working properly. Is this menopause? I have no other telling symptoms. Is it amenoria? Possibly. It has happened to me before - but I was a lot younger. If this is actually "symptom-free" menopause, then the below snip-it truly may be on to something.

The other punch that this article laid on me was the paradox between estrogen levels and breast cancer. My form of cancer, invasive lobular carcinoma (ILC), has been determined to be an estrogen-driven form of breast cancer. It has been hypothesized that my body does not eliminate estrogen properly. As a result, a build up of estrogen in my body became toxic / carcinogenic, and voila -- a fertile environment for cancer to grow. It would then appear, based on this theory, that my body "naturally" stores (or stored) a high level of estrogen.  The below snip-it reports that hot flashes are believed to be the result of low estrogen levels in the body. I am not experiencing anything resembling a "hot flash." It would appear, then, that my own experience may support the theory.  
 
I then took the leap to connect the dots in uncovering the "truth" about my own development of breast cancer. I started to rethink my history of multiple miscarriages. With each miscarriage it appeared that my hCG levels were not high enough to sustain the pregnancy. To my knowledge, there is no definitive evidence linking miscarriages and breast cancer. That said, there are clinical trials [See, Science Daily (Apr. 25, 2009) & Fox Chase Cancer Center] testing the use of  hCG (human chorionic gonadotropin) as an anti-cancer agent. The study is based on the thought that full term pregnancies earlier in a woman's life is a potential prophylactic against the development of breast cancer later in life. Recall, estrogen are steroids. They play a large role in a woman's monthly cycle, as well as in a pregnancy.

This then brought me to further bridge the chasm and consider the potential of a causal relationship between my reproductive hx of multiple miscarriages and low hCG levels (if hCG in indeed an anti-cancer agent), my lack of menopausal symptoms (theorized to be an indicator of high estrogen levels), and the development of ILC (an estrogen driven form of breast cancer). It is amazing the tangents the mind can indulge in when stuck in rush-hour traffic. Just proves the adage...a little knowledge can be a very dangerous thing.

Study Suggests Hot Flashes in Menopause May Reduce Risk of 2 Types of Breast Cancer

By Brenda Goodman
WebMD Health News
Reviewed by Laura J. Martin, MD
Jan. 28, 2011

A new study shows that having symptoms such as hot flashes during menopause appears to be tied to a lower risk of the most common kinds of breast cancer.

“There’s good news about hot flashes,” says Susan Love, MD, a breast cancer expert and author of Dr. Susan Love’s Menopause and Hormone Book.

Researchers from the Fred Hutchinson Cancer Center in Seattle interviewed more than 1,000 women with one of three kinds of breast cancer and compared them to nearly 500 randomly selected women of similar ages with no history of breast cancer.

Participants were asked whether they ever experienced menopausal symptoms, including hot flashes, sweating or night sweats, vaginal dryness, bladder problems, irregular or heavy menstrual bleeding, depression, anxiety, insomnia, or emotional distress.

With regard to hot flashes, women were asked how often they occurred, how long they typically lasted, and for how many total weeks or months they had them.

Compared to women who reported never having menopausal symptoms, those who had experienced symptoms had half the risk of invasive ductal carcinoma or invasive lobular carcinoma, two of the most common types of breast cancer.

And the more frequent or severe the hot flashes were, the lower their risk appeared to be.

Those associations remained even after researchers took into account other things that are known to influence breast cancer risk, such as the use of hormone replacement therapy, age at menopause, and body weight.

The study is published in the February issue of Cancer Epidemiology, Biomarkers & Prevention.

"This is the first study to ever look at this association,” says study researcher Christopher I. Li, MD, PhD, a breast cancer epidemiologist in the Hutchinson Center’s Public Health Sciences Division.

Li stresses, however, that his study was not designed to show cause and effect, and that the connection between menopausal symptoms and breast cancer is still largely a mystery.

“We don’t know a whole lot about all the biology that’s at work here,” he says.

In particular, scientists don’t know what causes hot flashes, only that they appear to be linked to lower levels of the hormone estrogen.

Breast cancer, in turn, has been linked to higher levels of estrogen, so it may be that hot flashes are acting as a marker for the intensity of hormonal changes in the body, Li says.

Indeed, a previous study showed that women who experienced hot flashes several times a day had 35% to 45% lower estrogen levels compared with women who did not experience hot flashes or who only experienced them infrequently.