Osteopathy and Breast Cancer
October is known for many things and breast cancer awareness is an important topic to discuss. Osteopathic manual practitioners deal with many issues in their clinics everyday so why would breast cancer be any different. In order to discuss how OMT can assist a patient who has a genetic predisposition for, is currently fighting or has dealt with a case of breast cancer we must understand the Structure and Function relationship. As we explore the intricate details of the mammary gland it is important to remember that it is a gland and receives a tremendous influence from the Endocrine, Nervous and Immune systems.
Anatomy of the Mammary Gland
The National Cancer Institute defines “the mammary gland as a glandular organ located on the chest. The mammary gland is made up of connective tissue, fat and tissue that contains the glands that can make milk.” As any true Osteopath would know this definition does not effectively describe the intricate details of the glands development, its function or how the rest of the body interacts with this specialized tissue.
Encyclopedia Britannica claims that the Mammary glands are regulated by the endocrine system and become functional in response to the hormonal changes associated with parturition. This definition is starting to explore the tissue in more depth but this still does not provide a complete understanding.
The breast tissue is a very specialized part of the female anatomy. Development is inactive until puberty when the anterior pituitary experiences increased activity. Glandular growth is primarily under the control of estrogen and progesterone stimulation.
During Pregnancy the breasts develop further due to rising levels of estrogen, progesterone, and prolactin. When nursing a mother will experience a neuro-endocrine reflex that will continue to influence prolactin release but will also cause oxytocin to contract the myoepithelial cells surrounding the lobules and ducts.
The breast receives blood supply from the lateral thoracic and acromio-thoracic branches of the axillary artery, and branches of the intercostal thoracic arteries. Venous drainage is into the axillary, internal thoracic, and intercostal veins. Lymphatic drainage is into the axillary nodes (anterior, posterior and lateral nodes and finally the apical) as well as infraclavicular group, the internal thoracic and intra-abdominal nodes.
There is no apparent central or parasympathetic nerve supply to the breast tissue. It does have innervation from sensory afferent somatic fibers which feed the hypothalamus and stimulate the anterior pituitary to release prolactin as well as the posterior pituitary to release oxytocin. Motor efferent fibers transmit impulses from the brain to cause reflex erection of the nipple and reflex vasoconstriction of arterial blood supply and therefore inhibition of milk flow.
The breast is made up of glands (also known as lobules) and ducts. These are the most common areas for the development of cancer.
The most common type of breast cancer is ductal carcinoma with the remaining cases following under the title lobular carcinoma. If cancer is found in the duct and then invades the rest of the breast tissue. On the other hand if it begins in the lobules and may metastasize in the other areas of the body like lymph vessels.
Treatment of the Breast Tissue
Dr. A. T. Still wrote extensively about many different ailments and disorders that afflict the human body. The subject of breast cancer
was no different. In Osteopathy: Research and Practice first printed in 1910 Dr Still dedicates time to review and present treatment for the breast tissue. Here is a small sample of his words.
“When the breast becomes hard after childbirth, or when you find a tumor in either breast it is because the venous system has failed to return the blood supplied by the mammary and the intercostal arteries.” This description is no different than any other message he gives regarding treatment. Structure and function are related at all levels. He always looks first to the physiology and anatomy. He observes what is in dysfunction and removes obstruction to fluid entering a tissue and drainage.
He continues by revealing some of his clinical observations. “In all tumefactions of the breast I have found ribs down and under the transverse processes. When you are trying to reduce tumors of the breast remember there are azygos veins, also mammary veins draining the venous blood.”
Once he has determined the true cause for the dysfunction in the thorax he simply goes about the business of correction. “To relieve these conditions I adjust the clavicles and ribs and set free the nerve and blood supply. Grasping the arm I bring it outward and upward strongly until I get it as high or higher than the normal position of the shoulder, and at the same time, with my other hand against the muscles and ribs in the axillary region, I bring strong upward pressure toward the head. I complete this movement by bringing the arm to its normal position at the patients side with firm upward pressure on it and the ribs and muscles.”
As Osteopathic professionals it is our duty to continue to explore both anatomy and physiology. Not separately but in relations to each other. They are connect at all levels and should never be seen as separate. Anatomy texts and charts depict the numerous systems of the body in isolation but that is false. There are always in connection with another and interwoven within each other. It is truly a complex three dimensional subject that is difficult to grasp.
Not one Osteopath who ever accomplish great things for the advancement of this science was ever satisfied with what they knew today about this subject. As Dr. Still has always said, “Dig on.”
1 Black, Rebecca F. et al. Lactation Specialist Self-Study Series, Volume 3. Jones & Bartlett Learning, 1998.
6. Still, A.T. Osteopathy: Research and Practice. 1910. Bibliolife. Kirksville, MO.