How can I reduce my risk for breast cancer?

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Dr. Amanda J. Morehouse, MD
Critical Care Surgeon

To reduce your risk for breast cancer there are modifiable things that you can change. The genetics obviously can't change. Having your first period early slightly increases your risk for breast cancer. The things that are modifiable include the following:

  • Smoking. Smoking increases your risk for breast cancer.
  • Alcohol. Drinking alcohol in excess increases your risk for breast cancer.
  • Being sedentary. Being sedentary increases your risk, so exercise is recommended. There may be something genetically mediated when you exercise, so it actually empowers your immune system's ability to kill cancer cells.
  • Breastfeeding reduces your risk slightly.

All of those things have an association with breast cancer, but the cause and effect is not really known. It’s hard to say if those individual things directly increase breast cancer risk or if they come with another factor that's the true risk.

Screening is important, but I think the number one thing that women need to know is what their real risk is for breast cancer. Talk to your primary provider. You can even go online if you want. There are lots of calculators out there and you can get a free estimate of what your breast cancer risk is, and then make sure you've got the right screening program for you. Also understand there are lot of lifestyle choices that can affect breast health. Smoking is linked, alcohol is linked, a high fat diet, high sugar diet, lots of processed food: all of that's linked to breast cancer.

The information, opinions, and recommendations presented in this article have been compiled from a podcast and are for general information only.

Trinity Health is a Catholic health care organization that acts in accordance with the Catholic tradition and does not condone or support all practices covered in this site. In case of emergency call 911.This site is educational and not a substitute for professional medical advice, always seek the advice of a qualified healthcare provider.

Dr. Janelle C. Sanda, MD
Internist

There are steps you can take to reduce your risk of developing breast cancer. In this video, Dr. Janelle Sanda, MD, talks about several of the most effective.

Breast cancer risk reduction measures would include exercising, quitting smoking and watching your alcohol intake. We usually recommend, according to the data, no more than three drinks a week for our breast cancer survivors. I would also try to avoid hormone replacement therapy, especially the estrogen and progesterone combination agents. There are really no specific dietary recommendations other than avoiding weight gain later in life.

Maintaining a healthy, active lifestyle can guard your health and help prevent breast cancer. Watch to learn steps to reduce your risks in this video from Coliseum Medical Centers.

Dr. Audrey K. Chun, MD
Geriatric Medicine Specialist

Getting regular exercise, eating healthy and avoiding obesity provide many health benefits that can help prevent breast cancer.

Limit alcohol use, quit smoking and eat a diet rich in fruits and vegetables (choose organic produce if the price isn't prohibitive). There is no magic pill or food that will prevent breast cancer. Living a healthy lifestyle and making informed choices about screening for breast cancer and other diseases seems the most prudent way to increase the chances of living a long, healthy life.

Dr. Stephanie L. Graff, MD
Hematologist & Oncologist

Exercise, maintaining a healthy weight, not smoking, using alcohol in moderation, breast feeding and avoiding post menopausal hormonal replacement therapy have all been shown to lower the risk of breast cancer. For women at the highest risk, sometimes we consider medications (like Tamoxifen or Aromasin) for risk reduction or even risk reducing surgeries. Talk to your doctor about how to estimate your individual risk.

Dr. Julie A. Blehm, MD
Internist

There's no way to guarantee that you won't get breast cancer, but adopting certain lifestyle habits can help. In this video, Dr. Julie Blehm, MD, talks about the steps that can reduce your risk. 

Avoiding alcohol and excessive weight gain can help lower the risk of breast cancer. Watch Tejas Raiyani, MD, discuss the importance of early prevention.
Dr. Elizabeth Boham, MD, MS, RD
Nutrition & Dietetics Specialist

To help prevent breast cancer, women should avoid refined sugar, get quality sleep, eat fresh produce, limit alcohol consumption and reduce stress. Watch functional medicine expert Elizabeth Boham, MD, give her tips for prevention of breast cancer.

Dr. Ajay K. Sahajpal, MD
Transplant Surgeon

Risk factors are factors that may increase one's risk of developing breast cancer. However, some women have several risk factors and never develop breast cancer, while some women have no risk factors and develop breast cancer. Risk factors that are modifiable (able to be controlled by you) include:

  • More than one alcoholic drink a day
  • Current or recent use of birth control
  • Postmenopausal hormone use
  • Never having children
  • Having first child after age 35
  • Gaining weight or being overweight as an adult
  • Low physical activity

Reducing risk for breast cancer may involve many options. Lifestyle choices, especially diet and weight management, are extremely important. Women are counseled to maintain a healthy weight because fat cells have estrogen receptors in them, and more fat cells promote breast cancer. Good nutrition and good quality food are both very important.

When doctors are considering methods of prevention, medications have to be nontoxic and have acceptable side effects, or women will not take them. If there were a completely nontoxic pill to prevent breast cancer, people would take it—but there isn't, so the better option is to exercise and eat well.

Beyond lifestyle measures, doctors can offer many options, both medical and surgical. Exemestane is one tool that is available, which may be a good choice for post-menopausal women at high risk based on their family history. Women at very high risk, such as those with BRCA1 or BRCA2 gene mutations, may choose surgical prevention. There are great surgical techniques including excellent reconstructive methods, and the rate of risk-reducing mastectomies has been increasing.

Dr. Elisa R. Port, MD
Surgical Oncologist

Maintaining a health weight after menopause and reducing alcohol consumption may lower your risk for breast cancer. In this video, Elisa Port, MD, a surgeon at The Mount Sinai Medical Center, says there aren't many known ways to reduce your risk.

Dr. Marina Johnson
Endocrinologist

You can reduce your risk of breast cancer by lifestyle measures, including exercise, not smoking, avoiding alcohol and eating a healthy diet that’s low in saturated animal fat and high in cruciferous vegetables like broccoli, Brussels sprouts and kale. It’s also important to get at least 7 to 8 hours of sleep and to maintain a normal body weight. Get at least 20 to 30 minutes of midday sun or take adequate Vitamin D3 supplements to normalize your 25-hydroxy vitamin D blood levels. When possible, breast-feed your baby because it lowers your breast cancer risk and gives your baby a good head start! When you go in for your yearly physical, ask your physician to teach you breast self-examination.

Read more in my guidebook for women, “Outliving Your Ovaries: An Endocrinologists Reviews and Risks and Rewards of Treating Menopause with Hormone Replacement.”

http://www.outlivingyourovaries.com/

Get screening to reduce your risk for breast cancer, says plastic surgeon Leslie Cohen, MD, of Retreat Doctors' Hospital. In this video, she also describes lifestyle changes to change risk factors you can control.

While there's no guaranteed way to prevent breast cancer, women are encouraged to be screened regularly, increasing the chances that breast cancer will be found early, when it's most treatable. All women should know the symptoms and warning signs of breast cancers.

Women should talk with their doctor about specific preventive measures they can take.

As with most cancers, knowing the family history of breast cancer can help patients take action toward prevention.

Women who are or may be at increased risk can take steps to reduce their chances of developing breast cancer. Before deciding, they should speak with their doctor to understand the risk and how much any of these approaches might lower their risk.

Because some studies suggest that the more alcoholic beverages a woman drinks the greater her risk of breast cancer, it is important to limit alcohol intake. Maintaining a healthy body weight is important because being overweight increases risk of postmenopausal breast cancer. New evidence suggests that being physically active may also reduce risk. Physical activity that is sustained throughout lifetime or, at a minimum, performed after menopause, may be particularly beneficial in reducing breast cancer risk. Eating a diet high in fruits and vegetables, and energy and fat intake balanced to energy expended in exercise are useful approaches to avoiding weight gain in adult life.

This answer is based on source information from National Cancer Institute.

Dr. Stuart A. Linder, MD
Plastic Surgeon

There are several risk factors that will significantly increase a women's chance of developing breast cancer. Being a woman has a higher rate of breast cancer than the male sex. The older you are, the greater the risk of breast cancer as well. The majority of invasive cancers are also found in women over 55 years of age. Women with BRCA genes are also at higher risks for breast cancer. Patients with strong family history or diathesis are also at increased risk. When a woman has already had breast cancer, the rate of recurrences is up to 4 times greater. White women have a slightly higher rate than African-American women. Other lesions including: ductal ectasia, apocrine metaplasia, phylloides tumor and peri-ductal fibrosis are not associated with a significantly increased risk. Atypical ductal hyperplasia and lobular hyperplasia are associated with an increased risk. Several lifestyle factors associated with breast cancer include having had no children by 30, hormone therapy after menopause, estrogen therapy, breast feeding and alcohol use. 

Dr. Cary Hsu, MD
Surgeon

To reduce your risk of breast cancer, it is essential that you have regular breast cancer screening. Another thing you can do is avoid hormone replacement therapy. Having a pregnancy at an early age and breastfeeding are also protective measures. Alcohol in moderation and a low-fat diet are helpful.

Tamoxifen is a drug used to treat breast cancer, but it can also be used as a preventative measure. It has major side effects, however, such as hot flashes, blood clots and predisposition to uterine cancer. Exemestane, a type of drug called an aromatase inhibitor, has been shown to reduce the risk of breast cancer by 65 percent, but this only amounts to a reduction of 0.3 percent. This is something to consider only if you are at an extremely high risk for breast cancer.

You can lower your risk of breast cancer by changing those risk factors that can be changed. Women who limit alcohol intake, exercise regularly and maintain a healthy body weight, have a lower risk of getting breast cancer. Women who choose to breast-feed for at least several months may also get an added benefit of reducing their breast cancer risk.

Not using post-menopausal hormone therapy (PHT) can help you avoid raising your risk.

Whether or not environmental chemicals that have estrogen-like properties (such as those found in some plastic bottles or certain cosmetics and personal care products) increase breast cancer risk is not clear at this time. If there is an increased risk, it is likely to be very small. Still, women who are concerned may choose to avoid products that contain these substances when possible.

Finding breast cancer early
Other than lifestyle changes, the most important action a woman can take is to follow early detection guidelines. Following the American Cancer Society's guidelines for early detection will not prevent breast cancer, but it can help find cancers when the likelihood of successful treatment is greatest.

Doctors have yet to pinpoint the exact cause of breast cancer, but there are identifiable risk factors and habits that have been discovered. Some of the known risk factors include:

  • Gender: Breast cancer occurs nearly 100 times more often in women than it does in men.
  • Age: Two out of three women diagnosed with breast cancer are diagnosed after the age of 55.
  • Race: Breast cancer is diagnosed far more often in white women than any other race.
  • Family history and genetic factors: If there is a history of cancer in your family, then you run a higher risk of being diagnosed with breast cancer.
  • Lack of physical activity: Living a lifestyle with little physical activity can increase your risk for breast cancer 10 to 20% percent.
  • Poor diet: Eating foods high in saturated fat and lacking fruits and vegetables can increase your risk for breast cancer.
  • Drinking alcohol: Excessive consumption of alcohol can increase your risk for breast cancer. Aim to have one drink a day or less to lower your risk.

Some of these factors, such as your gender and family history, are out of your control. Other factors you have plenty of control over. You can lower your risk for breast cancer by living an active lifestyle, eating healthier foods, managing your weight and moderating your consumption of alcohol.

There are both non-lifestyle-related risk factors and lifestyle-related risk factors for breast cancer. Non-lifestyle-related risk factors cannot be changed while lifestyle-related risk factors may be changed. Some risk factors are more influential than others and risk factors change over time, due to circumstances such as aging or lifestyle. Even when risk factors are present, most women who have one or more breast cancer risk factors may still never develop breast cancer, while many women with breast cancer may have no apparent risk factors. Thus, early detection of breast cancer through breast exams, mammograms, and other screenings, may help prevent unnecessary death by increasing the chances of detecting breast cancer at an earlier stage when the breast masses are most likely to be
curable. 

Lifestyle related risk factors:

  • Having Children 
  • Not Using Birth Control 
  • Breastfeeding Your Children
  • Not Using Combined Estrogen and Progesterone Post-Menopausal Hormone Therapy after menopause
  • Not Drinking Alcohol
  • Not Being Overweight or Obese
  • Increasing Physical Activity

Non-lifestyle related risk factors:

  • Gender
  • Aging
  • Genetic risk factors
  • Family history of breast cancer
  • Personal history of breast cancer 
  • Race and ethnicity
  • Dense breast tissue
  • Certain benign breast conditions
  • Non-proliferative lesions
  • Proliferative lesions without atypia 
  • Proliferative lesions with atypia
  • Lobular carcinoma in situ
  • Menstrual periods
  • Previous chest radiation
  • Diethylstilbestrol exposure

Unclear factors:

  • Diet and vitamin intake
  • Chemicals in the environment
  • Tobacco smoke
  • Night work

The most important thing you can do to prevent breast cancer is find yourself a medical home and develop a strong relationship with your primary care provider. Then, with your primary care provider, learn about the risk factors for breast cancer and what your personal level of risk is. Knowing your risk level is very important. After learning your risk level, your primary care provider and you can agree on a risk reduction plan. Sometimes this will involve a consultation with a specialist in breast cancer or a genetic counselor.

In addition to these steps, it's important to keep a couple of facts about breast cancer in mind:

  • First, you are at risk for breast cancer if you are a woman, and your risk increases as you get older. Just because you don't have a family history of breast cancer doesn't mean you can't get it. In fact, most women who develop breast cancer do not have family members with breast cancer. 
  • Second, no amount of exercise, healthy diet or vitamins can put a force field around you to keep you from getting breast cancer. So, in addition to getting a primary care provider and learning your risk level, you also need to get regular mammograms, regular breast exams by your primary care provider and report any new breast symptoms to your PCP.
Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

An ounce of prevention is worth a pound of cure, and it’s up to you to take the appropriate measures to lower your risk factors and protect yourself. There are some permanent risk factors that increase your risk, like family history and increasing age. The following, from the American Cancer Society (ACS), is a list of lifestyle-related factors that can increase your risk for breast cancer:

  • Obesity: Having extra fat in your body can raise estrogen levels, which can “increase your chance of getting breast cancer.” Furthermore, women who are overweight tend to have higher insulin levels, which has been “linked to some cancers, including breast cancer.”
  • Physical Activity: Physical activity bestows numerous benefits, including a lower cancer risk. In one study from the Women's Health Initiative, “as little as 1.25 to 2.5 hours per week of brisk walking reduced a woman's risk by 18 percent. Walking 10 hours a week reduced the risk a little more.”
  • Alcohol: Many studies have linked alcohol use with an increased risk of breast cancer, and the more you drink, the higher your risk.
  • Having Children: Because they tend to have higher exposure to estrogen, women who have had no children or who had their first child after age 30, have a slightly higher breast cancer risk.
  • Breastfeeding: Though the connection isn’t clear, breastfeeding may slightly lower one’s risk of getting breast cancer.
  • Birth Control: “Studies have found that women using oral contraceptives (birth control pills) have a slightly greater risk of breast cancer than women who have never used them.”
  • Hormone Therapy After Menopause: “Using combined hormone therapy [with both estrogen and progesterone] after menopause increases the risk of getting breast cancer. It may also increase the chances of dying from breast cancer.” However, for unclear reasons, taking estrogen-only therapy hasn’t been linked to an increased risk for breast cancer.
There are several ways you can help reduce your risk of developing breast cancer:
  • Exercise – An inactive lifestyle may increase the risk of breast cancer. The American Cancer Society recommends 45 to 60 minutes of physical activity at least five days a week.
  • Maintain a healthy diet and weight – Some studies have found that high-fat diets may increase breast cancer risk; yet, the results are inconclusive. The current recommendations, however, suggest that a diet rich in fruits and vegetables may reduce the risk of some cancers, including breast cancer.
  • Limit alcohol intake – Heavy drinking is linked to an increased risk of breast cancer.
  • Get regular screening tests – Your doctor may recommend regular self breast exams and mammograms, particularly after age 40, to detect early signs of breast cancer.
  • Talk with your doctor – When you work together with your doctor, you can better manage your breast cancer risk factors and receive the right kind of care when needed. Your doctor can tell you more about the recommended screening guidelines and help you decide what is best for you.
Managing your lifestyle and personal health care enables you to take control of your risk for breast cancer. Taking preventative steps may also increase the likelihood of early detection.
Staness Jonekos
Health Education Specialist

According to the American Cancer Society, breast cancer is the second leading cause of cancer death in women, exceeded only by lung cancer. About 1 out of every 7 women will get breast cancer over a 90-year lifespan. All women are at risk for breast cancer. Among the ways to lower your risk are:

  1. Maintain an ideal weight. The chance of developing breast cancer after menopause is higher in women who are overweight or obese.
  2. Exercise. The American Cancer Society recommends engaging in 45 to 60 minutes of physical exercise 5 or more days a week.
  3. Limit alcohol consumption. Alcohol can limit your liver’s ability to control blood levels of the hormone estrogen, which in turn can increase risk. The Harvard Nurses’ Health study, along with several others, has shown that consuming more than one alcoholic beverage a day can increase breast cancer risk by as much as 20 to 25 percent.
  4. Limit exposure to estrogen. The female hormone estrogen stimulates breast cell growth, so exposure to estrogen over long periods of time, without breaks, can increase the risk of breast cancer.
  5. Limit use of oral contraceptives. Recent use may slightly increase a woman’s risk for breast cancer.
  6. Eat fruits and vegetables. Broccoli, cabbage, brussels sprouts, kale, spinach, carrots, tomatoes, cauliflower, berries and cherries are all breast cancer fighters.
  7. Avoid high glycemic carbohydrates. Eat low to medium glycemic foods and avoid white rice, white potatoes and sugar products, because these foods may trigger hormonal changes that promote cellular growth in breast tissue. Eat whole grains and legumes.
  8. Stop smoking. Smoking is associated with an increase in breast cancer risk, and in the risk of other cancers.
  9. Reduce stress and anxiety. There is no clear proof that stress and anxiety can increase breast cancer risk, but some research suggests that practicing yoga, prayer and meditation to manage stress can strengthen the immune system.
  10. Perform monthly breast self-exams. Get routine screenings and work closely with your healthcare provider. We cannot control our gender, age, race or family history of breast cancer, but early detection can save lives.
Dr. William L. Owens, MD
Vascular Surgeon

A woman’s risk for developing breast cancer can be divided into genetic and environmental components. Though one can’t change their genetic make-up, a woman can learn if her family history places her in a high risk category for developing breast cancer. If so, she can then consider aggressive efforts to reduce her high risk, such as using medications or even surgery. Signs of a possible significant family history include breast cancer in a first degree relative (mother, sister, daughter), breast cancer in two or more second degree relatives (aunt, grandmother), a relative who had breast cancer in both breasts, a relative who developed breast cancer before the age of 45, a female relative who had ovarian cancer and a male family member who developed breast cancer. Probably the most important environmental component affecting a woman’s risk for developing breast cancer is her degree of estrogen exposure. Again, some of these elements are hard to change. For example, an early age of onset of menses and a late age of menopause mean more lifetime estrogen exposure and thus a greater breast cancer risk.

If a woman has children (and the more children she has the greater the effect), and if she nurses her children, this reduces the number of menstrual cycles she will have in her life and thus reduces her chance of developing breast cancer. There are some lifestyle factors a woman does have at least some control over that can reduce her chances of developing breast cancer.

In the body, fat can be converted to estrogen, and estrogen fuels most breast cancers. So following a diet that is low in fat, and proper control of body weight, are useful efforts. Cumulative alcohol exposure seems to associate with breast cancer risk, so moderation in alcohol use is wise. Exercise is preventative, at least 30 minutes daily. When a woman reaches menopause, it is best if she can avoid, or at least minimally use, hormone replacement therapy that uses estrogen combined with progesterone as intake of these agents raises breast cancer risk. There are mathematical models that can take many of these factors into account and generate a percentage prediction that a woman will develop breast cancer in her lifetime. If the risk number generated is large enough, the patient may be considered a candidate to take a medication to reduce her risk.

Continue Learning about Breast Cancer Prevention

Breast Cancer Prevention

Breast Cancer Prevention

Whether you have family history of breast cancer or not, you can take steps to prevent this common cancer in women. Some risk factors are lifestyle-related, while others are tied to genetics. Exercising and eating healthy are a st...

art, as well as quitting smoking and limiting alcohol. Your primary care provider can help assess your breast cancer risk; regular breast screenings and exams can catch cancer early. Women with increased risk for breast cancer, who carry BRCA genes for example, can consider risk-reducing surgery with their doctor. Learn more about preventing breast cancer and how to identify signs of cancer with our expert advice.
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.