Article: Can lifestyle changes impact breast cancer risk?
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AT A GLANCE
In her New York Times article, “You Can Take Steps to Lower Your Breast Cancer Risk,” author Jane Brody outlines lifestyle changes women can make to lower their risk of breast cancer(1).
According to Brody, one of the most important things women can do to reduce their risk of breast cancer is not smoke. She cites a study of more than 100,000 women conducted in northern Europe that compared nonsmokers to those who smoked 10+ cigarettes a day for 20 or more years(2). The women who smoked had a one third higher risk of developing invasive breast cancer than those who did not smoke. In addition, girls who started smoking before age 15 were nearly 50% more likely to get breast cancer.
In her article, Brody shares data from an editorial in The Journal of Clinical Oncology that outlines data that supports the conclusion that as many as 20,000 women in the U.S. continue to smoke even after a breast cancer diagnosis as well as data that show that smoking can have a negative effect on how well treatment (chemotherapy and radiation) will work for breast cancer patients.
Like smoking, drinking alcohol can impact breast cancer risk. Studies have shown that women who consume 2-5 drinks a day are 40% more likely to get breast cancer than nondrinkers. Even one drink a day can raise a woman’s cancer risk by almost 7%.
Alcohol use can also affect hormone levels. Increased levels of certain hormones can increase breast cancer risk in both pre- and post-menopausal women. And for women diagnosed and treated for breast cancer, consuming 3-4 drinks a week can increase their risk of recurrence especially in post-menopausal or overweight women. Brody states that moderation is key when considering alcohol’s potential to increase breast cancer risk.
Studies have shown that as body mass index (BMI) increases, so does a woman’s risk of breast cancer. This link is especially true if the extra weight is around the waist. Abdominal fat can produce growth factors and hormones that can stimulate breast cancer cells to grow. Maintaining a healthy weight is important both before and after a cancer diagnosis because being overweight not only increase a woman’s risk of getting breast cancer, but also can lower her chance of surviving the disease.
Paying attention to diet can lower women’s breast cancer risk. Following a heart-healthy diet can reduce risk of many diseases, including breast cancer. Healthy eating can help women maintain a healthy weight. Fiber-rich vegetables, fruits, and whole grains are good choices while limiting proteins high in saturated fats (red meat), as well as sugar-sweetened foods and drinks.
Brody shares information about some other specific food choices:
- Some studies have found the lowest risk of breast cancer among women who ate the most fruits and vegetables. However, the greatest protection was found when these healthy eating habits started early in life, not after a breast cancer diagnosis.
- Carotenoids – the orange colored plant pigments found in sweet potatoes, carrots, winter squash, cantaloupe and tomatoes – as well as dark-green, leafy vegetables such as spinach and kale are especially protective against breast cancer.
- Soy contains isoflavones that may play a protective role against breast cancer. Asian women -- who eat soy throughout their lives -- have one of the lowest breast cancer rates in the world. However, soy does not seem to show any benefit in women who eat a Western diet. Brody also suggested avoiding isoflavone supplements, which contain a high-concentration of plant-based estrogen.
- Finally, Brody points out that a number of studies have shown a diet high in saturated fats (red meat and processed meats) can increase cancer risk and that the American Cancer Society (ACS) recommends limiting red meat to two meals a week and avoiding processed meats when possible. The ACS also suggests limiting high-fat dairy foods such as cheese, ice cream, and whole milk because they can contain hormones that may stimulate cancer cell growth.
Many studies have shown that women who exercise regularly have a lower risk of breast cancer. In addition, staying active after a breast cancer diagnosis can lower your chance of dying from the disease. According to Brody, even simple exercise such as brisk walking at least 30 minutes a day can offer benefit.
What does this mean for me?
It is important to understand that this article shares actions individuals can take to lower their breast cancer risk, but not necessarily prevent breast cancer entirely. There is no direct cause-and-effect relationship between these lifestyle factors and cancer prevention. While we do know that such things as eating a heart-healthy diet can reduce the risk of many diseases, not just breast cancer, there is no way to completely eliminate breast cancer risk. Even if you have no family history, no known inherited mutation, do not smoke, drink in moderation, and maintain a healthy diet and weight, you may still be diagnosed with breast cancer. Finally, little is known about the degree to which the lifestyle changes described in this article impact risk for individuals who are already at high risk due to family history, an inherited mutation, or a previous breast cancer diagnosis.
Patients should discuss their individual breast cancer risk and how changes in lifestyle may effect that risk with their health care provider.
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New York Times: You Can Take Steps to Lower Your Breast Cancer Risk.
Parker BA and Pierce JP. Importance of Smoking Cessation to Reduce Breast Cancer Mortality. J Clin Onc.2016. 34(12):1295-6.
FORCE receives funding from industry sponsors, including companies that manufacture cancer drugs, tests and devices. All XRAYS articles are written independently of any sponsor and are reviewed by members of our Scientific Advisory Board prior to publication to assure scientific integrity.
This article is relevant for:
Any woman concerned about her risk for breast cancer
This article is also relevant for:
Breast cancer survivors
Women under 45
Women over 45
Healthy people with average cancer risk
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The American Cancer Society (ACS) guidelines on exercise, nutrition and weight for cancer prevention recommend the following:
Diet and nutrition
- Follow a healthy eating pattern, including:
- foods that are high in nutrients in amounts that help you get to and stay at a healthy body weight.
- a variety of vegetables, fiber-rich legumes (beans and peas), and whole fruits in a variety of colors. Consume at least 2½ to 3 cups of vegetables and 1½ to 2 cups of fruit each day, depending on your calorie requirements.
- whole grains rather than refined grains. At least half of the grains you eat should be whole grains.
- A healthy eating pattern that limits or does not include:
- red and processed meats.
- sugar-sweetened beverages.
- highly processed foods and refined grain products.
- It is best not to drink alcohol. People who choose to drink alcohol should:
- have no more than 1 drink per day (women) or 2 drinks per day (men).
- Exercise regularly.
- Adults should get at least 150 minutes of moderate-intensity activity (equal to a brisk walk) or 75 minutes of vigorous activity (heart rate is increased, breathing is faster and you are sweating) each week, preferably spread throughout the week.
- Physical activity has been shown to lower the risk of several types of cancer, including breast, endometrial, and colon. It also reduces the risk of other serious diseases such as diabetes and heart disease.
- Achieve and keep a healthy weight.
- Being overweight or obese is a risk factor for many cancers, including breast, colon, endometrial and pancreatic. You can control your weight through regular exercise and healthy eating.
Other experts, including the following, also provide guidelines for exercise, nutrition and health:
- The Academy of Nutrition and Dietetics
- The United States Office of Disease Prevention and Health Promotion
- The American Institute for Cancer Research
- What is my risk of breast cancer?
- Given my risk, what are some things I can do to lower that risk or prevent a recurrence?
- What can I do to help my children reduce their risk of breast cancer?
- I have smoked for a long time and I am having trouble quitting. What can I do?
- I have smoked for a long time—how will quitting now make a difference to my health?
The following are studies focused on nutrition and cancer prevention.
- NCT04125914: HEALTH4Families: Optimizing a Weight Management and Health Behavior Intervention for BRCA+ and Families. This trial studies how well weight management and health behavior intervention lower the risk of cancer in patients with hereditary breast and ovarian cancer mutations or mutations.
- Energetics and Lifestyle in Inherited Syndromes (ELLIE’s Study). ELLIE’s Project is designed to look at factors, such as weight, Body Mass Index, metabolism, dietary habits and activity levels that may affect cancer risk in people with inherited mutations linked to cancer.
- NCT05094466: Parent and Family Obesity Intervention in Reducing Obesity Risk in Racial Ethnic Minority Families. This compares the effects of parent/caregiver-focused programs to family-focused programs in reducing obesity risk in racial ethnic minority families.
- NCT04374747: Fruit and Vegetable Intervention in Lactating Women to Reduce Breast Cancer Risk. This trial is for nursing mothers. This study will look to see if eating at least 8 to 10 daily servings of fruits and vegetables reduces breast cancer biomarkers.
- NCT03448003: Comprehensive Lifestyle Change To Prevent Breast Cancer. This trial looks at how well lifestyle changes work to prevent breast cancer. Premenopausal women 18 years and older with intact breast and ovaries are eligible.
- NCT03779867: Acute Exercise Intervention in Reducing Breast Cancer Risk in Healthy Participants (ACE). This trial at the Fred Hutchinson Cancer Research Center in Seattle studies how well acute exercise in healthy participants reduces the risk of breast cancer in healthy participants.
- NCT03550885: Diet Modulation of Bacterial Sulfur and Bile Acid Metabolism and Colorectal Cancer Risk. This study investigates colorectal cancer risk in African Americans who consume high amounts of taurine and saturated fat (e.g., animal-based diets) compared with those who consume low amounts of taurine and saturated fat (e.g., plant-based diets).
- NCT04192071: Virtual Human Delivered Nutrition Module for Colorectal Cancer Prevention. This study will develop and test an interactive nutrition module for use with colorectal cancer screening to learn which messages and graphics promote understanding of cancer risk and promote screening.
Nutritionists and dieticians are experts in food and diet with a focus on helping people maintain or improve their health. Dieticians are experts who have received additional training and certification. You can find a registered dietician in your area through Eatright.org, the website for the Academy of Nutrition and Dietetics. You can search for nutritionists by specialty, including "cancer," "weight management" and "heart health."
The American College of Sports Medicine has a “ProFinder” search tool that allows you to locate certified fitness professionals by location and specialty.