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7 Things You Should Know About Breast Cancer RiskThere’s no one big way to reduce your risk for breast cancer, but a combination of approaches could make a difference. 1. Activity level
Many studies have shown that women who engage in regular physical activity have a lower risk of developing breast cancer compared with women who are sedentary. You may reduce your risk by 20%–30% by getting three to four hours of weekly exercise, from moderately intense (brisk walking and yoga, for example) to vigorous (such as jogging, cross-country skiing, and aerobic dance). Exercise also reduces the risk of recurrence if you have been treated for breast cancer.
What to do? The American Cancer Society recommends moderate to vigorous activity for 45–60 minutes on at least five days of the week. Housework and gardening count as long as you breath as hard as you would during a brisk walk. 2. Weight gain
Many studies show that weight gain is a risk factor for breast cancer after menopause. An American Cancer Society study found that women who gained 20–30 pounds during adulthood (that is, after age 18) were 40% more likely to develop breast cancer after menopause than women who gained no more than 5 pounds.
What to do? Do all you can to avoid gaining weight as an adult, and try to enter menopause at a healthy weight. If you’re overweight, try to lose weight. 3. Vitamin D There’s mounting evidence that vitamin D helps protect against several types of cancer, including breast cancer. For example, one study found that women who got plenty of vitamin D in early life — either in their diet or by spending time outdoors, where sun exposure triggers vitamin D production in the skin — had a lower risk for breast cancer. Another investigation linked high blood levels of vitamin D with a 50% reduction in risk for breast cancer. What to do? Experts have already begun to recommend 800–1,000 IU of vitamin D per day for adults. Natural food sources of vitamin D are limited, and not everyone can get the amount of sunlight needed to trigger adequate vitamin D production in the skin. The best bet is supplemental vitamin D. A standard multivitamin usually supplies 400 IU; you can get an extra 400 IU in a vitamin D supplement or in a calcium supplement containing vitamin D. 4. Alcohol Women who consume even a few drinks per week have an increased risk for breast cancer. It’s not known exactly why. Several studies suggest that the increased risk for breast cancer associated with alcohol occurs mostly in women who don’t get adequate amounts of the B vitamin folic acid. The same is true for colon cancer risk, which is more common among people who drink. According to Harvard School of Public Health nutrition expert Dr. Walter Willett, people who drink alcohol and get 600 micrograms (mcg) or more of folic acid every day aren’t at increased risk.
What to do? Women at average risk for breast cancer should limit their intake of alcohol to one drink per day. Women who have had breast cancer or are at increased risk for it for other reasons may want to avoid alcohol altogether. If you drink, make sure you get enough folic acid (at least 400 mcg per day), either in your multivitamin or by eating high folate foods such as leafy greens, peas, dried beans, or enriched cereals and whole-grain products. 5. Oral Contraceptives and/or hormone replacement
Lifetime exposure to estrogen is a risk factor for breast cancer, so there is some concern about women’s use of oral contraceptives and postmenopausal hormone therapy.
The Nurses’ Health Study found that women taking birth control pills have a slightly increased risk of breast cancer, but it falls to average within 10 years of stopping.
What to do? Birth control pills and hormone therapy have risks as well as benefits. Discuss them with your clinician before deciding whether to take them or for how long. If you know your mother took DES when she was pregnant with you, or if you took DES yourself, let your clinician know so you can discuss a screening schedule. 6. Breast density
Breasts are regarded as dense if they have less fat and more connective and glandular tissue. These features are more common in younger women’s breasts, but they are also found in many older women, especially those taking combined hormone therapy (estrogen and progestin). Breast density is also partly a heritable trait.
For reasons that aren’t fully understood, women with dense breasts are at increased risk for breast cancer.
What to do? Digital mammography has been shown to improve cancer detection in women with dense breasts. Ultrasound or MRI can also help answer questions raised by a suspicious mammogram. Much more needs to be learned about breast density before official recommendations can be made. In the meantime, if you have dense breasts, talk to your clinician about screening with digital mammography.
7. Prevention drugs?
In 1998, the 13,000-woman Breast Cancer Prevention Trial demonstrated that taking the anti-estrogen drug tamoxifen (Nolvadex) for five years cut the incidence of breast cancer by 49% in women at increased risk for the disease. Another prevention trial, the Study of Tamoxifen and Raloxifene (STAR), reported in 2006 that raloxifene (Evista) — already approved for preventing osteoporosis in postmenopausal women — works as well as tamoxifen in reducing the risk of invasive breast cancer.
What to do? If you have an elevated risk for breast cancer due to family history, age, genetic mutations, or other factors, talk to your clinician about whether tamoxifen or raloxifene might be appropriate for you. Both drugs can have serious side effects so you’ll need to weigh the decision carefully. |
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