Changes You Can Make to Lower Your Risk

Making the following changes in your life will improve your overall health and also MAY SIGNIFICANTLY REDUCE your risk for breast cancer.

Stop smoking. You should use every resource you can find to help you quit smoking — for good! Research shows that smoking causes many diseases, and it is associated with an increased risk of developing breast cancer. Smoking can also increase complications from breast cancer treatment. It can worsen radiation damage to the lung, cause difficulty healing after surgery, and increase risk of blood clots with hormonal therapy. But even knowing about all of the dangers isn't always enough to make you quit. Smoking is a habit that's very hard to break. Fortunately, if you're serious about trying, you have lots of help:

• The American Lung Association offers a free online smoking cessation program. The American Cancer Society also has a program to help people quit smoking. You can also call their “quitline,” at 1-800-ACS-2345, to get support and free advice on how to stop smoking from trained counselors.
• Medications to help you quit can be taken as a pill, chewed as gum, or worn as a patch on the skin.
• Acupuncture and meditation can also help.
• It's also easier if you have a friend or “buddy” who can either stop with you or cheer you on when you're feeling you can't make it on your own.

Get more exercise. Exercise has many healthy benefits. Research has shown that 5 hours of exercise a week may lower the risk of breast cancer. Over time, exercise may be able to lower the estrogen levels in your body. With less estrogen around, there is less stimulation of breast cell growth, which is associated with a lower risk of breast cancer. Other research on exercise and breast cancer has found that exercise also can help boost the immune system, limit weight gain from chemotherapy, and help ease treatment side effects.

Maintain a healthy weight. Overweight women have an increased risk of getting breast cancer after menopause. And being overweight can increase the risk of breast cancer coming back in women who have had the disease. There are probably several reasons that being overweight is associated with an increased risk of breast cancer. Extra fat cells make extra estrogen that might stimulate breast cell growth. Plus, overweight women tend to exercise less and eat higher-fat foods. Regular exercise can reduce fat in the body and help with weight loss. As we age, it's harder to keep weight under control because our metabolism slows down and we tend to get less exercise. But if you can stick to a low-fat, low-calorie diet and stay physically active, weight is much easier to control. Our Ask-the-Expert Online Conference from January 2005 has some good general tips on losing weight.

Reduce your exposure to estrogen. Prolonged exposure to estrogen without a break can increase your risk for breast cancer. To reduce or eliminate sources of extra estrogen from your diet and environment, try the following steps:

• Shed any extra pounds and try to keep those pounds off. Extra fat cells make extra estrogen. At a healthy weight, estrogen levels tend to be lower.
• If you have already had breast cancer, avoid taking estrogen-like and progesterone-like products such as menopausal hormone replacement therapy (HRT) and DHEA (dehydroepiandrosterone). So far the increased risk of breast cancer is most closely associated with the combination of estrogen and progesterone pills. Little is known about the relative safety of vaginal creams, gels, rings (such as Estring), “natural” hormones, and herbal hormone-like remedies. Your doctor may prescribe vaginal hormones to help with vaginal dryness and discomfort. Hormone preparations used in the vagina mostly stay in the vagina. But some of these hormones can be absorbed into your bloodstream and get to your breasts. Blood levels of estrogen depend on the dose, frequency of use, the type of estrogen preparation, and your body's ability to absorb the hormone. If you decide to use estrogen with your doctor's advice, try to use the lowest dose possible.
• Limit alcohol use. You may choose to stop drinking alcohol completely. But if you enjoy alcoholic beverages and plan to continue using them, try to have fewer than five alcoholic drinks a week. Significant alcohol use is unhealthy for your liver, which helps regulate estrogen levels in your system. So limiting your alcohol use helps your liver keep blood estrogen levels low.
• Restrict sources of red meat and other animal fats (including dairy fat in cheese, milk, and ice cream), because they may contain hormones, other growth factors, antibiotics, and pesticides. Some researchers believe that eating too much cholesterol and other fats are risk factors for cancer, and studies show that eating a lot of red and/or processed meats is associated with a higher risk of breast cancer.
• If circumstances allow, consider having children sooner rather than later in life and breastfeed your babies. A full-term pregnancy, which stops your menstrual cycle for 9 months, seems to offer protection against breast cancer. Pregnancy produces a blend of several hormones that forces breast cells to “grow up” and learn how to make milk. Estrogen is in the mix of the hormonal blend, but the other hormones seem to balance out its effects. When breast cells mature and have a job to do, they have less time to act out and cause problems — like starting a cancer. Additionally, research shows that breastfeeding lowers breast cancer risk for both younger mothers and women who have delayed having children.

Learn about good nutrition and start eating for good health. Everything your body does — from healing a wound to fighting cancer cells — is affected by what you eat. Bad nutrition seriously hampers your body's ability to function in top form. Good nutrition increases general wellness.

Two leaders in the field — Dr. Keith Block (University of Illinois and the Block Medical Center, Evanston, Illinois) and Dr. Mitch Gaynor (Strang-Cornell Cancer Prevention Center, New York City) — focus on nutrition as a means of reducing cancer risk, extending survival, and increasing quality of life. Their work emphasizes vegetarian diets and fat restriction, coupled with stress reduction and other complementary medicine therapies. They believe these factors combine to strengthen the immune system. A strong immune system can fight disease better, and it seems logical that this would lower your risk for all disease, including breast cancer.

The American Cancer Society has guidelines on nutrition and exercise for cancer risk reduction that may be helpful for you.

Eat your fruits and vegetables! Researchers disagree on whether certain vegetables or fruits reduce risk for breast cancer. One report that combined many dietary studies showed no clear decrease in risk of breast cancer from diets high in vegetables and fruits. But a diet full of produce can help you lose weight or maintain a good weight. So through this indirect result, this type of diet may also be able to help lower breast cancer risk.

Some people chose to eat organic foods when possible to minimize exposure to pesticides, extra hormones, antibiotics, and genetically modified organisms. But keep in mind that the U.S. Department of Agriculture makes no claims that organically produced food is safer or more nutritious than conventionally produced food. More research is needed to find out whether organic foods are more nutritious or healthier compared to foods produced by traditional farming methods.

Here are some easy ways to make sure you get at least five servings of vegetables and fruit in a day (nine is better):

• Add chopped squash and carrots to jarred or fresh spaghetti sauce (serve on pasta for a great dinner).
• Eat tomatoes, tomatoes, tomatoes — raw in salad, sandwiches, salsa, juice, or alone (like a piece of fruit), or cooked in sauces.
• Eat whole fruit rather than drink juice to reduce calories, add fiber, and increase feelings of fullness.
• Snack on baby carrots and celery (keep a cooler of them in the car).
• Throw handfuls of spinach into stews and soups.
• Add shredded lettuce to potato salad.
• Add broccoli, tomatoes, or zucchini to scrambled eggs or omelets.
• Freeze grapes and berries in single-serving containers for a cool treat during summer months.

Relax. Anything you can do to reduce your stress and to enhance your comfort, joy, and satisfaction will have a major effect on your quality of life. So-called “mindful measures” (such as meditation, yoga, visualization exercises, and prayer) may be valuable additions to your daily or weekly routine. Intriguing new studies suggest that these fundamental but non-traditional interventions may strengthen the immune system. And if your immune system is strong, it's better able to fight disease. For example, improved immune cell function has been documented after people with melanoma, a malignant skin cancer, attended regular support group meetings. Another study found that women in breast cancer support groups had a better quality of life and more immune cells in the blood than those who don't join such groups. The power of support goes a long way to reduce stress and make people feel connected — not alone — in their fight against cancer.