How to Reduce Your Risk of Breast Cancer
By: Barbara Urban, M.D.
According to the American Cancer Society, about one in eight women in the United States will develop invasive breast cancer. It is the second leading cause of cancer death in women, yet the survival rate continues to improve each year, thanks to earlier detection, increased awareness and improved treatment. The breast cancer death rate has decreased by 36 percent between 1989 and 2012. And the five-year survival for breast cancer has improved by 21 percent according to ACS statistics.
Recent studies show there are ways to help reduce the risk of breast cancer—especially for women who are at high risk. Women should talk with their doctor or health provider to understand their personal risk and to individualize their risk-reduction plan.
Certain risk factors associated with breast cancer cannot be changed. They include:
- Gender – While men can develop breast cancer, the disease is 100 times more common among women than men, the American Cancer Society says.
- Age – Risk increases as you age. About two out of every three invasive breast cancers are found in women above age 55.
- Family history – If you have a first-degree relative, such as your mother, sister or daughter who has had breast cancer, your relative risk may be two to three times higher.?
- Genetics – The society estimates five to ten percent of breast cancer cases are hereditary (the rest are sporadic cases or mixed familial and environmental factors). Inherited mutations of the BRCA1 and BRCA2 gene are the most common cause of hereditary breast cancer but other gene mutations can be responsible. Cancers tied to these mutations may be diagnosed in younger women, in both breasts or even in men.
- Race and ethnicity – Those with Ashkenazi Jewish ethnicity may have a higher risk. White women are slightly more at risk for the disease than African-American women.?
- Milestones- First menstrual period under age 12; First child born over age 30 or no children; and Menopause occurring after age 55.
- Certain types of cells discovered at breast biopsy—benign breast conditions in the category of proliferative breast lesions (especially those with atypical cells)
- Dense breast tissue
Other risk factors include weight gain, sedentary lifestyle, smoking and excess alcohol use. Women who gain weight or are obese after menopause, as well as women who drink alcohol more than seven drinks per week, have a higher risk of the disease. The use of hormone replacement in menopause still remains controversial, but studies point to some potential causal relationship to increased breast risk after two-five years of hormone use.
Still, there are approaches to reduce your risk of breast cancer-- including the following:
- Less exposure to estrogen – According to the National Cancer Institute (NCI), decreasing the length of time a woman’s breast tissue is exposed to estrogen can help prevent cancer. This can occur through:
- Breastfeeding – When the breast secretes milk during lactation, the mammary gland matures and it’s understood may decreases estrogen effects and promote healthy cell turn over. [Incidentally, women who breastfeed especially 3-6months or longer have many benefits including bonding, uterine involution and weight loss PLUS babies see improved immunity, less ear and dental issues, improved lifelong weight/blood lipids, and also the benefits of close bonding].
- Early pregnancy – Women who have first childbirth at younger age have a lower risk than those who have not had children or the first child born after age 30.
- In some cases reducing estrogen or uptake through medications (see below)
- Ovarian ablation or removal – estrogen levels can be reduced by removal of ovaries. This is usually reserved for carriers of genetic mutations or in some women with early breast cancer. It can lower cancer risk when performed before the age of natural menopause but carries other implications for bone health, etc.
- Avoiding additional hormone supplements beyond menopause.
- Weight loss and exercise can reduce body fat that contributes to estrogen levels.
- Exercise – Studies show women who exercise four or more hours a week have a lower risk. Addition of daily exercise (even adding several small intervals) may benefit by several suggested pathways: cell growth regulation, improving DNA repair, influencing epigenetics or gene expression, improving immunity and reducing chronic inflammation.
- Maintain adequate Vitamin D levels although data is limited.
- Reduce alcohol consumption and Quit smoking
If you or a loved one is at risk for breast cancer or interested in a breast cancer risk-reduction plan, talk with your primary care physician or a breast cancer specialist for more information.
Dr. Barbara Urban is a medical breast specialist at the Aiello Breast Center at the University of Maryland Baltimore Washington Medical Center.