Breast Cancer Prevention: Improve Your Odds of Staying Breast-Cancer-Free

I often am asked what a woman can do to minimize her risk of developing breast cancer. Despite the fact that no currently available intervention can guarantee that a woman will remain breast-cancer-free for her lifetime, there are a number of things a woman can do to minimize her risk of getting breast cancer.  The idea that there is nothing anyone can do to avoid breast cancer is not only false but also harmful.

One thing a woman can do to decrease her risk of breast cancer is to avoid long-term use of medications containing estrogens. One type of treatment often referred to as “hormone replacement therapy,” is known to increase a woman’s risk of developing breast cancer. Other forms of medications containing estrogens also may slightly increase a woman’s risk of developing breast cancer. Women taking such medications should discuss the relative risks and benefits of these medications with their personal health care providers.

Another known risk factor for breast cancer is obesity. This is due to the fact that after menopause the majority of the estrogens created are produced in fat tissue and not in the ovaries.  Since stimulation of breast tissue by estrogens is thought to cause some breast cancers, it makes sense that decreasing fatty tissue and thereby decreasing the amount of estrogens produced by fatty tissue decreases a woman’s risk of breast cancer.

Yet another thing many women can do to decrease their risk of breast cancer is something that most women would think only benefits the heart and other muscles ­— exercise.  Exercise has been shown to decrease the likelihood of breast cancer development. This may be because it can help women to avoid weight gain while also decreasing the amount of estrogen that circulates unbound in the blood stream. There is evidence that this unbound form of estrogen may be more able to induce breast cancer than the bound form of estrogen.

Family planning also can lower a woman’s risk of breast cancer. A woman who has children before age 30 and who also breastfeeds can significantly reduce her risk of breast cancer.  While not everyone’s life circumstances will make this sort of family planning practical, it is a useful way to decrease lifetime risk of breast cancer for many women.

Avoiding smoking can decrease a woman’s risk of developing breast cancer. There are many carcinogens in cigarette smoke that adversely affect many tissues in the body including breast tissue.

Alcohol is a substance that is best avoided by women who wish to minimize breast cancer risk.  One theory states that alcohol may increase breast cancer risk through the production of cancer-causing chemical substances called free radicals within breast tissue.

Knowledge of both a woman’s family medical history and her personal medical history is very important in reducing her risk of breast cancer. A personal history of certain non-cancerous breast conditions (including increased breast density on mammography) may increase a woman’s risk of breast cancer. For some women this elevated risk of breast cancer makes it reasonable to consider intensified breast cancer screenings.  If a woman’s risk of breast cancer is high enough, she may be a candidate for breast surgery or for medications. Both of these types of treatment are known to substantially decrease breast cancer risk in women who are appropriate candidates for these treatments.

Often vitamins or other over-the-counter substances are advertised as breast cancer preventatives. These over-the-counter substances are unproven, costly and potentially even harmful. I would, therefore, encourage women to speak with their health care providers before taking such substances.

While we certainly have a long way to go before we understand everything a woman can do that is useful in decreasing her breast cancer risk, we have come a long way in being able to provide useful breast-cancer-prevention recommendations to women. Please take these tips into consideration for your own health care needs and the needs of the women in your life.

By Dr. Michael Peterson

Radiation Oncologist at Avera Sacred Heart Hospital