You’ve seen the statistics: 1 in 8 women will be diagnosed with breast cancer during her lifetime, 230,000 new invasive breast cancer cases are discovered annually, and more than 39,000 women will die this year of the disease. But during this month of pink ribbons and breast cancer awareness campaigns, many health experts are focusing on another number: 38 percent. According to a sweeping 2010 report by the American Institute for Cancer Research (AICR), that’s the minimum number of cases that could be prevented if women kept their weight in check, followed a cancer preventive diet, and steered clear of certain risk-boosting compounds.
“For a long time, when people have talked about breast cancer prevention, they have focused on mammograms and other forms of early detection,” says Robert Pendergrast, MD, author of Breast Cancer: Reduce Your Risk with Foods You Love (Penstokes, 2011). “Those are important and no doubt save lives. But there are a lot of things women can do to lower their risk of ever developing it in the first place.”
Contrary to popular belief, only 5 percent to 10 percent of breast cancer cases are rooted firmly in genetic abnormalities, such as mutations in the BRCA1 and BRCA2 genes. Although other genes may also boost susceptibility, a family history hardly seals one’s fate, says Jennie Yoon Buchanan, MD, medical director of women’s imaging at Florida Hospital in Orlando. “People may be born with a set of genes, but how those genes get activated depends a lot on what you eat and how you live,” she says. Results from numerous studies suggest certain compounds in foods have the power to “turn on” or “turn off” cancer-promoting or -preventing mechanisms; and lifestyle changes can alter the amount of cancer-fueling hormones circulating in the body.
Some risk factors are, of course, beyond control: Women who start menstruating before 12 or stop later than 55 are more likely to get breast cancer. So are older women, those who never have children, those with dense breast tissue, and those who take birth control pills or hormone replacement therapy (HRT). And it’s likely you know someone who “did all the right things” but got sick anyway.
That said, women shouldn’t feel helpless, says Moshe Shike, MD, director of clinical nutrition for Memorial Sloan-Kettering Cancer Center. Instead, be aware of the risk factors and proactively search for available protection, including the following choices.
Keep your weight in check.
Of all the things you can do to reduce risk, this tops the list; it’s even more effective than quitting smoking and drinking, studies show. “If you have a lot of fat cells, you have more circulating estrogen, and increased estrogen is associated with breast cancer risk,” explains Buchanan.
This especially holds true for older women. One 2012 study of 6,400 postmenopausal women found that those who are obese have 50 percent more circulating estrogen than those of healthy weight. And according to AICR, a woman with a body mass index, or BMI, of 30 (classified as obese) has a 13 percent increased breast cancer risk compared with a woman with a BMI of 25 (slightly overweight). So cut back your portions and get moving; exercise also reduces risk.
There is no such thing as a “miracle” cancer-prevention diet, but mounting research suggests that a diet low in refined carbohydrates (which may boost insulin levels and fuel tumor growth) and high in antioxidant-rich fruits, vegetables, and good fats may reduce risk, says Shike.
Cruciferous vegetables, including broccoli and brussels sprouts, are rich in the potent anticancer compound sulforaphane, as well as a compound called indole-3-carbinol, which helps the body metabolize estrogen into a more benign form, says Pendergrast. Antioxidant beta-carotene, found in bright orange squash, carrots, and sweet potatoes, also lowers breast cancer risk, according to a 2012 meta-analysis in The American Journal of Clinical Nutrition.
Fiber, via fruits, vegetables, and whole grains, helps to usher toxins and excess estrogen out of the body, Buchanan says. Flaxseed is a good source because it contains both soluble and insoluble fiber, as well as lignans, which have both plant estrogen and antioxidant qualities; in fact, flaxseed contains 75–800 times more lignans than other plant foods. Sprinkle 1–2 tablespoons ground flaxseed on cereal per day.
Fatty fish, including wild Alaskan salmon and farmed rainbow trout, is rich in anti-inflammatory omega-3 fatty acids. “Recent research shows that inflammation in the tissues actually allows cancer cells to dodge the body’s immune response,” says Pendergrast.
In laboratory studies, certain spices, including curcumin, have been shown to reactivate sleeping tumor suppressor genes (TSGs), enabling them to kill off proliferating cells before they become cancerous. Fresh ginger and rosemary are potent anti-inflammatories, too.
Got teen daughters? Turn them on to soy smoothies. Evidence indicates that soy, particularly during puberty, reduces breast cancer risk later in life, possibly by moderating estrogen production in the breast tissue as it develops. And forget the myth that soy exacerbates breast cancer or interferes with treatment; two of the most recent human studies of women who ate or drank soy products after being diagnosed with breast cancer showed a slightly lower risk of cancer recurrence, says Robert Rountree, MD, Delicious Living’s medical editor.
Go easy on alcohol.
In addition to packing on pounds and boosting overall cancer risk, booze boosts activity of an enzyme called aromatase, which converts other hormones into estrogen. “For any increase in alcohol use, there is a linear increase in breast cancer risk,” says Pendergrast. According to AICR, five drinks per week boosts a woman’s risk by5 percent; two or more drinks per day skyrockets risk by more than 40 percent. So if you like the occasional cocktail, keep it below five a week. Or, if you have a strong family his- tory of the disease, consider teetotaling.
Don’t burn meat.
Research dating back more than a decade shows that charring meat in a pan or on the grill produces carcinogenic compounds called heterocyclic amines, which can fuel production of tumor-promoting hormones. One study involving 42,000 women found that those who consistently ate well-done hamburger, beef, or bacon had more than four times breast cancer risk than those who ate medium or rare meats.
3 risk-reducing supplements
Curcumin. This research-backed spice from the turmeric plant shows anticancer and anti-inflammatory properties; unfortunately, it’s not well absorbed when sprinkled on food. Try 500 mg twice daily in a standardized powder capsule.
Omega-3 fatty acids. Inflammation is increasingly linked to many forms of cancer, and omega-3s fight inflammation. Try 2 grams of EPA-DHA daily in a fish oil or vegetarian capsule.
Vitamin D. Some studies show that vitamin D supplementation reduces breast density, a risk factor for developing breast cancer. (Breast density can also make it hard for clinicians to find tumors with a mammogram.) One four-year trial of 1,179 postmenopausal women found that those who took 1,100 IU vitamin D3 plus calcium daily significantly reduced their risk for all cancers.
When detected before symptoms appear, breast cancer survival rates approach 100 percent, but nearly one-third of cases are discovered after that point.
Starting at age 20:Conduct breast self- examinations regularly and have a clinical breast exam (CBE) at least every three years.
Starting at age 40: Have a mammogram and CBE every year.
If you are at high risk (family history, dense breasts, or confirmed gene mutation): Consider getting a more sensitive MRI in addition to a mammogram annually.
Source: American Cancer Society