4 lifestyle habits to reduce your breast cancer risk

While you can’t change your family’s medical history or your genetics, there are lifestyle choices you can make to help reduce your risk of breast cancer.

“Breast cancer is hormone related and develops in response to hormones such as estrogen and progesterone,” said Peter Hopewood, MD, a Falmouth Hospital surgeon who heads the Cape Cod Healthcare Cancer Committee for Cape Cod and Falmouth hospitals.

There are certain lifestyle habits that help decrease the amount of estrogen in the body and help reduce your risk of breast cancer, he said. They include:

• Exercising regularly
• Maintaining a healthy weight
• Eating a healthy diet
• Avoiding alcohol.

The American Institute for Cancer Research (AICR) published research in 2023 that showed the importance of exercise and diet in relation to breast cancer. The following are three key takeaways from the research:

• Maintaining a healthy body weight can help to prevent breast cancer and improve survival chances after diagnosis.
• Physical activity may reduce the risk of death after a breast cancer diagnosis and also help reduce breast cancer recurrence.
• Healthy eating helps reduce risk of death from breast cancer. Research showed eating more dietary fiber from whole grains, pulses, vegetables and fruits helps improve survival. Soy foods including tofu and edamame may reduce risk of death and breast cancer recurrence.

The AICR also recommends against taking dietary supplements for cancer prevention because they don’t offer the same benefits as eating whole foods.

In addition to eating a variety of fresh vegetables and fruits, whole grains and beans, you should also add oily fish, like mackerel, swordfish, tuna and salmon, because they are high in beneficial omega-3 fatty acids, said Dr. Hopewood. “Any diet that has low animal fat like the Mediterranean diet is good.”

Weight Control and Estrogen

Weight control is important because of its relationship with estrogen, he said.

“Estrogen is found in many different places in the body and the building blocks of estrogen are in the fatty tissues under your skin. If you are overweight, you make more estrogen, and this is especially a concern for women who are postmenopausal because they can develop obesity-related breast cancer or uterine cancer.”

Alcohol consumption also causes concerns because of its relationship with weight gain and estrogen. Breast cancer is one of the six types of cancer linked to drinking alcohol, according to the Breast Cancer Research Foundation (BCRF). Alcohol contains a significant amount of empty calories and increases breast cancer risk by contributing to weight gain and obesity. Researchers have also observed that drinking alcohol causes a rise in estrogen receptor positive breast cancer (ER+), the most common form of breast cancer.

“The thinking now is that no alcohol is better that even a small amount of alcohol,” said Dr. Hopewood.

Hormone Replacement Therapy Extends the Estrogen Window

The “estrogen window” is also something to consider when thinking about breast cancer risk, he said. The estrogen window is the total time a woman’s body is exposed to estrogen in her life. “It begins with your first menstrual period and ends with the last one,” he said. The earlier you start your period and the longer you have them, the more the estrogen continues and the estrogen window stays open.

Pregnancy will close the window for a bit because of elevated progesterone levels, which prevent the body from preparing for another menstrual cycle. If you’ve never been pregnant, the estrogen continues and remains open. Hormone replacement therapy during menopause to alleviate symptoms of hot flashes also extends your exposure to estrogen, said Dr. Hopewood.

New Guidelines

Newer guidelines by the American College of Radiology in 2023 recommend that all women have a risk assessment for breast cancer when they reach age 25, he said - this is in addition to the established screening guidelines recommending that women begin having mammograms at age 40 if they were of average risk for developing breast cancer. The new recommendations help to identify women at higher-than-average risk so they can begin appropriate screening earlier, if necessary.