Nothing guarantees that you won't develop breast cancer. But there are some things you may be able to do to reduce your risk of the disease.
ChemopreventionChemoprevention is the use of certain medications to decrease breast cancer risk. Two drugs used for breast cancer prevention in high-risk women come from the class of drugs known as selective estrogen receptor modulators (SERMs):
§ Tamoxifen (Nolvadex). Tamoxifen is approved for use as a preventive agent in women age 35 and older who have an elevated risk of developing breast cancer within the next five years. Data from several clinical prevention trials found that tamoxifen use in women at higher than average risk results in a relative risk reduction of about one-third for noninvasive breast cancer and about one-half for invasive breast cancer.
§ Raloxifene (Evista). Raloxifene is approved for prevention and treatment of postmenopausal osteoporosis, but it's also used off-label as a preventive agent for breast cancer. Large clinical trials have suggested that raloxifene is as effective as tamoxifen in preventing estrogen receptor positive breast cancer in high-risk postmenopausal women who don't have a personal history of breast cancer.
Preventive surgeryAlthough it's a radical step, preventive surgery also reduces breast cancer risk in high-risk women. Options include:
§ Prophylactic mastectomy. This preventive surgery involves removing one or both of your breasts to prevent or reduce your risk of breast cancer. You might consider this option if you're at high risk of breast cancer, you've already had cancer in one breast, you have a family history of breast cancer, you received positive results from genetic testing, or your doctors have identified early signs of cancer in your breast.
§ Prophylactic oophorectomy. This preventive option involves surgically removing your ovaries. Although the procedure is usually performed to reduce ovarian cancer risk, having an oophorectomy before you reach menopause also reduces your risk of breast cancer.
Lifestyle factorsSome lifestyle strategies may help reduce breast cancer risk:
§ Ask your doctor about aspirin. Taking an aspirin just once a week may help protect against breast cancer, but be sure to talk to your doctor before you start. When used for long periods of time, aspirin can cause stomach irritation, bleeding and ulcers. More serious aspirin side effects include bleeding in the intestinal and urinary tracts and hemorrhagic stroke. In general, you're not a candidate for aspirin therapy if you have a history of ulcers, liver or kidney disease, bleeding disorders, or gastrointestinal bleeding.
§ Limit alcohol. Drinking alcohol is strongly linked to breast cancer. The type of alcohol consumed — wine, beer or mixed drinks — seems to make no difference. To help protect against breast cancer, limit the amount of alcohol you drink to less than one drink a day or avoid alcohol completely.
§ Maintain a healthy weight. There's a clear link between obesity — weighing more than is appropriate for your age and height — and breast cancer. The association is stronger if you gain the weight later in life, particularly after menopause.
§ Avoid long-term hormone therapy. The link between postmenopausal hormone therapy and breast cancer has been a subject of debate for years, partly because research results have been mixed. Estrogen exposure clearly contributes to breast cancer risk, but for most women, the size of the contribution over a lifetime is small — particularly in the absence of other risk factors, such as family history of the disease. If you're approaching menopause and having frequent symptoms, it's probably safe to take hormones for as long as four to five years. Any longer does increase your breast cancer risk, without conferring any clear benefits. The same is true of hormone therapy after age 60.
§ Stay physically active. No matter what your age, aim for at least 30 minutes of exercise on most days. Try to include weight-bearing exercises such as walking, jogging or dancing. These have the added benefit of keeping your bones strong.
§ Eat foods high in fiber. Try to increase the amount of fiber you eat to between 20 and 30 grams daily — about twice that in an average American diet. Among its many health benefits, fiber may help reduce the amount of circulating estrogen in your body. Foods high in fiber include fresh fruits and vegetables and whole grains.
§ Emphasize olive oil. Oleic acid, the main component of olive oil, appears both to suppress the action of the most important oncogene in breast cancer and to increase the effectiveness of the drug Herceptin.
§ Avoid exposure to pesticides. The molecular structure of some pesticides closely resembles that of estrogen. This means they may attach to receptor sites in your body. Although studies have not found a definite link between most pesticides and breast cancer, it is known that women with elevated levels of pesticides in their breast tissue have a greater breast cancer risk.
New directions in researchScientists are investigating a number of potential preventive therapies for breast cancer, including:
§ Retinoids. Natural or synthetic forms of vitamin A (retinoids) may have the ability to destroy or inhibit the growth of cancer cells. Unlike other experimental therapies, retinoids may be effective in premenopausal women and in those whose tumors aren't estrogen positive. Research is ongoing. Flaxseed. Flaxseed is high in lignan, a naturally occurring compound that lowers circulating estrogens in your body. Flaxseed appears to decrease estrogen production — acting much like tamoxifen does — which may inhibit the growth of breast cancer tumors