The leading risk factor for breast cancer is an obvious one: being female. The second major risk, which can’t be avoided, is getting older.
However, many other risk factors for breast cancer — including drinking alcohol, smoking and being overweight — can be reduced through simple lifestyle and behavior changes. Joanne Mortimer, M.D., the Baum Family Professor in Women's Cancers and director of the Women’s Cancers Program at City of Hope, encourages women to take the following steps to minimize their chance of getting breast cancer.
1. Know your family history. The vast majority of breast cancers — about 85 percent — occur in women who have no family history of cancer. However, as many as 10 percent of cases are linked to inherited genetic mutations, such as those on the BRCA1, BRCA2 or PALB2 genes, Mortimer explained. An estimated 55 to 65 percent of women who inherit a harmful BRCA1 mutation and 45 percent of women who inherit a harmful BRCA2 mutation will develop breast cancer by age 70.
Women with family histories of breast or ovarian cancer should discuss genetic screening options with their doctor.
Women who are interested in genetic screening should consult with a cancer risk counselor who is trained in cancer genetics, as they can interpret test results and advise patients on their options. If a genetic mutation is identified, the patient will gain access to more insurance-covered tests, including more frequent mammograms and MRI screening.
2. Don’t miss your mammogram. Conflicting recommendations for screening can create confusion. The American Cancer Society (ACS) recommends annual mammograms beginning at age 40. Due to concerns over false positives leading to unnecessary and invasive treatments, the U.S. Preventive Services Task Force recommends screening every two years for women ages 50 to 74. The key is risk assessment, Mortimer said.
“Some organizations have left the screening age at 40 because it’s such a contentious issue. It’s more about emotion than data,” she explained. “Risk assessment is really very critical. We harp on individualized health care, and that means understanding each woman’s risk. At low risk, don’t expose them to radiation unnecessarily. Women at very high risk? By all means they may need mammograms and they may also need an MRI.”
3. Be physically active. Exercise reduces the cancer risk for all women — whether obese, overweight or lean. ACS recommends 150 minutes of moderate intensity or 75 minutes of vigorous activity each week, preferably spread throughout the week. Mortimer said a half-hour walk five days a week will do the trick.
4. Maintain a healthy weight. Being overweight or obese after menopause increases a woman’s breast cancer risk. Fat tissue produces estrogen, and having more fat tissue after menopause can increase risk by raising estrogen levels, Mortimer explained.
According to ACS, women who are overweight also tend to have higher insulin levels, which has been linked to some cancers, including breast cancer.
5. Limit alcohol intake. Alcohol is clearly linked to higher breast cancer risk — and the more you drink, the higher your risk. Women who consume one alcoholic drink per day have a slightly elevated risk compared to women who do not drink. However, those who consume two to five drinks a daily have 1.5 times the risk of those who don’t drink.
6. Don’t smoke. No study has settled the debate among scientists about a link between smoking and breast cancer definitively. Some studies have linked long-term heavy smoking to a higher breast cancer risk. The risk is believed to be highest among women who started smoking when they were young.
Mortimer joins other breast cancer experts in recommending that women avoid or quit smoking to reduce their risk for breast cancer and to promote their overall health.
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