Outsmart Breast Cancer
Nine steps that make a difference — from eating the right vegetables (not all are equal) to taking the correct supplements
Here's the good news about breast cancer: No matter what age you are now, or what generation you belong to, it's not too early, or too late, to take steps to avoid the disease. And recent research has given you more ways — and more effective ones — to do just that.
1. Watch Out for Weight Creep
If you could still fit into your high school prom dress (with Spanx, if necessary), you're in good shape in more ways than one. Women who have gained between 21 and 30 pounds since age 18 have a 40 percent increased risk of breast cancer compared with those who have put on five or fewer pounds, an American Cancer Society (ACS) study found for non-HRT users. Interestingly, this was true even if the low-gainers weren't at a perfect weight when they were young. That's because a rise in overall body fat is tied to an increase in circulating insulin and estrogen levels — both of which are linked to breast cancer risk. No way your prom dress would fit today? "Taking off just 5 to 10 percent of your body weight can make a difference," says the ACS's Colleen Doyle, M.S., R.D. If you weigh 160, that's only eight to 16 pounds.
2. Embrace Cauliflower
You wouldn't think that the benefits of fruits and veggies would be in question, but.... While experts agree that eating loads of produce is good for your overall health, when it comes to specific protection against breast cancer, evidence has been shakier. Recent research, however, does seem to show that adopting a pattern of eating that includes lots of fruits and vegetables is beneficial. When Colorado State University scientists took a second look at the famed Singapore study — the research that initially pointed to the pluses of an Asian-style diet — they found that even among Chinese women, those who ate a more "vegetable-fruit-soy" diet had a lower risk of breast cancer than women whose plates contained less of these. The vegetables that seemed to do the most good: the cabbage family — cabbage itself, broccoli, cauliflower, Brussels sprouts, and kale.
3. Back Away from the Bar
No one's advocating a return to Prohibition, but the reality is that the more alcohol you consume, the greater your odds of getting breast cancer — possibly because it raises estrogen levels. "I tell my patients that doesn't mean you can't enjoy a glass of wine at a party, but you do need to consider that your risk increases with every drink you have," says cancer prevention and detection specialist Therese Bevers, M.D., of the MD Anderson Cancer Center. The consensus among health groups: Limit consumption to one drink or less per day.
4. Swallow a Super Supplement
In a Canadian study involving more than 6,000 women, those who reported taking a daily dose of vitamin D were 24 percent less likely to develop breast cancer. The science is not definitive, but evidence is growing that women with adequate vitamin D blood levels have a lower risk of breast cancer than those whose levels are below normal — a surprising number of us, it turns out. Doctors can now do a simple blood test to check D levels, which may be particularly important if you're a breast cancer survivor or are at high risk. Government guidelines call for 200 to 600 IUs of D daily (depending on age), but many experts advise 1,000 IUs or more — and are urging that the guideline be revised. If you're deficient, ask your doctor about supplements, suggests oncologist Marisa Weiss, M.D., founder of Breastcancer.org.
As for other supplements, the evidence isn't as clear. At a recent meeting of the American Association for Cancer Research, Puerto Rican scientists presented study findings that linked daily multivitamin and calcium supplement intake to reduced odds of breast cancer. But this research hasn't been published yet, and other studies have had mixed results — some found a benefit, some didn't. It's therefore too early to say that you should be taking these.
5. Avoid Excess Hormones
Most women are aware that hormone therapy has been linked to a higher risk of breast cancer. But studies have also found that birth control pills raise your chances slightly, at least while you're actually on the Pill (the risk starts to go down when you stop taking it; after 10 years, it's the same as it would be if you'd never been on the Pill). Even low-dose versions may be problematic. "No one really knows the long-term impact of being on the low-dose Pill nonstop for decades," says Dr. Weiss. The best strategy: Talk to your doctor about whether the Pill is right for you, weighing its risks against its benefits (including a significantly lower chance of getting ovarian cancer).
6. Race for the Prevention...
Being physically active, it turns out, could be the single best thing you can do to protect your health. For a start, regular aerobic activity — 30 minutes a day, five days a week — helps control your weight. But it also acts directly on body chemistry to lower levels of circulating insulin and estrogen. Even if you haven't been active before, you can still reap the benefits. A new Canadian study found that formerly sedentary postmenopausal women who did three hours of aerobic exercise per week were able to lower their hormone levels significantly — thereby cutting their risk.
7. ...And Keep on Going
Surviving and thriving after diagnosis may also depend on stepping up the pace. In a review of six studies involving 12,000 breast cancer patients, researchers found that regular exercise could reduce disease recurrence by 24 percent, breast cancer deaths by 34 percent, and overall deaths by 41 percent.
8. Don't Dis (or miss) Mammos
When a government-sponsored task force announced last year that it didn't think there was enough evidence to subject women in their 40s to regular mammograms — and that women in their 50s could be screened every other year — women were understandably confused. Lost in the uproar, however, was the fact that this isn't a new debate; experts have been arguing about the best starting age for years. Also, these were just recommendations. So far, other groups, including the American Cancer Society, haven't changed their guidelines. And neither have most doctors, who continue to advise women to have a mammogram every one to two years in their 40s, then yearly starting at 50. "I think the task force overemphasized the downsides of screening women in their 40s — false positives that need to be further investigated — and didn't give enough weight to the potential benefit of finding cancer early," says Dr. Bevers. And in case you need convincing about the importance of keeping those mammogram appointments: A major 2009 study reported that three-quarters of breast cancer deaths occurred among women who did not undergo regular screening.
9. Assert Your Individuality
Public health guidelines focus on the population as a whole, but to protect your health, you need to get specific. You may need a stepped-up screening schedule if, for example, you've ever had a breast biopsy (even if benign). Likewise, if you are at increased risk due to family history, you may need more frequent exams or screening with MRI. Make sure, too, that your doctor knows your family history (father's as well as mother's). "One of the biggest advances in the past decade has been the ability to do a more personalized risk assessment," says Dr. Bevers. In a world where breast cancer prevention for high-risk women can include everything from taking antiestrogen drugs like tamoxifen to prophylactic mastectomy, "one size fits all" no longer makes sense.
Last fall, a group of researchers from California and Texas, writing in the Journal of the American Medical Association, made the all-important point that discovering how to prevent greater numbers of cancers trumps any advances in treatment. Organized medicine, they wrote, should put more energy (and research money) into learning how to prevent the disease. Just as with treatment, we need to figure out how to personalize prevention. And since an occasional glass of wine doesn't seem to hurt, we could all toast to that.
Number of cases that could be prevented with diet, exercise, and weight control: 38%
http://www.goodhousekeeping.com/health/diseases/outsmart-breast-cancer
