Looking for ways to decrease your breast cancer risk? Learn more about proven modifiable risk factors and how BCRF is investing in breast cancer prevention research

When it comes to breast cancer, there are a number of ways you can protect yourself. While it’s important to note that that several factors shaping your personal lifetime risk of breast cancer are completely out of your control—among them genetics, family history, race, ethnicity, breast density, being born female—lifestyle choices can play a role.

According to a 2017 American Cancer Society (ACS) study, nearly 42 percent of cancer diagnoses and 45 percent of deaths in the US are linked to controllable risk factors for cancer. For breast cancer specifically, ACS estimates that figure is between 25 and 30 percent of cases. Other studies have shown that as many as 50 to 70 percent of breast cancers can be prevented depending on when people adopt risk-reducing behaviors and lifestyle changes.

While researchers are still working to fully understand breast cancer’s causes to ultimately prevent the disease entirely through smarter screening or even vaccines, they have identified several proven risk factors for breast cancer—including many that are potentially modifiable.

If you’re looking for ways to reduce your risk of breast cancer, we’ve rounded up research-backed modifications and tips, plus resources for starting a conversation with your doctor.

Ways to help reduce your risk of breast cancer

While lifestyle choices can potentially lower your overall risk of breast cancer, it’s important to note that there is no guaranteed “breast cancer diet,” exercise regimen, so-called “cancer-fighting superfood,” or other silver bullet that is guaranteed to lead to total breast cancer prevention. Women and men who do all the “right” things—make healthy choices, breastfeed after childbirth, maintain an ideal weight, and more—still devastatingly get diagnosed with breast cancer because of factors outside of their control.

But below you will find 10 things you can do that may positively impact your risk of breast and other cancers, along with other serious conditions like heart disease and diabetes.

1. Try to maintain a healthy weight and avoid weight gain

The relationship between body weight and breast cancer risk and outcomes is complex. BCRF investigators and others continue to study their interplay.

According to the National Cancer Institute, excess weight and obesity after menopause increases a woman's risk of breast cancer and can worsen outcomes after a diagnosis at any age. Data from the American Cancer Society links rising rates of the most common type of breast cancer—hormone receptor (HR)–positive disease—to increases in obesity.

BCRF researchers have shown that chronic obesity also accelerates the growth of basal-like breast cancer—among the most aggressive subtypes—and that gaining weight in childhood and adolescence significantly increases a person’s chance of developing breast cancer after menopause. Other investigators have found that postmenopausal women who have healthy weights (as measured by body mass index) but high levels of body fat (as measured by dual energy X-ray absorptiometry) may have an increased breast cancer risk—indicating there may be “a large proportion of the population has an unrecognized risk of developing cancer,” according to BCRF investigator Dr. Neil Iyengar.

The good news is studies have consistently shown that losing weight and maintaining a healthy diet can decrease your cancer risk. One 2020 BCRF-supported study from Dr. Walter Willett showed that women over 50 who sustained weight loss of 10 or more pounds could potentially reduce their future breast cancer risk by 32 percent.

“These findings—combined with the known connections between body weight, blood estrogen levels, and breast cancer risk—provide strong evidence that even moderate weight loss later in life can tip risk of breast cancer in a favorable direction,” Dr. Willett said of the findings.

Other research has found that even avoiding weight gain can have a big impact on your future disease risk—potentially cutting your breast cancer risk by up to half. Getting back to, say, your high school weight is likely “largely unattainable,” and can lead to weight swings and overall gains, BCRF investigator Dr. Graham Colditz said on BCRF’s podcast. His recommendation: Watch your scale to keep your weight steady as you incorporate more healthy behaviors.

“If we all avoided more weight gain in 10 years’ time, the nation would be leaner than if we all kept gaining one to two pounds a year,” he said. “[Aim to] self-monitor scales and pay attention to your weight—rather than what we may do as a nation: [set] a new year's resolution, try to lose weight, give up, gain it back. It's a seesaw that keeps going up.”

2. Eat less meat…

BCRF-supported studies and others have found that a higher intake of red meat (such as beef, pork, veal, and lamb), animal fats, and processed meat (bacon, deli meats, sausages, etc.) are correlated with a greater risk of breast and other cancers for reasons that are still being uncovered.

Aim to incorporate more plant-based sources of protein, such as beans and lentils, nuts, and quinoa—and keep your meat intake moderate.

3. …and eat more fruit, vegetables, and whole grains

A diet low in fruits and vegetables is associated with a higher risk of breast cancer—particularly estrogen receptor (ER)–negative breast cancer. The USDA dietary guidelines recommend consuming two cups of fruit and two-and-a-half cups of vegetables each day, though many Americans struggle to hit that target.

"Greens like spinach, kale, and collards are often a weak spot in many diets," Dr. Willett told BCRF as an example. "In fact, in our surveys we found about 50 percent of Americans eat almost no greens."

Vegetables, fruit, and whole grains are unparalleled sources of fiber, which may play a role in breast cancer risk reduction. BCRF-supported research has found that a higher intake of dietary fiber early in life was associated with a lower future risk of breast cancer.

Cruciferous vegetables (cauliflower, broccoli, cabbage, etc.) and leafy greens are also high in carotenoids—naturally occurring pigments in plants that act as antioxidants—which may be linked to a lower risk of ER-negative breast cancer.

The bottom line: Aim to eat a balanced mix of vegetables, fruits, and whole grains, increase plant-based proteins, and decrease meat-based/animal proteins.

4. Limit alcohol 

Many people don’t realize that alcohol is a known carcinogen: Up to six percent of cancer diagnoses and four percent of deaths have been linked to its consumption. Researchers have hypothesized that alcohol may increase estrogen in the blood and cause DNA damage, but its connection to cancer risk is still being studied.

Still, even moderate consumption—defined as up to one drink per day for women and up to two drinks for men—is associated with a higher risk of breast cancer and particularly HR-positive breast cancer. Women who have between two and three alcoholic drinks per day have a 20 percent higher risk of the disease compared to those do that do not drink.

If your goal is to do all you can to reduce your risk of breast cancer, take stock of your alcohol consumption and either limit it significantly or cut it out entirely.

5. Quit smoking

Need another reason to quit smoking? Several studies have demonstrated a link between smoking and an increased risk of developing breast and other cancers. Women who currently smoke or did in the past and have a family history of breast cancer have an even higher increased risk.

Make this year the year you finally kick cigarettes for good. The American Lung Association offers several resources to get started.

6. Get moving

Exercise plays a role in preventing breast cancer. Cardio and strength training can not only help people maintain a healthy body weight—especially when coupled with a balanced diet—but can also improve outcomes and reduce recurrence after a breast cancer diagnosis. Exercise may even help alleviate unpleasant symptoms during treatment.

If you don’t already get the recommended 30 minutes a day, it’s never too late to try. BCRF investigators recommend starting by doing something, anything, that gets you moving and that you find enjoyable to help you stick with it. Whether you walk, run, garden, play tennis, do an at-home workout, or something else, if you’re getting your heart rate up, you’re reaping benefits.

7. Breastfeed, if you can

Studies have shown that breastfeeding may reduce your risk of breast cancer, possibly because it decreases the number of menstrual cycles a woman has in her lifetime.

One BCRF investigator, Dr. Doris Germain, is even studying ways to leverage this protective effect and create a lactation-replacement therapy to prevent post-pregnancy breast cancers.

If you’re able to breastfeed, do so knowing you may reap a small protective benefit.

8. Evaluate your hormone use

Hormone-based contraceptive methods (such as the pill and intrauterine devices) and menopausal hormone therapy (a.k.a. hormone replacement therapy) may potentially increase a woman’s risk of breast cancer.

But it’s important to note that this risk is not the same for everyone, and for many women, the benefits of these therapies far outweigh it. Your family history of breast cancer, your lifestyle, how long you’ve used these methods, and more are also important factors.

Always discuss your personal breast cancer risk and use of hormones with your doctor.

9. Know your family history

When many people think of their family history of breast cancer, they tend to focus on their maternal lineage. But it’s just as important to look on your father’s side, too. Breast cancer susceptibility genes, for example, can present differently in men and women.

If you don’t already know the history of breast and other cancers on both sides of your family tree, ask. A full picture of your family history can help guide conversations with your doctor and better assess things like when you should be screened and what lifestyle changes you should especially heed.

10. If you know you have a high risk, consider your other options

If you already know you have a far-higher-than-normal risk of breast cancer—because you carry a breast cancer–associated gene mutation, such as BRCA1/2 or PALB2, for example—you may have additional options to reduce your risk including medications, surgical interventions, and heightened surveillance. As always, discuss your options with your doctor.

Assessing your lifetime risk of breast cancer

Healthcare providers often use the National Cancer Institute’s Breast Cancer Risk Assessment tool (also known as the Gail model or Gail risk assessment) to estimate someone’s average five-year and lifetime risk of breast cancer. The method has limits; it cannot predict anyone’s individual risk or give good risk estimates for women with inherited gene mutations or histories of lobular and ductal carcinomas in situ. But it can help inform screening and risk-reduction strategy recommendations.

In 2013, longtime investigator and breast cancer prevention expert Dr. Graham Colditz developed the Rosner-Colditz model for breast cancer risk with BCRF support. This method was notable for not only considering well-established factors known to increase a person’s risk of the disease (such as alcohol consumption, age of first menstrual cycle, and weight) but also those factors that were not included in other models (such as what age a woman started menopause). A subsequent validation study found that Dr. Colditz’ model outperformed the NCI model.

Unlike NCI’s Gail model—which should only be used by providers—Washington University School of Medicine’s Siteman Cancer Center provides a patient-friendly version of the Rosner-Colditz model via its Your Disease Risk website.

While this tool cannot and should not replace discussions with your doctor, it may be a useful starting point to assess your habits, see how they influence your breast cancer risk, and guide further conversations with your healthcare team.

BCRF’s focus on breast cancer prevention and risk reduction

To drastically reduce breast cancer incidence rates and death, BCRF’s overall research portfolio includes a significant investment in breast cancer prevention research and all it encompasses—personalized risk assessment, early detection, individual risk-reducing lifestyle interventions, and everything in between.

The Foundation is currently funding 40 projects to advance our understanding of risk factors for breast cancer. These projects include studies to: understand obesity, weight loss, and exercise and their impacts on risk breast cancer risk and outcomes (Drs. Anne McTiernan, Melinda Irwin, Stephen Hursting); test risk-reducing diet, exercise, weight loss, and other lifestyle programs (Drs. Iyengar, Vered Stearns); investigate early-life behaviors (Drs. Colditz and Thomas Kensler); examine the links between the gut microbiome, diet, and breast cancer risk (Drs. Willett, Dipali Sharma); and more.

These investments work in concert with the Foundation’s significant support of research into uncontrollable risk factors for breast cancer—including genetics, ethnicity and race, environmental exposures, family history—and ways to apply principles of precision medicine to prevention strategies via our pioneering Precision Prevention Initiative.

BCRF investigators are at work on every angle of breast cancer prevention and risk reduction research to ultimately stop the disease in its tracks.

This article has been updated since initial publication.

Further Reading:
Selected References:

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American Cancer Society, Inc. (2019). Breast Cancer Facts & Figures 2019–2020. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and…

Can I Lower My Risk of Breast Cancer? (2021, December 16). American Cancer Society. Retrieved March 1, 2022, from https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/can-i-l…

Farvid, M. S., Eliassen, A. H., Cho, E., Liao, X., Chen, W. Y., & Willett, W. C. (2016). Dietary Fiber Intake in Young Adults and Breast Cancer Risk. Pediatrics, 137(3). https://doi.org/10.1542/peds.2015-1226

Iyengar, N. M., Arthur, R., Manson, J. E., Chlebowski, R. T., Kroenke, C. H., Peterson, L., Cheng, T. Y. D., Feliciano, E. C., Lane, D., Luo, J., Nassir, R., Pan, K., Wassertheil-Smoller, S., Kamensky, V., Rohan, T. E., & Dannenberg, A. J. (2019). Association of Body Fat and Risk of Breast Cancer in Postmenopausal Women With Normal Body Mass Index. JAMA Oncology, 5(2), 155. https://doi.org/10.1001/jamaoncol.2018.5327

Mendes, E. (2017, November 21). More than 4 in 10 Cancers and Cancer Deaths Linked to Modifiable Risk Factors. American Cancer Society. Retrieved March 1, 2022, from https://www.cancer.org/latest-news/more-than-4-in-10-cancers-and-cancer…

Obesity and Cancer Fact Sheet. (2017, January 17). National Cancer Institute. Retrieved March 1, 2022, from https://www.cancer.gov/about-cancer/causes-prevention/risk/obesity/obes…

Rosner, B., Eliassen, A. H., Toriola, A. T., Chen, W. Y., Hankinson, S. E., Willett, W. C., Berkey, C. S., & Colditz, G. A. (2017). Weight and weight changes in early adulthood and later breast cancer risk. International Journal of Cancer, 140(9), 2003–2014. https://doi.org/10.1002/ijc.30627

Strait, J. E. (2016, January 13). Better predictor of breast cancer risk developed - The Source - Washington University in St. Louis [Press release]. https://source.wustl.edu/2013/11/better-predictor-of-breast-cancer-risk…

Teras, L. R., Patel, A. V., Wang, M., Yaun, S. S., Anderson, K., Brathwaite, R., Caan, B. J., Chen, Y., Connor, A. E., Eliassen, A. H., Gapstur, S. M., Gaudet, M. M., Genkinger, J. M., Giles, G. G., Lee, I. M., Milne, R. L., Robien, K., Sawada, N., Sesso, H. D., . . . Smith-Warner, S. A. (2019). Sustained Weight Loss and Risk of Breast Cancer in Women 50 Years and Older: A Pooled Analysis of Prospective Data. JNCI: Journal of the National Cancer Institute, 112(9), 929–937. https://doi.org/10.1093/jnci/djz226

What Can I Do to Reduce My Risk of Breast Cancer? (2020, September 14). Centers for Disease Control and Prevention. Retrieved March 1, 2022, from https://www.cdc.gov/cancer/breast/basic_info/prevention.htm

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