How much do we really know about how you can decrease your risk of breast cancer? Turns out, we know a lot.
We also know that prevention is the best cure.
Cancers of all kinds are feared more than any other lifestyle disease, even though we are more likely to die of a cardiovascular event like heart attack.
The wonderful news is that all the things we can do to decrease our risk of breast cancer, will also decrease our risk of heart disease.
So, let’s take an empowering look at some breast cancer facts and then we’ll be able to see clearly how to decrease the chances of getting cancer.
Breast Cancer Statistics
Women in the US have a 1 in 8 lifetime chance of getting breast cancer, but each decade of life brings an increase in incidence: at 20 years old, there is a 0.1% chance of getting breast cancer in the next 10 years, while at 70 years old there is a 3.9% chance in the next ten years.
- This year, over 300,000 new breast cancer cases will be diagnosed.
- Most women erroneously believe that breast cancer is mainly due to genetics or other factors outside of their control.
- Only 5 to 10% of breast cancers are due to genetics—inherited mutations like the BRCA gene. That means that 90% of breast cancer patients DO NOT have an inherited genetic component to their disease.
- 80% of all diagnosed breast cancers are estrogen receptor positive (ER+). Estrogen fuels those cancers.
- Before menopause, lifestyle changes will cut a woman’s risk of breast cancer by 50%.
- After menopause, lifestyle changes will cut a woman’s risk by 80%.
There are many more statistics, but the ones that I have mentioned here, show that getting breast cancer is not all about chance or genetics.
Each of us has a unique individual risk for breast cancer that is dependent on a lot of things.
In fact, breast cancer is not caused by any one of these risk factors but is due to an accumulation of several of them.
Some of those risk factors we have no control over, but we do have control over many. And the controllable risk factors often have a more powerful negative or positive effect on total risk than the uncontrollable ones.
Total Risk = What We Can Change + What We Can’t Change
So, let’s take a closer look at what total risk is based on…
These 2 lists of risk factors are a summary from the book Breasts: The Owner’s Manual, by Dr. Krisiti Funk. These risks are separated into 2 categories: 1) risk you can’t change, 2) risk you can change.
Genetics is always going to be in the “you can’t change it” list. But the study of epigenetics is showing us more and more about how our lifestyle choices affect DNA replication. So, while genetics is in that list, that is not the end of the story.
Breast Cancer Risks that You Can’t Control (MAYBE!)
- Gender—men get breast cancer too, but at a rate of less than 2500 annually.
- Age—each decade of life comes with an increase in risk.
- Age at menstruation—girls who begin breast development before the age of ten have a 22 percent increase rate of breast cancer compared to girls who develop after the age of ten. Girls who start menstruation after the age of 16 have a 50% decreased risk over those who start at the age of 12.
- Age at menopause—later menopausal age, increases risk of cancer.
- Ethnicity/Race—from greatest risk to lowest: Non-Hispanic white women; Non-Hispanic black women; Native American women: Hispanic women; Asian women.
- Socio-economic status—Increased economic status is linked to increased risk behavior: 1) no or fewer pregnancies, 2) hormone use, 3) older age at full term pregnancy, 4) fewer months breast feeding, 5) alcohol use, 6) increased weight.
- Increased Height and Bone Density—this seems weird, but both of these are associated with increased production of hormones that also cause increased risk of cancer. The hormones that cause increased height and bone density are the sex hormones, insulin-like growth factor, and insulin among others.
- Breast Density—dense breast tissue (as opposed to fatty breast tissue), comes from an increased number of ducts. Since most breast cancers are found in the ducts, that would technically increase risk.
- Personal History of Breast Cancer—if you’ve battled breast cancer once, you have an increased risk for a second diagnosis.
- Family History of Breast Cancer—on both mother’s and father’s side.
- Gene Mutations—having a gene mutation will increase your risk, but it is NOT a guarantee of cancer, especially if you work on making the lifestyle changes that we’ll talk about below. There are different mutations, and each one carries a different rate of risk. For more information on those mutations and how much risk each one carries, please go to pinklotus.com/gene mutations.
Breast Cancer Risks that You Can Control
- Weight Gain—increasing weight, increases risk. The amount of weight we gain starting from the age of 18 gives us a good look at how increased body fat increases breast cancer risk. What was your weight at age 18? If you’ve gained from 0 to 8 pounds since then, you DO NOT have any increased risk. An 8 to 14-pound weight gain, gives us a 25% increased risk. A 14 to 21-pound weight gain, has a 60% increased risk, and over 21-pound weight gain, comes with a 90% increased risk. Yikes. That was me.
- Sedentary Lifestyle—exercise decreases the amount of circulating estrogens, so, thereby decreasing risk.
- Smoking—smoking increases the risk of many cancers. The link to breast cancer is clearest is young women who have started smoking as young adults. In these women, a pack a day for 20 years (and before their first pregnancy) have a 73% increased risk. One study of California Teachers (The California Teachers Study) found that active smokers had a 32% increased risk over those who had never smoked or those who had quit.
- Increased Environmental Risk—This comes is the form of 1) Radioactivity that is often job-related, and 2) Environmental chemicals that are in our cleaning and body products which act as estrogens in our bodies. These are known as xeno-estrogens and they are much more potent and harmful than our body’s own natural estrogens.
- Stress—Chronic stress is a killer. Stress increases inflammatory pathways in the body that contribute to all kinds of lifestyle diseases including cancer. Stress is not the cause of breast cancer, but it contributes to changes in the immune system that allow for cancer cells to take hold.
Weighting the Risks
Each risk (from both lists) carries a different weight.
For example, women who are morbid obesity (BMI > 40) have a risk factor that is 3 times higher than that of a thin woman. However, a family history of 1 or 2 first or second degree relatives with breast cancer after the age of 50 has a risk factor of 1.8.
So, you see that some of the risk factors that you CAN change (like morbid obesity) have a greater influence on relative risk than others (like some genetic mutations) that CAN’T be changed.
And while we can’t go back in time to change the age at which we started to menstruate, we can be a positive influence of change for our daughters and granddaughters.
Here’s how we weight those risks. In other words, this is a list of the risks in order of greatest to least impact:
Relative risk of > 4.0:
- Inherited mutations—BRCA-1, BRCA-2, PTEN, TP53, PALB2, STK11
- Age over 50
- Mammographically dense breasts
- High dose radiation to chest prior to age 30
Relative risk of 2.1 to 4.0:
- Inherited mutations—CDH1, CHEK2, NBN, NF1, ATM, BARD1
- Personal history of ER (-) cancer prior to age 35
- Family history of 1st or 2nd degree relative prior to age 50
- Three or more relatives on the same parent’s side with breast cancer at any age.
- High post-menopausal estrogen or testosterone levels
- Morbid obesity (BMI > 40)
Relative Risk 1.1 to 2.0
- Personal history ER (-) after age 35 or ER (+) before age 30
- Family history of 1 to 2 1st or 2nd degree relatives diagnosed after age 50
- Height of 5’7” or taller
- High socioeconomic status
- High bone mineral density
- Non-Hispanic white and black races
- No full-term pregnancies
- First full-term pregnancy after age 35
- Never breastfed a child
- Menopause at or after age 54
- Menstruation started before age 12
- Diethylstilbestrol (DES) exposure
- Night shift work
- Obesity (BMI 25 to 39.9)
- Adult weight gain over 8 pounds
- Sedentary lifestyle
Each of us can look at this information and get a rough idea of how high our breast cancer risk is.
If you have a high level of family history risk, it may be worth getting a formal risk assessment and genetic testing done.
Knowing this information will help you to make decisions in making lifestyle changes and in creating a personal plan going forward.
Diving Deeper into Change
Let’s take a much closer look into each of the categories that we have the ability to change, because that is where we have the power to decrease our risk of breast cancer.
In part 2 we’ll look at obesity and weight gain and specific foods that have been shown to decrease the risk of breast cancer.
If you’ve read any of my other articles, you know that I promote a whole food type of ketogenic diet that will balance your hormones and cause weight loss. To read more about that, you can go to “Ketogenic Diet: Healthy or Harmful?”
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