Every woman wants to know what she can do to lower her risk of breast cancer. Some factors associated with breast cancer cannot be changed — being a woman, your age, and your genes. This month, I want to address the factors you can have an impact on by making wise choices. I want to empower you to keep your breast cancer risk as low as possible.

Factors you CANNOT control:

• GENDER: Breast cancer is the most common cancer in American women. There will be about 190,000 new cases of breast cancer and 60,000 cases of non-invasive breast cancer in American women this year. About 39,000 women will die of breast cancer. However, after increasing in numbers for two decades, the incidence decreased by 2% per year from 1998 to 2007.
• AGE: Approximately two out of three invasive breast cancers are found in women ages 55 and older.
• Family History: If you have a first degree relative (sister, mother, daughter) diagnosed with breast cancer, your risk is doubled. If two first- degree relatives have been affected, your risk is FIVE TIMES HIGHER.
• PERSONAL HISTORY: If you have had breast cancer, you are three to four times more likely to develop a new cancer in the other breast.
• RACE/ETHNICITY: White women are slightly more likely to develop breast cancer than African-American, Hispanic, and Asian women. However, African- American women are more likely to develop more aggressive and advanced stage breast cancer at the time of diagnosis.

Factors you CAN control that will lower your risk of breast cancer:

• WEIGHT: Having a BMI (Body Mass Index) greater than 25 places you at a higher risk for breast cancer, as well as for recurrence. The higher risk is because of increased estrogen levels produced in the fat cells. Weight gain is more of a risk factor after menopause. The location of fat in the abdomen is greater risk than fat in the thighs and hips.
• HORMONE REPLACEMENT: The studies in this area are somewhat confusing, with some data showing no increase risk with estrogen, but increase risk with estrogen and progesterone. All of these studies have been with synthetic hormones, and the data on bio-identical hormones has been limited. A large study looking at French women using the estrogen patch with bio-identical progesterone versus synthetic progesterone showed a two-fold increase with the synthetic and no increase risk with the bioidentical. The use of estrogen should be the lowest possible dose and taken for the shortest amount of time. I personally try to get most of my patients off of synthetic estrogen. Many menopausal women are estrogen dominant, and the use of estrogen only compounds the problem with weight gain and increase risk of breast stimulation.
• DRINKING ALCOHOL: Research consistently shows that drinking alcohol increases the risk of hormone-receptor-positive breast cancer. Women who have two to five drinks per day have about a 50% increase in breast cancer, as compared to non-drinkers.
• EXERCISE: Research has shown a link between exercising regularly at a moderate intensity level for 4-7 hours per week and a lowered risk of breast cancer. Exercise controls blood sugar and insulin growth factor, a hormone that affects how breast cells grow and behave. Fat cells make estrogen. When breast cells are exposed to extra estrogen over time, the risk of developing breast cancer is higher.
• VITAMIN D LEVELS: Vitamin D stimulates the immune system. Women with low levels of vitamin D have a higher risk of breast cancer. Vitamin D may play a role in controlling normal breast cell growth and be able to stop cancer cells from growing.
• LIGHT EXPOSURE AT NIGHT: Women who work the night shift have a higher risk of breast cancer. This is felt to be due to low levels of melatonin.
• DIET: Diet is responsible for about 30 – 40% of all cancers. No food or diet can prevent you from getting cancer. But some foods boost your immune system and help to keep your risk at a minimum. Breast cancer is low in countries where the diet is plant-based and low in total fat (polyunsaturated and saturated fats). What can you do? Eat plenty of fruits and vegetables – more than 5 cups each day. Foods that have shown to boost the immune system include tomatoes, mushrooms, onions, carrots, squash, broccoli, whole fruit, berries, and greens. Eat lots of salad. Think whole foods and fiber, and avoid processed meats and cold cuts.
• CHEMICALS IN FOODS: This is a hot topic that has not yet shown a direct connection to breast cancer; but, it is an area where we should be cautious. Pesticides on commercially grown fruits and vegetables – as well as steroids given to livestock – get into our system. What about mercury in fish, which is a known toxin to the body? Also, Atrazine (a commonly used pesticide) can increase estrogen levels. So the “better safe than sorry” principle applies here.
• GRILLED FOOD: Women who eat a lot of grilled, barbecued, and smoked meats have a higher risk of breast cancer. The longer and hotter the cooking, the more heterocyclic amines (HCA) are formed. Polycyclic aromatic hydrocarbons (PAH) form in smoke that is produced when fat burns or drips onto a hot grill. These both have been linked to breast cancer.

Some of these changes will yield instant payoff – like going on bio-identical hormones and keeping your weight controlled. Many cancers are preventable with the proper lifestyle changes. Set goals for yourself and do the best you can on a daily basis.

Dr. Dent is the creator of the “Synergy System,” a wellness and weight loss program that promotes metabolic and hormonal balance. With weight loss centers in Columbia, Florence, and Sumter, SC, Dr. Dent’s program has helped patients from all across South Carolina meet their weight loss goals and improve their overall wellness.