Being physically active

We know from research that physical activity can help to prevent breast cancer. Studies have found a protective effect of about 15 to 20% in women who take half an hour of exercise 5 times a week. This is probably because physical activity lowers oestrogen and testosterone levels.

Breastfeeding

Statistics show that if you breastfed you are less at risk of developing breast cancer, particularly if you have your children when you are younger. The longer you breastfed your baby, the more you lower your risk. This may be because your ovaries don't produce eggs so often when you are breastfeeding. Or it may be because breastfeeding changes the cells in the breast and may make them more resistant to the changes that lead to cancer.

Aspirin and anti inflammatory drugs

Research has shown that women regularly using aspirin or other non steroidal anti inflammatory medicines probably have a small reduction in their risk of breast cancer. However, aspirin can irritate the lining of your stomach and cause bleeding. So you should talk to your own GP before starting to take it regularly. You shouldn't take it if you have any history of stomach ulcers.

Medicines to prevent breast cancer

Research is looking into drugs that may prevent breast cancer. Tamoxifen is a drug that has been used to treat breast cancer for more than 35 years. It works by stopping oestrogen from triggering hormone receptors in breast cancer cells. Some women who are at high risk of breast cancer took tamoxifen for 5 years as part of trials to see if it reduced their risk of developing it. They showed that tamoxifen can lower your risk of breast cancer if you are at high risk. The benefits of tamoxifen in preventing breast cancer seem to last for at least another 5 years after the treatment has ended.

The researchers estimate that 1 breast cancer would be prevented for every 42 women who took the drug for 5 years. The researchers also looked at other drugs similar to tamoxifen that are used to treat bone thinning (osteoporosis). These were raloxifene, arzoxifene, and lasofoxifene. These drugs also reduced the number of women who developed breast cancer. The drugs have side effects though and they increase the risk of blood clots and strokes. Tamoxifen also slightly increases the risk of womb cancer.

Other hormone drugs are being investigated for preventing breast cancer. Doctors hope that these drugs may have fewer side effects than tamoxifen. These are raloxifene (Evista), exemestane (Aromasin), anastrozole (Arimidex) and tibilone (Livial). An American systematic review in September 2009 found that tamoxifen, raloxifene and tibilone did reduce the risk of breast cancer in women at high risk.

This content is based on information published by Cancer Help UK, the patient information website of Cancer Research UK.

Diet

Diet and cancer

Researchers estimate that we may be able to prevent 9% of cancer cases by changing our diets. But it is difficult to be exact about this. Research also suggests that about 5% of cancers could be avoided by maintaining a healthy body weight.

Ways to help maintain a healthy body weight

Researching diet and breast cancer

This area of research is very difficult because we all eat such a range of different foods in such differing amounts. We have a clue about diet and breast cancer when we look at the rates of the disease in different countries.

Japanese women have a much lower rate of breast cancer than American women. But when Japanese women emigrate to live in the USA their breast cancer risk goes up. So the difference in risk must be to do with lifestyle or the environment rather than any inherited risk. The most obvious change is diet.

To draw firm conclusions about diet and disease, researchers would have to control everything a group of people ate throughout the whole of their lives. This is not really possible to do.

The next best thing is to record a large group of healthy people’s eating habits for a set period of time, then follow them up to see who has particular illnesses later in life. This is the basis of a big Europe wide research project called EPIC (European Prospective Investigation into Cancer). It is studying the links between lifestyle and cancer and involves around 520,000 people in 10 European countries.

If you would like to keep up to date with the findings from the EPIC study you can look online at the EPIC website. An overview study (meta analysis) of 45 studies reported that women who had more fats in their diet had an increased risk of breast cancer. The EPIC study has shown that women who ate higher levels of saturated fats had double the risk of breast cancer compared to those eating the least.

Foods high in saturated fat include

• Fatty cuts of meat
• Meat products, including sausages and pies
• Butter, ghee and lard
• Cheese, especially hard cheese
• Cream, soured cream and ice cream
• Some savoury snacks and chocolate products
• Biscuits, cakes and pastries

Based on the evidence we have, it appears that saturated fat does play a role in increasing breast cancer risk. But it is probably a combination of this as well as other things that causes breast cancer.

Sugars, carbohydrates and breast cancer

There is no strong evidence of a direct link between sugars and carbohydrates and breast cancer. But a large study of Chinese women in the USA reported in 2009 that for women younger than 50 a high carbohydrate diet slightly increased the risk of developing breast cancer. And the EPIC study showed that high carbohydrate diets are linked to an increased risk of a type of breast cancer called oestrogen receptor negative breast cancer.

Eating too much sugar can make you put on weight and we know that being overweight increases the risk of breast cancer in post menopausal women.

Dairy foods and breast cancer

Some recent studies have shown that women with a high intake of dairy products have a lower risk of breast cancer, but we need results from more studies before we can be sure about this. Dairy products are high in calcium, and several studies show a lower risk of breast cancer for women with high calcium intakes or calcium blood levels.

Fibre and breast cancer

Fibre is found mostly in fruit, vegetables and whole meal cereals (including flour and all kinds of bread, particularly whole grain). There is some evidence that diets containing more than 25g of fibre per day reduce the risk of breast cancer in pre menopausal women. Eating wheat bran fibre has been found to lower the levels of oestrogen in the blood in women who have not yet had their menopause. Lower levels of oestrogen may help to reduce the risk of breast cancer. Researchers aren't quite clear about why wheat fibre reduces oestrogen levels. It may not be an effect of the fibre itself. Instead it may be that high fibre diets contain less fat and more antioxidants than low fibre diets.

Fruit and breast cancer

An overview study found that women who ate more fruit had a lower risk of breast cancer. This may be due to the fibre and antioxidants that they contain. Anti oxidants are molecules that prevent a chemical process called oxidation, which occurs when oxygen molecules join with another chemical. Oxidation can cause gene damage in cells that may lead to cancer. Antioxidants include vitamins A, C and E and selenium.

If you change your diet to include more fruit and vegetables, as well as more starchy carbohydrates, you will almost certainly eat less fat. So you will be more likely to keep your weight within a healthy range. This helps to reduce your risk of breast cancer.

Soya foods and other phyto oestrogens

Phyto oestrogens are chemicals found in plants (phyto means plant). So they can also be called plant oestrogens. They have a similar structure to the female sex hormone oestrogen. There are different types of phyto oestrogens. Some are found in soya bean products (isoflavones). Others are found in the fibre of whole grains, fruit, vegetables and flax seed (lignans). Milk may also contain phyto oestrogens, but this depends on what the cows have been eating.

Lignans are the main type of phyto oestrogens in the Western diet. Research into the effect of lignans on breast cancer risk was conflicting, so in 2009 researchers looked at all the studies that had been done. They found that in women who had had their menopause, high levels of lignin in the diet slightly reduced their breast cancer risk. It had no effect for premenopausal women though. We need more studies to confirm these results.

A joint study reported in July 2002, produced by Cancer Research UK, the National Cancer Institute of the USA, and the National University of Singapore. It found that women with a diet high in soya had less dense breast tissue than women with low soya diets. Higher density of breast tissue has been linked to a higher risk of breast cancer. This is the first study to directly link eating soya with an effect on breast tissue. Combining the results of lots of separate studies (a meta analysis) showed that Asian women who eat the highest amounts of soy foods had a lower risk of breast cancer. In other parts of the world, most women do not eat enough soy to reduce their risk of breast cancer.

In some studies, eating phyto oestrogens (soya flour and linseed supplements) regularly over several weeks reduced oestrogen levels. One of the active ingredients in soya is isoflavone. This chemical is similar to oestrogen and reduces the effect of human oestrogen in the body. High levels of human oestrogen can increase breast cancer risk.

Carotenoids

Carotenoids are organic colourings (pigments) found in some plants. Foods that are good sources of carotenoids include carrots, sweet potatoes, spinach, kale, greens, papaya, bell peppers, and tomatoes. A summary of published studies has shown that women with higher levels of carotenoids in blood samples may have a lower risk of breast cancer.

Coffee and breast cancer

We have included information about coffee because it is often in the news. A lot of research has looked into coffee drinking and cancer risk. Breast cancer is one of the cancers investigated, but there is no research evidence to show that coffee increases breast cancer risk.

Preventing breast cancer with diet

It may help to prevent breast cancer if you:

• Replace animal fats with polyunsaturated fats (in many vegetable oils and margarines) and monounsaturated fats (such as olive oil)
• Eat more isoflavones (found in soy, peas and beans) and lignans (found in vegetables, fruits, grains, tea and coffee)

We are not sure, but it may help if you:

• Eat more fibre from wheat bran, cereals, beans, fruit and vegetables
• Make sure you have enough calcium in your diet – from milk, cheese and other dairy foods, green leafy vegetables (such as broccoli, cabbage and okra, but not spinach), soya beans, tofu, nuts, bread, and fish where you eat the bones, such as sardines and pilchards
• Eat plenty of fruit and vegetables

If you follow these guidelines, you will be eating a healthier diet. This helps you keep your weight within normal limits and can help protect against a variety of chronic health conditions. Reducing your alcohol intake can also reduce your risk of breast cancer and other illnesses.

This content is based on information published by Cancer Help UK, the patient information website of Cancer Research UK.