Breast cancer risk reduction strategies

  • Dr. Sharon Gunsher —Courtesy

Concord Hospital
Published: 11/27/2021 1:01:47 PM
Modified: 11/27/2021 1:00:12 PM

With one in eight women developing breast cancer over their lifetimes, many are asking what they can do to reduce their risk. A panel of specialists from Concord Hospital recently discussed breast cancer risk factors and risk reduction strategies.

What are the risk factors for developing breast cancer?

Having breasts is the number one risk factor for breast cancer; however, men can get it too. Overall, women have about a 12 percent chance of developing breast cancer, but that number can be higher for certain groups. Some factors that increase your risk are older age, a family history of breast or ovarian cancer, a previous breast cancer diagnosis, and BRCA1 or BRCA2 genetic mutations. While we have no control over some factors, others, such as diet and lifestyle can be altered to reduce our risk.

What can be done to decrease risk for those with past or family history or genetic mutations?

There are both pharmaceutical and surgical options to reduce the risk of breast cancer in patients who are at significantly higher risk of developing breast cancer.

Two major classes of drugs are available; selective estrogen receptor modulators and aromatase inhibitors. Selective estrogen receptor modulators (such as Tamoxifen and Raloxifene) can decrease the risk of developing an invasive breast cancer by 50 percent. They do have the potential to cause side effects such as hot flashes, endometrial cancer, deep vein thrombosis or a stroke. Aromatase inhibitors (Arimidex, Femara or Aromasin) are also effective and they have a better side effect profile. These are only for use in post-menopausal women. Premenopausal women can only take Tamoxifen or Raloxifene.

Surgical options include oophorectomy, removal of both ovaries; and mastectomy, removal of the breast(s). Oophorectomy only decreases the risk for breast cancer in those patients with BRCA mutations and mastectomy is a serious surgery with the potential for both physical and psychological complications. The Choosing Wisely campaign from the American Society of Breast Surgeons has a wealth of information from many specialists, including breast cancer surgeons, to help patients and their doctors determine what treatment is best for them (

What kind of diet should women follow to reduce their risk of breast cancer?

Women should choose what is called an abundance model versus a deprivation model. This simply means the focus should be a balance and variety of healthy choices and ample portions versus counting calories and rules of ‘do not’ and ‘should not,’ which leave us feeling guilty and demoralized. To be successful in maintaining or achieving a healthy body weight, it has to be a lifestyle focus, not just calories in and calories out. Women should follow a plant-based diet for optimal health. This does not necessarily mean vegan, but rather a diet with lots of vegetables, fruits, herbs and spices, nuts, seeds, whole grains, fiber-rich beans, healthy fats, and plant-based proteins such as tofu or tempeh. Sugary drinks should be limited, opting instead for water, seltzer or teas. Alcohol should also be limited or avoided completely.

Which exercise works best to reduce breast cancer risk?

Active women have a 25 percent decrease in breast cancer risk when compared to sedentary women. Exercise also reduces the chance of breast cancer recurrence as well as a variety of other health problems and diseases. The Centers for Disease Control (CDC) and the American College of Sports Medicine (ACSM) recommend that healthy adults ages 18 to 65 engage in moderate-intensity aerobic exercise for 30 minutes a day for five days per week and strength training two times per week. Moderate exercise is considered to be at 55 to 75% of an individual’s max heart rate. Activity can be occupational, recreational, walking/cycling, household chores, or other forms, though recreational or walking/cycling have been shown to be better at risk reduction than other forms of movement. High intensity intermittent training (HIIT) has become popular as it may decrease the time needed for exercise. Regardless of what is chosen, activity should be changed up every six weeks to better challenge your body.

What are environmental risk factors and how can women reduce their exposure?

We interact with the environment and can be exposed to toxins in it by breathing the air, ingestion, and skin absorption. Behavior and lifestyle can increase or reduce your exposure to environmental toxins, including carcinogens and endocrine-disrupting chemicals. Carcinogens are natural or manufactured substances known to cause cancer. Endocrine-disrupting chemicals mimic, block or interfere with hormones in the body’s endocrine system. Many chemicals are both carcinogens and endocrine disruptors, such as BPA, flame-retardants and pesticides. Smoking, drinking alcohol, use of certain personal care products, eating certain types of foods, cleaning and cooking practices, and indoor air quality are all factors we can alter or mostly control. To reduce your risk, keep your air clean, be careful what you eat and drink, think about what goes onto your skin, minimize the use of plastic and tin cans, use safe cleaning products, don’t use pesticides, and always read ingredients. Remember the adage ‘when in doubt, do without.’

Concord Hospital’s Dr. Sharon Gunsher (Concord Surgical Associates), registered dietitian/nutritionist Megan Ryder (Payson Center for Cancer Care), physical therapists Austri Monette and Barbara Baker (Rehabilitation Services), were joined by Deborah de Moulpied of the Anticancer Lifestyle Program to present on breast cancer risk factors and reduction strategies at the October Concord Hospital Trust “What’s Up Doc?” Donor Lecture Series. The monthly series, supported by the Walker Lecture Fund, features members of Concord Hospital’s medical staff speaking to Concord Hospital Trust donors about new and innovative medical treatments and services. You can watch the panel’s presentation on Concord Hospital’s YouTube channel at:

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