Tips for lowering your breast cancer risks

Healthy lifestyle choices may help lower your risk of breast cancer as well as your risk of heart disease, diabetes, colon cancer and osteoporosis. To promote overall health and possibly reduce the risk of breast cancer, everyone should try to:

Be physically active by getting regular exercise.

Achieve and maintain a healthy weight.

Eat at least 2½ cups of fruits and vegetables every day.

More often choose 100 percent whole grain foods, such as 100 percent whole grain breads and cereals, brown rice, popcorn and quinoa.

Limit red meat and processed meat.

Cut down on “bad” fats, saturated and trans fats, and eat more “good” fats, or polyunsaturated and monounsaturated fats (walnuts, sunflower seeds, avocados and oils of olive, peanut and sesame).

Get enough vitamin D and calcium every day. For women and men ages 51 to 70, this means 600 IU of vitamin D and 1,200 mg of calcium. For men ages 51 to 70, this means 600 IU of vitamin D and 1,000 mg of calcium.

If you drink alcohol, consume less than one drink a day for women and fewer than two drinks a day for men. Those who drink alcohol should try to get enough folic acid, either through a multivitamin or foods such as oranges, orange juice, leafy green vegetables and fortified breakfast cereals.

Sources: American Cancer Society’s Nutrition and Physical Activity Guidelines, Washington University School of Medicine’s Siteman Cancer Center’s Your Disease Risk, and Institute of Medicine’s Dietary Reference Intakes for Calcium and Vitamin D.

Keeping up with research on breast cancer risks can be challenging and frustrating.

Breast Cancer Awareness Month Events

All month: Light the Town Pink. Clear Channel Radio will be selling festive pink light bulbs for $3 at area Walgreens. People are urged to use the bulbs and “Light the Town Pink” in October.

All month: The Race for the Cure Corn Maze. Boone Hall Plantation, Mount Pleasant. Eight-acre corn maze pays tribute to the 20th anniversary of the local Race for the Cure event. 9 a.m.-6 p.m. Mondays through Saturdays. 11 a.m.-6 p.m. Sundays. $8 for ages 3 and up Monday-Thursday and $10 Friday through Sunday. A portion of the proceeds will go to support the efforts of Komen Lowcountry.

Saturday: Sea Kayak Carolina’s second annual Paddle Breast Cancer Awareness Kayak Trip. 1-4 p.m. Folly River. $10 donation. Rental kayaks available for $30 each. Proceeds go to Breast Cancer Action. Registration is required at 225-7969 or info@seakayakcarolina.com. www.seakayakcarolina.com/schedule.html?expandable=0

Saturday: Georgetown Hospital System’s “In The Pink” Breast Cancer Awareness Walk. 8:30-11 a.m. Murrell’s Inlet. Benefits the system’s Indigent Breast Cancer Fund and the Susan G. Komen Lowcountry Affiliate. www.georgetownhospitalsystem.org/evc/Page.asp?PageID=EVC000087

Oct. 13: Trek Breast Cancer Awareness Bike Rides (rides of 33, 25 and 10 miles). 10 a.m.-3 p.m. Awendaw Green. $30. 100 percent of proceeds benefit The Breast Cancer Research Foundation. http://bcar-tbsmountpleasant.eventbrite.com/

Oct. 13: Rockers for Knockers Pub Crawl and Rock the Dock. 11 a.m.-7 p.m. Starts at Red’s Ice House and goes to Vickery’s, The Shelter, RB’s and Shem Creek Bar & Grill. $20 in advance $25 day of show. http://rockers4knockers.com/

Oct. 19: 20th annual Komen Lowcountry Race for the Cure 5K and 1-mile event. 7-10 a.m. Daniel Island. $38-$45. Benefits Komen Lowcountry. http://lowcountry.info- komen.org/site/TR/Raceforthe Cure/CHS_LowcountryAffiliate?fr_id=3258&pg=entry

Oct. 20: 6th annual Jerry Zucker Ride for Hope, 8 a.m. Awendaw Green. $500 for 67-mile ride and $250 for 30-mile ride. Proceeds benefit several local cancer charities, including Share Our Suzy, a breast cancer cause. http://charlestonrideforhope.com/

Oct. 26 and 27: Worship in Pink, a free outreach program for faith communities. Various places of worship. www.komenlowcountry.org/get-involved/komen-activities/ special-events.html

Does eating meat, soy or dairy products raise risks? What impact does taking birth control pills or breast feeding have on the disease? Does taking vitamin D lower risks and, if so, how should women get it? And so on.

Complicating matters even more are the differences that lifestyles have in pre- and post-menopausal women, as well as in breast cancer survivors.

Studies of varying scientific and statistical depth seem to come out every week. Some confirm previous studies while others contradict findings. Sometimes it’s hard for the everyday person with no medical or nutritional background, busy with work and family responsibilities, to separate the wheat from the chaff and to know how to lower risks.

Organizing clutter

Among the array of efforts the Susan G. Komen for the Cure breast cancer foundation has done over the years is to compile studies and try to make some sense of them. Komen has neatly organized it all, including some “Komen Perspectives,” on its national website, ww5.komen.org/BreastCancer/BreastCancerResearch.html.

Lucy Spears, community outreach coordinator for Komen’s Lowcountry affiliate, says that while she loves research, “I have to admit it can make my head spin. ... It can be confusing and sometimes even seem contradictory.”

“When I was first diagnosed, my husband and I threw ourselves into research looking for answers. I felt like all we did was find more questions,” says Spears.

“There are so many factors in just figuring out which research to trust, including the type of research. Is it an observational study or a randomized study, a prospective cohort study or a case control study? The list goes on. And then there’s the whole issue of how something specifically affects breast cancer and the impact it may have on some other health issue.”

Spears adds that many of the questions have been answered through Komen-funded research over the years and that Komen’s 2013 research portfolio addresses the full spectrum of breast cancer care, including finding answers to questions about environmental factors.

Research ahead

The foundation, she notes, recently announced $4.5 million in new grants to learn what role environmental factors such as pollution, radiation exposure and synthetic chemicals play in breast cancer development. The grants augment nearly $14 million Komen has invested into 38 research grants studying environmental and lifestyle factors that may affect breast cancer.

“For instance, we now know that exercise and a healthy body weight are important to reducing risk. Breast feeding decreases risk not just for breast cancer but also ovarian cancer, Type 2 diabetes and postpartum depression. Getting enough vitamin D and calcium every day is also a benefit,” says Spears.

But it gets trickier after that, and Spears says more research and review needs be done on breast cancer risks related to a daily aspirin regimen and consuming meat or dairy.

“Then there’s the really tricky one: soy. It seems to reduce risk for those who have not developed breast cancer but may increase risk in women who have had estrogen-positive breast cancers. So what’s a person to do?” says Spears, saying another informative Komen page is ww5.komen.org/BreastCancer/LowerYourRisk.html.

“The biggest takeaway is to live a healthy lifestyle and discuss prevention with your doctor. Everyone is different, and we have different risk factors. People also need to be reminded that having a risk factor does not mean that you will necessarily develop breast cancer, nor does not having a known risk factor mean that you won’t.”

In a nutshell

Here’s a nutshell version of various breast cancer risk issues, as detailed on the Komen web page:

Body weight

Maintaining a healthy weight is one of the best things you can do for your health, but the percentage of Americans who are overweight or obese is higher than ever. Currently, about 72 percent of men and 64 percent of women in the U.S. are overweight or obese, according to the Centers for Disease Control and Prevention.

Being overweight or obese is linked to many types of cancer, including postmenopausal breast cancer. Understanding how body weight and weight gain affect your risk of breast cancer both before and after menopause may be a good first step in making healthy lifestyle choices.

Body weight and its effects on breast cancer depend upon whether a woman has gone through menopause. Notably, before menopause, being overweight modestly decreases the risk of breast cancer. After it, being overweight increases the risk of breast cancer.

Drinking alcohol

It’s clear that heavy drinking, defined as more than one drink per day for women and two for men, is harmful to health and is responsible for 79,000 deaths per year in the United States, according to the CDC.

Among the increased risks include cancers of the liver, mouth, throat, colon, esophagus and breast.

The mixed messages come, however, when it comes to light to moderate drinking.

Having even just a few alcoholic drinks each week appears to modestly increase the risk of breast cancer.

Komen found that a pooled analysis of data from 53 studies found for each alcoholic drink consumed per day, breast cancer risk increased by about 7 percent. Women who had two to three alcoholic drinks per day had a 20 percent higher risk of breast cancer compared to nondrinkers.

The increased risk typically comes from the additional, nutritionally “empty” calories and the resulting weight gain, as well as the way alcohol affects the way the body processes estrogen. (Heavier women tend to have higher blood levels of estrogen, and higher estrogen levels are linked to an increased breast cancer risk.)

Yet, Komen notes the flip side of light to moderate alcohol consumption are benefits to heart health.

Exercise

Everyone knows that regular exercise is good for health. But why for breast cancer specifically? Physical activity may protect against breast cancer in several ways, including healthy body weight because thinner women have lower risk of postmenopausal breast cancer, as well as lowering estrogen and insulin levels in the body.

Eating meat

In countries where people eat a diet heavy in meat, there are higher rates of breast cancer compared to countries where people eat little to no meat, which suggests that eating meat may be a potential risk factor for breast cancer.

However, studies have not found a definitive link between eating meat and increased risk of breast cancer. Some have suggested an increased risk possibly from increased fat intake, exposure to chemical formed from cooking meat at high temperatures and exposure to hormones.

Komen says more studies are under way.

Milk & dairy products

Researchers have found a mixed bag in consumption of dairy products.

Some researchers have suggested the high fat content of many dairy products or traces of pesticides or growth hormones in milk may increase risk. Others have studied whether the calcium and vitamin D in dairy products may protect against breast cancer.

A pooled analysis of data from more than 20 studies found no link between dairy product intake, including milk, cheese and yogurt, and breast cancer risk.

However, data from the Nurses’ Health Study II, which included 88,000 participants, found that women who ate two or more servings of high-fat dairy products, such as whole milk or butter, every day had a higher risk of premenopausal breast cancer.

While Komen says postmenopausal woman eating or drinking dairy products appear not to increase breast cancer risk, more research is needed to draw solid conclusions about a possible link.

Soy products

Soybeans and soy products (tofu and soy milk), as well as other plants such as flaxseed, certain grains, beans, fruits and vegetables, contain chemicals called phytoestrogens that mimic estrogen in the body, which sometimes increases breast cancer cell growth.

While lower rates of breast cancer are seen in many Asian countries where people eat a lot of soy, studies offer mixed results. Studies of Asian women show a high soy diet lowered the risk of breast cancer, but that may be due to the fact that they tend to eat soy at an earlier age, in greater quantities and as a lightly processed whole food.

Komen says the effect of soy and phytoestrogens on breast cancer risk remains unclear and continues to be studied.

Vitamin D

Vitamin D, in regard to breast cancer, is complicated.

First, it is difficult to measure sunlight exposure, which is the main source of vitamin D, and to separate out the foods containing both the vitamin and calcium.

Many food items that have vitamin D also contain calcium (such as milk), which may also lower risk of breast cancer. Thus, if these foods are shown to lower risk, researchers have to determine whether the benefit is related to vitamin D, calcium or both.

Some studies have found women with higher blood levels of vitamin D had a lower risk of breast cancer compared to women with lower levels, while others found no link.

Caffeine

Some data suggest that caffeine may affect blood hormone levels, but the largest cohort studies to date have found no link between drinking either coffee or tea and the risk of breast cancer. Further, an analysis of the combined results of 37 studies found no link between caffeine or coffee intake and breast cancer risk.

Komen says that although findings to date suggest there is no link between caffeine and breast cancer risk, more research is needed.

Birth control pills

Studies show that current or recent use of birth control pills slightly increases the risk of breast cancer.

An analysis of data from more than 50 studies found that women who were taking birth control pills, and shortly afterward, had a 10 to 30 percent higher risk of breast cancer than women who had never used the pill. Once women stopped taking the pill, their risk began to decrease and returned to that of never users in about 10 years.

That said, most women on the pill are at low risk of breast cancer because they are young and premenopausal. Even with a slight increase in risk, they are still unlikely to get breast cancer. And despite the breast cancer risks, birth control pills also have some benefits in decreasing the risk of both uterine and ovarian cancers.

Current studies are underway on lower-dose pills. One large case-control study found no link between these birth control pills and breast cancer.

Breast feeding

Strong evidence shows that breast feeding protects against breast cancer, especially in premenopausal women.

In an analysis of 47 studies, mothers who breast fed for a lifetime total of one year were slightly less likely to get breast cancer than those who never breast fed. Mothers who breast fed for a lifetime total of two years got about twice the benefit of those who breast fed for a total of one year.

Smoking

Smoking and breast cancer. No brainer, right? Well, think again. Smoking increases the risks of many cancers, but its effect on breast cancer is still under study. Although there is growing evidence that smoking may slightly increase the risk of breast cancer, overall study findings remain mixed.

Some studies show that smoking long-term, starting early in life, especially before a first pregnancy, may increase risk later in life.

Women who smoke are more likely than nonsmokers to be lean, have lower blood estrogen levels and be younger at menopause, all of which can lower risk of breast cancer. And some data suggest smoking is linked to factors that can increase risk of breast cancer, such as having fewer children and alcohol use.

Although it is unclear whether smoking is linked to breast cancer, stopping smoking, or never starting to smoke, is one of the best things you can do for your health.

Cosmetics

Parabens are chemical preservatives found in many cosmetics and body-care products, such as make-up, lotion and shampoo, as well as foods and medicines.

Parabens have been shown to have very weak estrogen activity.

In 2008, the Cosmetics Ingredient Review Expert Panel, which conducts research on product safety for the U.S. Food and Drug Administration, concluded that paraben exposure from cosmetics and body care products was safe.

Still, Komen says more research in this area is needed before conclusions can be made about a possible link.

Plastics, BPA

Reports over exposure to plastics, notably Bisphenol A, or BPA, increasing risks of breast cancer periodically comes up in the media. BPA is a chemical found in some plastics and some coatings on metals that leaches small amounts from containers into foods and beverages.

Findings from laboratory studies have found that BPA can affect hormone levels in animals, although these hormone changes have not been linked to any harmful effects. And, at this time, there is no evidence to suggest a link between BPA and risk of breast cancer specifically.

The focus of current BPA studies is primarily on exposure in infants.

Deodorants

Similar to parabens and plastics, concern is periodically raised about the chemicals found in deodorants and antiperspirants that could penetrate the skin of the underarm and cause harm.

Although there have been only a few studies looking at use of these products and breast cancer risk, the research to date doesn’t support a link between the two.

The largest study, which included more than 800 women with breast cancer, showed no increase in risk from use of either deodorant or antiperspirant. It also showed no increase in risk among women who shaved prior to applying deodorant or antiperspirant.

Hair dyes, relaxers

Concerns over the raised risks of using hair dyes and relaxers have been eased by studies. Cohort and case-control studies have shown the use of permanent hair dyes is not related to the risk of breast cancer. An analysis that combined the results of 14 studies confirmed these findings.

As for hair relaxers used primarily by African-American women, the largest study to date found no link between use of hair relaxers and risk of breast cancer. However, it was the first study to look at these products.

Use of cell phones

Because cell phones have not been a part of our daily lives for many years, there are few data on a possible link between cell phone use and cancer.

Evidence shows no increase in risk of breast or other types of cancer from cell phone use.