October is National Breast Cancer Awareness Month. Even though one in eight women in the United States will be diagnosed with breast cancer at some point in her lifetime, there's more information than ever about how to reduce your risk. "Women are not powerless," says Dr. Ann Kulze, wellness expert and author of the best-selling Eat Right for Life series. "There are simple steps women can take to diminish their chances of getting breast cancer."
Minimize your alcohol intake. "The most powerful risk factor for breast cancer is alcohol use," Kulze says. "Studies have shown that one drink a day can bump up risk 7 to 8 percent. And going from one to two drinks a day will bump risk up 25 or 30 percent." Bottom line: "The more you drink, the higher your risk," she says, adding "binge drinking—having more than five drinks at once—is especially bad."
Get moving. "There is solid evidence that regular physical activity provides significant protection against breast cancer," Kulze says. "Strive for 30 minutes or more of moderate aerobic activity a day, which is the equivalent of a brisk walk, five or more days a week. For best results, do up to an hour per day.
"The important thing is consistency and duration, not intensity," she adds—meaning you don't have to go full-out Jillian Michaels to reap the benefits.
Eat a healthy diet. Step one: eat lots of produce. Not only do people who eat more fruits and vegetables have an easier time maintaining their weight, Kulze says, but certain fruits and vegetables contain micronutrients that are protective against cancer.
The superstars of the produce aisle include cruciferous vegetables like broccoli, cabbage, Brussels sprouts, cauliflower and watercress; vegetables that contain carotenoids, including dark leafy greens (collards, kale, spinach), tomatoes, carrots and bell peppers; all citrus fruits; and all berries.
Another key: Minimize your consumption of "white carbs," including white flour, white rice, white potatoes and sugar, says Kulze. "Instead, substitute whole grains and beans." They contain loads of fiber, and studies have shown that women who eat more fiber are less likely to get breast cancer.
Maintain your weight. "One of the most important things you can do to reduce your risk of getting breast cancer is to maintain a healthy body weight throughout your life," says Kulze. "The data is very convincing that being obese, or even overweight, puts you at an increased risk of postmenopausal breast cancer."
Gaining weight, not your starting weight, is the key factor. "Say your BMI when you were 20 was 21. Now you're 50, and your BMI is 24. Even though your BMI is still in the normal range (normal is 18.5-24.9), you have gained weight, and that increases your risk of breast cancer. So weight stability is very important."
If you're overweight or obese, Kulze recommends taking action to try and reduce your weight.
Breast-feed your baby. Not only is nursing good for your baby, but it's also good for you. "Breast-feeding reduces breast cancer risk by a modest amount," says Debbie Saslow, director of breast and gynecologic cancer for the American Cancer Society. "It depends, however, on how long you breast-feed. In the United States, we usually don't breast-feed for all that long. For every 12 months of breast-feeding, it decreases your risk an additional 4.3 percent—if you don't supplement that with bottle-feeding," which most American moms do.
Bonus points: Just giving birth reduces your risk by 7 percent, Saslow points out.
Avoid certain environmental contaminants. You want to minimize your exposure to xenoestrogens, which are estrogen-like environmental contaminants, Kulze says. These include pesticides and dioxins, which are chemicals found in plastics that have estrogenic properties. She recommends that you:
buy organic produce if your budget permits, or wash regular fruits and vegetables,
switch to organic meat, poultry and dairy products whenever possible,
don't freeze water in plastic bottles and
don't microwave food in plastic containers.
Eat soy. Regular consumption of whole soy foods, such as tempeh, tofu, roasted soy nuts and edamame can have a protective effect, says Kulze. "Strive for several servings a week. Asians eat 15 times more soy than we do and they hardly ever die of breast cancer. The top theory is that it's because of soy."
Know your family history. "A lot of women think family history is more important than it is," explains Saslow. "But even if you have three sisters who have breast cancer, you might not be at [higher] risk." Other factors, including the age at which they were diagnosed and the type of breast cancer they had, must be weighed.
Here are some of the important aspects of family history, according to Saslow:
If you have two or more relatives on the same side of the family who were diagnosed with it
If they are closely related to you (a sister or mother with breast cancer is more relevant than an aunt or grandmother)
If their breast cancer was diagnosed before they were 50
If any men in your family were diagnosed with breast cancer
If any female relatives have been diagnosed more than once (for instance, if cancer was found in their left breast and then three years later in their right)
If you have any close relatives who have had ovarian cancer
If you're of Jewish heritage
And if possible, see a specialist: "Most doctors aren't trained in analyzing family history, so they should refer you to a genetic counselor," says Saslow, adding, "it's very difficult to evaluate family history."
Consider foregoing hormone replacement therapy. "Ever since women have gone off hormone replacement therapy, there has been a significant decrease in breast cancer incidence," points out Kulze. In 2002, a large study by the National Institutes of Health found that women taking HRT had a significantly higher incidence of breast cancer; it was then recommended that women should take the lowest possible dose of HRT for the shortest possible time, just enough to ease menopausal symptoms. "Never take it unless it's medically indicated," she says.
Get screened. While screenings won't keep you from getting breast cancer, they will decrease your risk of dying from breast cancer, as early detection will greatly boost the likelihood of successful treatment. The American Cancer Society recommends these screenings and practices:
Mammograms are the most important screening tool, says Saslow. "We recommend women get one every year, starting at age 40. The reason [mammograms] are important is there is actual evidence that they will reduce a woman's risk of dying (assuming diagnosis is followed by treatment). There's some question about how much it will reduce risk—it's 30 percent or 50 percent." In either case, those are pretty great numbers.
Women with a family history of breast cancer or other risk factors may be advised to begin getting mammograms and an MRI as early as age 30.
2. Clinical Breast Exams
Women in their 20s and 30s should get a clinical breast exam every three years, and women 40 and over should get one every year. "Mammograms aren't 100 percent perfect, so a clinical breast exam might find a lump that was missed," Saslow says.
Women should know how their breasts normally look and feel and report any changes to their doctor. "Some women will find a lump through self-monitoring," says Saslow. "Most of the time it won't be cancer." You should also let your doctor know if you notice any change in the skin of the breast such as dimpling, if there's any change to the nipple, if there's any discharge, or if the nipple is retracted. "Those are much less common than a lump but can be signs of breast cancer," she says.