Factors with Unclear Effects on Breast Cancer Risk

There are some things that might be risk factors for breast cancer, but the research is not yet clear about whether they really affect breast cancer risk.

For information on other known and possible breast cancer risk factors, see:

Diet and vitamins

While being overweight or obese and not being physically active have been linked to breast cancer risk, the possible link between diet and breast cancer risk is less clear.  Results of some studies have shown that diet may play a role, while others have not found that diet influences breast cancer risk.

Studies of women in the United States have not found a consistent link between high-fat diets and getting breast cancer, although some studies have found a possible link between high-fat diets and a higher risk of dying from breast cancer. Studies have also found that breast cancer is less common in countries where the typical diet is low in total fat, low in polyunsaturated fat, and low in saturated fat. Researchers are still not sure how to explain this. Studies comparing diet and breast cancer risk in different countries are complicated by other differences (such as activity level, intake of other nutrients, and genetic factors) that might also affect breast cancer risk.

We do know that high-fat diets can lead to being overweight or obese, which is a known breast cancer risk factor. A diet high in fat is also a risk factor for some other types of cancer. And intake of certain types of fat is clearly linked to a higher risk of heart disease.

Some (but not all) studies have also suggested that diets high in fruits and vegetables might lower the risk of breast cancer. This remains an active area of research.

Several studies looking at women in Asian countries have found that diets high in soy products might lower breast cancer risk. But this link has not been as clear in studies looking at women in Western countries. This might be because Asian women generally eat more soy products (and start at an earlier age) than Western women.

Studies looking at vitamin levels in the body have had inconsistent results. So far, there’s no strong evidence that taking vitamins (or any other type of dietary supplement) reduces the risk of breast cancer. 

The lack of a strong link between diet and breast cancer in studies so far doesn’t mean that there’s no point in eating a healthy diet. A diet low in fat, low in red meat and processed meat, and high in fruits and vegetables can clearly have many health benefits, including lowering the risk of some other types of cancer.

Chemicals in the environment

A great deal of research has been reported and more is being done to understand possible environmental influences on breast cancer risk.

Chemicals in the environment that have estrogen-like properties are of special interest. For example, substances found in some plastics, certain cosmetics and personal care products, pesticides, and PCBs (polychlorinated biphenyls) seem to have such properties. In theory, these could affect breast cancer risk.

At this time research does not show a clear link between breast cancer risk and exposure to these substances, but studying such effects in humans is hard to do. More research is needed to better define the possible health effects of these substances and others like them.

Tobacco smoke

Some studies have found that heavy smoking over a long time might be linked to a slightly higher risk of breast cancer. In some studies, the risk has been highest in certain groups, such as women who started smoking before they had their first child. The 2014 US Surgeon General’s report on smoking concluded that there is “suggestive but not sufficient” evidence that smoking increases the risk of breast cancer.

Researchers are also looking at whether secondhand smoke increases the risk of breast cancer. Both mainstream and secondhand smoke contain chemicals that, in high concentrations, cause breast cancer in rodents. Studies have shown that chemicals in tobacco smoke reach breast tissue and are found in breast milk of rodents. In human studies, the evidence on secondhand smoke and breast cancer risk is not clear. Most studies have not found a link, but some studies have suggested it may increase risk, particularly in premenopausal women. The 2014 US Surgeon General’s report concluded that there is “suggestive but not sufficient” evidence of a link at this point. In any case, this possible link to breast cancer is yet another reason to avoid secondhand smoke.

Night shift work

Several studies have suggested that women who work at night, such as nurses on a night shift, might have an increased risk of breast cancer. This is an active area of research. Some researchers think the effect may be due to changes in levels of melatonin, a hormone that’s affected by the body’s exposure to light, but other hormones are also being studied.

The American Cancer Society medical and editorial content team

Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

American Cancer Society. Breast Cancer Facts & Figures 2019-2020. Atlanta, Ga: American Cancer Society; 2019.

Chen WY. Factors that modify breast cancer risk in women. UpToDate. 2019. Accessed at
https://www.uptodate.com/contents/factors-that-modify-breast-cancer-risk-in-women on July 24, 2019.

Chlebowski RT, Aragaki AK, Anderson GL, et al. Association of low-fat dietary pattern with breast cancer overall survival: A secondary analysis of the Women's Health Initiative randomized clinical trial. JAMA Oncol. 2018 Oct 1;4(10):e181212. Epub 2018 Oct 11.

Farvid MS, Cho E, Chen WY, Eliassen AH, Willett WC. Dietary protein sources in early adulthood and breast cancer incidence: Prospective cohort study. BMJ. 2014;348:g3437.

Henry NL, Shah PD, Haider I, et al. Chapter 88: Cancer of the breast. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, eds. Abeloff’s Clinical Oncology. 6th ed. Philadelphia, Pa: Elsevier; 2020.

Jagsi R, King TA, Lehman C, et al. Chapter 79: Malignant tumors of the breast. In: DeVita VT, Lawrence TS, Rosenberg SA, eds. DeVita, Hellman, and Rosenberg’s Cancer: Principles and Practice of Oncology. 11th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2019.

US Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. 2014. Accessed at https://www.hhs.gov/sites/default/files/consequences-smoking-exec-summary.pdf on July 24, 2019.

 

Last Medical Review: September 10, 2019 Last Revised: September 10, 2019

American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.