Can I Lower My Risk of Breast Cancer Progressing or Coming Back?
If you have (or have had) breast cancer, you probably want to know if there are things you can do that might lower your risk of the cancer growing or coming back, such as exercising, eating a certain type of diet, or taking nutritional supplements. Fortunately, breast cancer is one of the best studied types of cancer in this regard, and research has shown there are some things you can do that might be helpful.
Staying as healthy as possible is more important than ever after breast cancer treatment. Controlling your weight, exercising, and eating right may help you lower your risk of your breast cancer coming back, and may help protect you from other health problems.
Getting to a healthy weight
If you have had breast cancer, getting to and staying at a healthy weight might help lower your risk. A lot of research suggests that being overweight or obese (very overweight) raises the risk of breast cancer coming back. It has also been linked with a higher risk of getting lymphedema, as well as a higher risk of dying from breast cancer.
However, there is less research to show whether losing weight during or after treatment can actually lower the risk of breast cancer coming back. Large studies are now looking at this issue. This is complicated by the fact that many women gain weight (without trying) during breast cancer treatment, which itself might increase risk.
Of course, for women who are overweight, getting to a healthy weight can also have other health benefits. For example, weight loss has been shown to improve quality of life and physical functioning among overweight breast cancer survivors. Getting to a healthy weight might also lower your risk of getting some other cancers (including a new breast cancer), as well as some other chronic diseases.
Because of the possible health benefits of losing weight, many health care providers now encourage women who are overweight to get to and stay at a healthy weight. Still, it’s important to discuss this with your doctor before trying to lose weight, especially if you are still getting treatment or have just finished it. Your health care team can help you create a plan to lose weight safely.
Being physically active
Among breast cancer survivors, studies have found a consistent link between physical activity and a lower risk of breast cancer coming back and of dying from breast cancer. Physical activity has also been linked to improvements in quality of life, physical functioning, and fewer fatigue symptoms.
It’s not clear exactly how much activity might be needed, but more seems to be better. More vigorous activity may also be more helpful than less vigorous activity. But further studies are needed to follow up on these findings.
Some people used to think that breast cancer survivors with lymphedema should avoid certain arm exercises and vigorous activities. But studies have found that such physical activity is safe. In fact, it might actually lower the risk of lymphedema, or improve lymphedema for women who already have it.
As with other types of lifestyle changes, it’s important to talk with your treatment team before starting a new physical activity program. This will likely include meeting with a physical therapist as well. Your team can help you plan a program that can be both safe and effective for you.
Eating a healthy diet
Most research on possible links between diet and the risk of breast cancer coming back has looked at broad dietary patterns, rather than specific foods. In general, it’s not clear if eating any specific type of diet can help lower your risk of breast cancer coming back. Studies have found that breast cancer survivors who eat diets high in vegetables, fruits, whole grains, chicken, and fish tend to live longer than those who eat diets that have more refined sugars, fats, red meats (such as beef, pork, and lamb), and processed meats (such as bacon, sausage, luncheon meats, and hot dogs). But it’s not clear if this is due to effects on breast cancer or possibly to other health benefits of eating a healthy diet.
Two large studies (known as WINS and WHEL) have looked at the effects of lowering fat intake after being diagnosed with early stage breast cancer. One study found that women on a low-fat diet had a small reduction in the risk of cancer coming back, but these women had also lost weight as a result of their diet, which might have affected the results. The other study did not find a link between a diet low in fat and the risk of cancer coming back.
Many women have questions about whether soy products are safe to eat after a diagnosis of breast cancer. Soy foods are rich sources of compounds called isoflavones that can have estrogen-like properties in the body. However, some recent large studies have not found that soy food intake affects breast cancer coming back or survival rates. While eating soy foods doesn’t seem to pose a risk, the evidence regarding the effects of taking soy or isoflavone supplements is not as clear.
While the links between specific types of diets and breast cancer coming back are not certain, there are clearly health benefits to eating well. For example, diets that are rich in plant sources are often an important part of getting to and staying at a healthy weight. Eating a healthy diet can also help lower your risk for some other health problems, such as heart disease and diabetes.
Women often want to know if there are any dietary or nutritional supplements they can take to help lower their risk. So far, no dietary supplements (including vitamins, minerals, and herbal products) have been shown to clearly help lower the risk of breast cancer progressing or coming back. This doesn’t mean that none will help, but it’s important to know that none have been proven to do so.
Dietary supplements are not regulated like medicines in the United States – they do not have to be proven effective (or even safe) before being sold, although there are limits on what they’re allowed to claim they can do. If you're thinking about taking any type of nutritional supplement, talk to your health care team. They can help you decide which ones you can use safely while avoiding those that might be harmful.
It’s clear that alcohol – even as little as a few drinks a week – increases a woman’s risk of getting breast cancer. But whether alcohol affects the risk of breast cancer coming back is not as clear. Drinking alcohol can raise the levels of estrogen in the body, which in theory could increase the risk of breast cancer coming back. But there is no strong evidence from studies to support this.
As part of its guidelines on nutrition and physical activity for cancer prevention, the American Cancer Society recommends that women who drink alcohol limit their intake to no more than 1 drink a day to help lower their risk of getting certain types of cancer (including breast cancer). But for women who have completed cancer treatment, the effects of alcohol on cancer recurrence risk are largely unknown. This issue is complicated by the fact that low to moderate alcohol use (1 drink a day or less) has been linked with a lower risk of heart disease.
Because this issue is complex, it’s important to discuss it with your health care team, taking into account your risk of breast cancer coming back (or getting a new breast cancer), your risk of heart disease, and your risk of other health issues linked to alcohol use.
Chen WY, Rosner B, Hankinson SE, Colditz GA, Willett WC. Moderate alcohol consumption during adult life, drinking patterns, and breast cancer risk. JAMA. 2011;306:1884-1890.
Rock CL, Doyle C, Demark-Wahnefried W, et al. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012;62: 242–274.
Last Medical Review: June 1, 2016 Last Revised: August 18, 2016
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