Risk reduction for breast cancer
We can’t predict who will get breast cancer. And we can’t confidently say what might have caused someone’s breast cancer. However, there are some lifestyle factors that could reduce the risk of getting breast cancer.
Remember - nothing you do will cause breast cancer . You can take every precaution, and still get it. The most important thing is to chat to your GP about your risk, know your breasts, check them regularly and have mammograms when eligible.
Post menopause
Your risk of breast cancer increases as you age. For women who have gone through menopause, it is a time where knowing your normal and regularly checking for breast changes is important.
Maintaining a healthy body weight, especially after menopause can reduce your risk of developing breast cancer. After menopause, oestrogen is produced in fat tissue rather than in the ovaries, so maintaining a healthy body weight can reduce your exposure to excess oestrogen.
Body weight does not appear to be correlated with breast cancer risk prior to menopause.
Physical activity
Many large studies have shown that engaging in regular physical activity can reduce your risk of developing breast cancer. It also decreases the risk of recurrence in those who have already been treated for breast cancer.
Regular exercise can reduce levels of oestrogen, insulin and insulin-like growth factors in your body. These substances all contribute to the growth of breast cancer cells.
Alcohol consumption
Drinking alcohol has been established as a risk factor for developing breast cancer. Alcohol changes the way the body metabolises oestrogen, causing blood oestrogen levels to rise. The risk increases the more you drink.
Read the Cancer Society’s position statement on Alcohol and Cancer
Use of combined hormone replacement therapy
Several studies have shown that women taking combined hormone replacement therapy, using both oestrogen and progestogen, had an increased breast cancer risk during use and for two to five years afterwards. The longer you use it for, the higher your risk. Oestrogen-only HRT(prescribed for women who no longer have a uterus) is associated with little or no change in breast cancer risk.
If you are considering using HRT to support menopausal symptoms, talk to your doctor about the risks versus benefits. It is recommended that HRT use should be at the lowest possible dose to control symptoms, for the shortest possible time.
Oral contraceptive pill and Depo Provera use
The risk of developing breast cancer in women who currently or recently used contemporary, combined (oestrogen and progestogen) oral contraceptive pills is higher than in women who have never used hormonal contraceptives. The risk increases with longer duration of use. However the absolute increase in risk is quite small. The increase in risk also applies to the use of hormone secreting intra-uterine devices
Oral contraceptive use is considered relatively safe for women under the age of 40 who are not already at high risk of breast cancer, and it reduces the risk of ovarian and endometrial cancers.
Depo Provera, an injectable progesterone, has been shown to slightly increase breast cancer risk but the increase in risk disappears after discontinuation of use.
Timing of childbearing – age at first birth, number of children and breastfeeding
There is evidence to show the timing of having children can influence risk. This is due to exposure to oestrogen during uninterrupted menstrual cycles.
Not having children in your 20s, very slightly increases your risk of breast cancer.
We know that decisions about family planning and timing are sometimes out of our control and multifaceted. If you are worried about your risk, have a chat to your GP .
Although childbirth lowers your lifetime risk of breast cancer, it's important to know there is a short-term increase in risk for two to five years after giving birth. It's not something to stress about – breast cancer is less common in younger women – but it does mean you should take breast lumps or other changes after childbirth seriously, and insist on being referred for assessment if you're concerned.
Disrupted sleep patterns
Disruption of circadian rhythms (sleep patterns) has been linked to increased risk of breast cancer in women. It is not fully understood how sleep impacts breast cancer, but underlying causes could be increased exposure to hormonal alteration, or changes in immune system and biological processes. Sleep disruptions could be caused by shift work, short sleep duration and exposure to light at night.
This risk is not significant. If you are a shift worker, or have disrupted sleeping patterns, you should talk to your GP about your overall risk.
Sources
- The incidence of breast cancer among female flight attendants: an updated meta-analysis Journal of Travel Medicine, November 2016, https://doi.org/10.1093/jtm/taw055
- Night Shift Work and Risk of Breast Cancer Curr Environ Health Rep. 2017 Sep;4(3):325-339. doi: 10.1007/s40572-017-0155-y.