Today, one in eight women will be diagnosed with breast cancer. But nearly all cancer cases—90 percent or more—are linked to lifestyle, not genetics. To lower your risk, follow this advice from trailblazing doctors and scientists.

By Sarah Engler
Updated July 21, 2020
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Women have superpowers, like tracking down missing items in seconds and remembering everyone's birthday and sushi order. But unfortunately, we can't know or do everything—and that makes the illnesses that affect us most acutely, like breast cancer, frustrating. However, there's plenty you can do to rein in your risk, whether it's from genetic causes, which account for only five to ten percent of all cancers, or from the controllable, day-to-day ones behind most diagnoses.

Familiarize Yourself

Your first move is to get to know your breasts—how they look and feel. Even though federal guidelines now recommend against clinicians teaching women to do breast self-exams, Elizabeth Morris, M.D., chief of breast imaging at Memorial Sloan Kettering Cancer Center, in New York City, suggests checking them monthly for any new lumps or skin changes to find abnormalities that are not detected on mammography.

Make a Plan

Developing a personalized screening regimen with your doctor based on family history is also essential. Ideally, Morris says, you'd have this conversation at around age 30, but it's never too late. A typical time line calls for your first mammogram at 40. That's especially important for African-American and Hispanic women, who tend to develop breast cancer earlier in life. Research conducted by Elisa Port, M.D., chief of breast surgery and director of the Dubin Breast Center at Mount Sinai Hospital, in New York City, shows that women who get annual mammograms starting at 40 and develop breast cancer are less likely than those who don't get them to need chemo, have all their lymph nodes under the arms (where the cancer spreads first) removed, or require a mastectomy. "Not only do mammograms save lives, but they give doctors the ability to save more lives while doing less [invasive treatments]," Port says. "Women have way more options when they screen."

Mikkel Vang

Eat Your Cruciferous Vegetables

Load up on the crunchy kind, like cauliflower, kale, and broccoli, says San Diego–based former surgeon turned natural-health expert Christine Horner, who spearheaded a campaign in the 1990s that led to the passing of a federal law requiring insurers to cover postmastectomy breast reconstruction. They contain compounds called indoles and isothiocyanates that may help stop breast cancer from developing. Even better, make them part of a Mediterranean diet, which calls for about six servings of vegetables and fruit daily, with up to six half-cups of whole grains or legumes and some fish. A 20-year study published last year in International Journal of Cancer revealed that women who ate this way were 40 percent less likely to develop breast cancers known as hormone-receptor-negative, which tend to be more aggressive.

Sip Wisely

Be mindful of your overall booze intake. "Alcohol use is associated with an increased risk of breast cancer," says Anne McTiernan, M.D., a researcher and epidemiologist at the Fred Hutchinson Cancer Research Center, in Seattle, who is investigating the long-term effects of diet, weight loss, and exercise on breast-cancer biomarkers in partnership with the Breast Cancer Research Foundation. "Women should limit their intake to no more than one drink per day, regardless of the kind." A weekly maximum of five is even more optimal.

Make Time for an Outdoor Walk

The benefits are twofold. A study of nearly 60,000 postmenopausal women published in Cancer Epidemiology, Biomarkers & Prevention in 2014 found that those who consistently walked about 35 minutes a day were 10 percent less likely to develop cancer. And a 2017 study out of the University of Alberta, in Edmonton, saw early signs that the same blue light wavelengths that regulate your circadian rhythm may stop subcutaneous fat cells from storing too much of the stuff. Most women add this form of fat as they gain weight, says McTiernan, and being overweight or obese raises the chances of breast cancer postmenopause. To keep your BMI healthy (under 25) and breast-cancer risk in check, get regular moderate-intensity exercise, like two and a half hours a week of brisk walking, swimming, or biking—and if you can, log some of it outside.

Get Smart About Hormones

"If you take them to manage menopausal symptoms, avoid ones that contain progesterone, and limit their use to less than three years," says McTiernan. Synthetic progesterone, or progestin, is tied to higher breast-cancer risk. (Plant estrogens, like the isoflavones in soy, are not; one to two servings a day of soy milk or tofu are safe, per the Mayo Clinic.) She also warns against over-the-counter hormonal gels and creams— they're no better than prescription ones."

Take Ten-Minute Stress Breaks

"Stress plays a major role in at least 90 percent of chronic illnesses, including breast cancer," Horner says. Stress hormones can weaken your immune system, and therefore your body's ability to kill diseased cells and prevent them from multiplying. Chronic stress can also increase your blood supply, which can speed the development of tumors. Whether it's a few yoga poses or a quick guided meditation, "do some sort of stress-reducing technique on a daily basis," she advises. "Even 10 minutes can make a difference."

Banish Household Dust

There's more in it than lint and pollen. It can also contain chemicals from items such as TVs, furniture, flooring, and toys that, per a 2016 study published in Environmental Science & Technology, degrade and collect in the air. "Many of them mimic estrogen and significantly raise your breast-cancer risk," Horner says. To reduce exposure, dust often with a damp microfiber cloth, use a HEPA filter-equipped vacuum, and maintain a shoes-off policy. And watch what you bring home: For guidance, use the Silent Spring Institute's Detox Me app.

Go to Bed Earlier

"Your sleep quality is as important as the food you eat," says Horner. To get the deepest rest, be in bed by 10 PM and up by 6 AM. "When you stay up late, many hormones—estrogen; insulin; cortisol, which is linked to stress; and melatonin, a potent antioxidant—become imbalanced, increasing the likelihood of many illnesses, including breast cancer." Keep your bedroom dark (light, including from devices, inhibits melatonin), cool (around 65 degrees), and distraction-free.

For Extra Peace of Mind...

Hormonal factors, like a pregnancy after 35; family links (a close relative with breast cancer); or being among the approximately 40 percent of women with dense breast tissue can up your odds for the disease. But don't panic—just be vigilant. Here, three additional steps you can take to protect your health.

Find a High-Risk Clinic

Doctors at these centers work with genetic counselors to design screening and prevention programs around your risk factors, says Kimberly Allison, M.D., breast pathology director at Stanford University School of Medicine.

Screen Smarter

Next-gen 3-D mammograms, otherwise known as digital breast tomosynthesis (DBT), reduce false positives and unnecessary additional testing, says Mount Sinai's Port. About 25 percent of mammos in the U.S. use DBT; see if your center does. If you have dense breasts, ask about contrast mammograms (for which an iodinated fluid is injected for more detailed results), ultrasound, or MRIs.

Know What's New

Estrogen-blocking drugs may help prevent the disease in women with some precancerous lesions. Clinical trials found that taking tamoxifen daily for five years cut subjects' risk of developing hormonereceptor-positive breast cancer by 75 percent, says Abeena Brewster, a professor at Houston’s MD Anderson Cancer Center who is working to educate eligible high-risk women on its benefits.

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