Can you reduce your breast cancer risk? What you can change and what you cannot

GREAT BAY--Can breast cancer be prevented? It sounds like a simple question, but the answer requires some care.

There is no guaranteed way to prevent breast cancer. A woman can exercise regularly, maintain a healthy weight, avoid alcohol and still develop the disease. Another woman may have several known risk factors and never develop breast cancer. Risk is about probability, not certainty, and a breast cancer diagnosis should never be treated as evidence that someone did something wrong.

As part of The Peoples’ Tribune Breast Cancer Awareness Series, it is useful to separate the factors women may be able to influence from those they cannot change.

Alcohol Is One Risk Women Can Influence

Alcohol consumption is associated with an increased risk of breast cancer, and the risk generally rises as alcohol consumption increases. Even relatively moderate drinking can increase risk compared with not drinking.

For women who drink alcohol, reducing how much they consume is one practical step that may lower breast cancer risk. Choosing not to drink is also an option. This does not mean alcohol causes every breast cancer, but it is one of the established risk factors over which women can have some control.

Physical Activity Matters

Regular physical activity is associated with a lower risk of breast cancer. Exercise may affect hormone levels, inflammation, body weight and other processes linked to cancer risk.

Women do not need to become athletes to benefit from being active. Walking, swimming, dancing, cycling and other forms of regular movement can contribute to overall health while also helping reduce the risk of several chronic diseases.

Physical activity is especially important because it can work together with another factor women may be able to influence: maintaining a healthy weight.

Weight After Menopause

The connection between body weight and breast cancer is complicated, but excess body weight after menopause is associated with an increased risk of breast cancer.

Before menopause, the ovaries produce most of a woman's estrogen. After menopause, fat tissue becomes an important source of estrogen. Having more body fat can therefore contribute to higher estrogen levels, which can influence the development of some hormone-sensitive breast cancers.

The message should not be reduced to a number on a scale. Maintaining a healthy weight over time, avoiding substantial weight gain where possible and remaining physically active are more useful goals than approaching breast cancer prevention through extreme dieting.

Hormones Require an Individual Conversation

Hormones can also affect breast cancer risk. Some forms of menopausal hormone therapy, particularly treatment combining estrogen and progesterone, can increase breast cancer risk depending on how they are used and for how long.

That does not mean women should automatically stop hormone treatment. Hormone therapy can provide important relief from menopause symptoms and may have other medical benefits. The decision should be made with a healthcare professional who can consider the woman's symptoms, personal risk factors and the benefits and risks of treatment.

Women using hormonal contraception should likewise discuss their individual situation with their healthcare provider rather than making medical decisions based only on general information about breast cancer risk.

Age Cannot Be Changed

Age is one of the strongest risk factors for breast cancer, and it is completely outside a woman's control.

Breast cancer can occur in younger women, but the likelihood increases as women grow older. Most breast cancers are diagnosed in women over age 50.

Women cannot change their age, but knowing that risk rises over time makes appropriate screening and paying attention to breast changes increasingly important.

Genetics Cannot Be Changed Either

Some women inherit gene changes that substantially increase their risk of breast cancer. BRCA1 and BRCA2 are among the best known, although other inherited genetic changes can also raise risk.

A woman cannot change the genes she was born with. What she can do is learn whether her personal and family history suggests that genetic counselling or testing should be considered.

Knowing about an inherited risk can allow a woman and her healthcare team to discuss earlier or more intensive screening and, for women at particularly high risk, additional options for reducing risk.

Family History Matters, But It Is Not Destiny

Having a mother, sister, daughter or other close relative with breast cancer can increase a woman's risk, particularly when relatives were diagnosed at younger ages or when several family members have had breast or ovarian cancer.

Family history cannot be changed. But it can be learned.

Women should ask questions where possible. Who in the family had breast cancer? How old were they when diagnosed? Has ovarian cancer occurred in the family? Has a male relative ever had breast cancer?

That information can help a healthcare professional assess whether a woman may be at higher risk.

At the same time, having no family history does not mean breast cancer cannot happen. Many women who develop breast cancer do not have a strong family history of the disease.

For this installment of The Peoples’ Tribune Breast Cancer Awareness Series, the message is not that breast cancer can always be prevented. It cannot.

The better message is that women can understand their risk, make healthier choices where possible, know their family history and speak with healthcare professionals about factors they cannot control.

Risk reduction is not about guaranteeing that cancer will never happen. It is about giving yourself the best opportunity to protect your health with the information and choices available to you.

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