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U.S News Tops Docs 2012

Diet, Exercise, and Breast Cancer

Whether you have been diagnosed with breast cancer or have never been diagnosed but want to reduce your risk of breast cancer, healthy eating and some physical activity are important. Research has been done on the ability of diet to reduce your risk of breast cancer, and some research has also been done on the role of diet in reducing the risk of the cancer coming back (recurrence). Most existing research suggests that lack of exercise and being overweight can increase the risk of breast cancer and breast cancer recurrence.

DIET

There is no strong evidence that any specific foods or supplements will lower the risk of getting breast cancer or reduce the risk of recurrence.
Research has shown that getting the nutrients you need from a variety of foods, especially fruits, vegetables, and whole grains, can make you feel your best and give your body the energy it needs. You can get many of the nutrients you need from the food you eat. If you're considering taking supplements, it's a good idea to have a registered dietitian evaluate your diet.

Low-fat diet may reduce the risk of breast cancer development or breast cancer recurrence.
Sticking to a low-fat diet may help reduce the risk of breast cancer. More research is needed to know who is most likely to get the biggest benefit from this dietary change, but no matter if you have had breast cancer or what kind of breast cancer you've had, you may still benefit from lowering the amount of fat in your diet. Plus, other healthy choices are more likely to come with a low-fat diet, such as eating more fruits and vegetables. All these changes together may help lower your risk.

Healthy weight reduces risk of breast recurrence.
Maintaining a healthy weight may help reduce the risk of developing breast cancer or a breast cancer recurrence.   Several studies have found that maintaining a healthy weight is strongly correlated with a lower risk of a first-time breast cancer and breast cancer recurrence.  Post-menopausal weight gain is associated with an increased risk of breast cancer, while post-menopausal weight loss is associated with a decreased incidence of breast cancer.

Research on diet and breast cancer is ongoing.
Studies are looking at the relationship between diet and breast cancer risk and the risk of recurrence. The Women's Health Initiative Trial suggested that a diet very low in fat may reduce the risk of breast cancer. More research is needed in this important area for women who are interested in eating well to reduce their risk of getting breast cancer.

In the meantime, here's what dietitians suggest:

  • Keep your body weight in a healthy range for your height and frame.

  • Eat plenty of vegetables and fruit (at least 5 cups a day).

  • Try to limit your fat intake to less than 20% of your total calories per day. This is an extremely small amount of fat to eat (an average amount is about 30 to 35% of total calories per day). Start by eliminating some foods with the highest fat content (like fried foods and margarine) and gradually lower the amount of fat you eat.

  • Eat foods high in omega-3 fatty acids.

  • Limit red meat intake to 3 servings or less a week.

  • Limit alcohol consumption.  Studies show that even one serving a day can increase the risk of breast cancer over time. 

SOY AND BREAST CANCER

Soy is a protein-rich food which can be used as a low-fat entrée or meat replacement.  It is also used in side dishes, soups, beverages, snack bars, and other foods.  Soy is available in many forms, such as fresh and dried soybeans, soybean sprouts, tofu, soy milk, and soy protein powder drinks. 

Soy contains components that may help in cancer prevention.

  • Isoflavones found in soy are chemically similar to the hormone estrogen.

  • Isoflavones compete with estrogen for estrogen receptors.  This lowers estrogen levels in the body and may decrease the risk of breast cancer.

  • Epidemiologic studies of populations with a higher soy intake (e.g. Asian) have found a lower incidence of breast cancer.

These same components may also interfere with certain cancer treatments.

  • Isoflavones can also increase estrogen activity, which may enhance cancer development, especially in women with hormone sensitive breast cancers.

  • Tamoxifen and similar drugs are prescribed for some breast cancer patients because they can block the effects of the body’s estrogen.  At this time, researchers are unsure whether soy can work with Tamoxifen to block estrogen, or if soy may interfere with Tamoxifen to increase the risk of breast cancer recurrence.

  • At this time, there is no scientific evidence available to support the use of isoflavone/soy supplements by breast cancer survivors.

More research is needed, but at the present time, most experts agree that it is probably safe and possibly beneficial to eat up to 3 servings of soy foods/day.

Tofu ½ cup
Soybeans (edamame) ½ cup
Miso 1 tbsp
Soymilk 1 cup
Soy yogurt 1 cup
Soy cheese 1 oz
Soy burger ¼ cup

BREAST CANCER AND EXERCISE

Regular exercise is an important part of being healthy. More and more research is showing that regular exercise can reduce the risk of developing breast cancer and breast cancer recurrence.

  • Studies have demonstrated that regular exercise may reduce the risk of breast cancer by as much as 30-50%.

  • The benefits of exercise are dose-dependent, meaning the more you exercise, the more your breast cancer risk may be reduced. 

  • Any exercise at a moderate level of activity (including brisk walking) counts.

  • Exercise is safe during and after all breast cancer treatments (as long as you take any necessary precautions and keep the intensity low) and improves physical functioning, quality of life, and cancer-related fatigue. There also is evidence that exercise can help breast cancer survivors live longer and lead a more active life.

WHY EXERCISE?

Exercise can lower your risk of breast cancer, as well as help you maintain a healthy weight and boost your energy. We’ve all heard it hundreds of times: exercise is good for us. Some of the added benefits of exercise include:
  • Lower risk of breast cancer development and breast cancer recurrence

  • Help maintain a healthy weight.
    Regular exercise can help you maintain a healthy weight by building muscle and burning fat. This higher risk is because fat cells make estrogen. Extra fat cells mean more estrogen in the body and estrogen can make hormone-receptor-positive breast cancers develop and grow.

  • Fewer and less severe side effects from treatment.
    Research suggests that exercise can:
    • ease nausea during chemotherapy
    • improve blood flow to the legs, reducing the risk of blood clots

    • ease constipation by stimulating digestion and elimination systems

    • improve your sex drive and enhance your arousal

    • ease fatigue caused by radiation and/or chemotherapy

  • Increased energy.
    Fatigue is a side effect that many women have before, during and after treatment for breast cancer. Regular exercise can boost your endurance and help your heart and lungs work more efficiently, both of which give you more energy for the work you do each day.

  • Improved mobility.
    Scar tissue that forms after breast cancer surgery, reconstruction, or radiation can lead to your arm and shoulder muscles feeling tight. Not using your arm and shoulder as much after treatment also can cause the muscles in those areas to lose flexibility. Over time, careful stretching exercises can improve any range of motion issues you may have in your arm and shoulder.

  • Improved strength.
    As most people age, they tend to lose muscle and gain fat. Chemotherapy and hormonal therapy medicines can throw you into sudden menopause, which also can cause muscle mass to decrease. Strength training exercises can help make sure you have more muscle than fat.

  • Improved bone health.
    As you age, you lose bone mass. If you’ve been diagnosed with breast cancer, maintaining healthy bones is especially important for you. Some breast cancer treatments (such as aromatase inhibitors) can lead to bone loss. Plus, women are about twice as likely as men to develop osteoporosis after age 50. Weight-bearing exercises, such as jogging or walking and strength training, can slow bone loss.

  • Improved sense of well-being.
    A breast cancer diagnosis can leave some women feeling scared, depressed, and anxious. Exercise can help lift your spirits, keep depression at bay, and boost your self-esteem. Physical activity triggers the release of brain chemicals such as endorphins that can make you feel happier and more relaxed. You also might feel better about yourself and your appearance if you exercise regularly and see a fit, strong, toned woman looking back at you in the mirror.

  • Improved sleep.
    If you struggle with insomnia or wake up a lot at night, regular exercise can help you fall asleep faster and sleep more deeply.

  • Less stress.
    Any type of exercise can help melt away stress. Besides pumping up endorphin production in the brain, exercise can be a type of meditation. By focusing on just one task – running or dancing or whatever you’re doing -- you may find that you forget the day’s annoyances and settle into a calm, clear state of mind.

Signs and Symptoms
Self Breast Examination
Reducing Your Risk
Breast Cancer Myths
Genetic Testing
Diet, Exercise and Breast Cancer
For Patients