How Do You Reduce the Risk of Breast Cancer?

While some risk factors cannot be changed (such as having a family history or known genetic mutations), there are some ways to reduce the risk of breast cancer by engaging in healthy lifestyle choices. In addition, some women who are at high risk may choose preventive measures such as certain medications or surgery. Although there is no way to completely prevent breast cancer, these measures have been shown to lower certain women’s risk of the disease.

Lifestyle approaches to reducing advanced breast cancer risk

While there is no proven way to prevent breast cancer, studies have found that there are several healthy lifestyle choices which can potentially decrease a person’s risk of developing the disease, including ^1,2

• Maintaining a healthy weight – Women who are overweight or obese, particularly after menopause, have an increased risk of developing breast cancer. Maintaining a healthy weight, through diet and exercise, can help lower an individual’s risk.
• Staying physically active – Physical activity has multiple health benefits, including helping lower a person’s risk of breast cancer. The American Cancer Society recommends at least 150 minutes of moderate intensity exercise each week for adults, and/or at least 75 minutes of vigorous intensity exercise (that which increases heart rate and breathing) every week for adults.
• Reducing or avoiding alcohol intake – Alcohol use has been linked to a higher risk of breast cancer and limiting or eliminating alcohol can help reduce an individual’s risk.
• Breastfeeding – Breastfeeding may help lower a woman’s risk of breast cancer.
• Choosing non-hormonal options for menopause – Since hormone therapy for menopause has been associated with an increased risk, choosing non-hormonal options can potentially reduce an individual’s risk of breast cancer.

Medications to reduce advanced breast cancer risk

For women with a higher than average risk of breast cancer – such as those who have a BRCA1 or BRCA2 mutation or who have had ductal carcinoma in situ (DCIS) or lobular carcinoma in situ (LCIS) – medications may be an option to reduce breast cancer risk. The use of medications to prevent breast cancer is called chemoprevention.

Currently, the U.S. Food and Drug Administration (FDA) has approved two selective estrogen receptor modulators (SERMs) to lower breast cancer risk: tamoxifen (brand names: Nolvadex® and Soltamox™) and raloxifene (brand name: Evista®). SERMs block the action of estrogen in some tissues, such as breast tissue. Tamoxifen can be used by women who are premenopausal or postmenopausal, and raloxifene is approved only for use in women who are postmenopausal.^2,3

Other medications that may help reduce breast cancer risk are aromatase inhibitors, which reduce the production of estrogen. Aromatase inhibitors, like anastrozole (brand name: Arimidex®) and exemestane (brand name: Aromasin®), can only be used in women who are postmenopausal.²

Chemoprevention can cause side effects and may not be safe for women with certain conditions (like those who have a higher risk of developing blood clots or who are pregnant).³ Women who are at a high risk of breast cancer should talk to their doctor about their risks and benefits of potentially taking chemoprevention.

Surgery to reduce advanced breast cancer risk

Some women who are at a significantly increased risk of breast cancer may choose to have a procedure called a prophylactic mastectomy. In a prophylactic mastectomy, both breasts are surgically removed. This procedure can reduce the risk of developing breast cancer by approximately 95%. However, it is not a guarantee. In a mastectomy, it is impossible to remove all breast cells, and the small amount of breast tissue that is left could still develop into breast cancer. This is a serious surgery and has physical and emotional implications. It is generally only considered for women who have genetic mutations (like BRCA1 or BRCA2), a strong family history of breast cancer, having had chest radiation therapy prior to age 30, a history of LCIS, or who have had breast cancer in the other breast.^2,4

Women with a BRCA1 or BRCA2 mutation are also at an increased risk of ovarian cancer. Some women with these genetic mutations may choose to have their ovaries removed in a procedure called prophylactic oophorectomy. Removal of the ovaries can also reduce the risk of breast cancer, as it greatly reduces the amount of estrogen in the body.^2,4