Early detection is the focus of breast cancer education simply because there is no scientifically proven way to prevent breast cancer yet.
However, some research results do suggest that women who eat a low-fat, high-fiber diet rich in fruits and vegetables, exercise daily, don’t smoke, and rarely drink alcohol appear to have a lower risk of breast cancer. Maintaining a healthy lifestyle overall is a risk-free way for you to help prevent many forms of the disease, possibly including breast cancer.
Drugs with preventive powers
On the pharmaceutical front, two prescription drugs offer some real promise for preventing breast cancer.
Tamoxifen citrate (brand name Nolvadex) is a chemotherapy drug that has been used for the last 20 years to treat women with breast cancer, as well as to prevent them from developing it again. Tamoxifen works by blocking the hormone estrogen.
In September 1998, a study called the National Surgical Adjuvant Breast and Bowel Project (NSABP), performed in Pittsburgh, Penn., showed that for healthy women at high risk for developing breast cancer, tamoxifen reduced risk by up to 50%. The benefit was even higher for women over 60; their risk of developing breast cancer was reduced by 55%. Women with a history of the precancerous condition atypical hyperplasia saw an amazing 86% reduction in their risk of getting breast cancer over the five-year course of the study.
But the news about tamoxifen isn’t all good. While it’s true that this antiestrogenic drug actually mimics estrogen in some positive ways (tamoxifen boosts bone density and lowers cholesterol levels), these same estrogenic actions also increase the risk of some life-threatening side effects. Women in the NSABP study, especially those over 50, showed a greater chance of endometrial (uterine) cancer, stroke, and blood clots.
Other more common side effects of tamoxifen include weight gain, nausea, vomiting, hot flashes, flushing, skin rash, liver dysfunction, and blood changes that can result in easy bruising.
The bottom line is that tamoxifen isn’t a miracle drug. If you are already battling breast cancer, or if you are at unusually high risk for the disease, tamoxifen may be right for you — or it may not. Any woman who is considering tamoxifen, whether for breast cancer treatment or prevention, needs to learn all she can about the risks involved and how they compare to potential benefits.
Raloxifene (brand name Evista) is an antiestrogenic medication currently prescribed to treat osteoporosis. Its mechanism is similar to tamoxifen’s — so much so, in fact, that preliminary studies regarding raloxifene and breast cancer show that the drug may also prevent the disease, and without increasing a woman’s risk of uterine cancer.
There is a lot of hope surrounding raloxifene. Some experts speculate that the drug may even become an alternative to standard hormone replacement therapy that would actually protect against not just the osteoporosis and high cholesterol associated with menopause, but breast cancer as well.
The National Cancer Institute (NCI) is presently comparing the benefits and risks of the two drugs in a five-year study called the Study of Tamoxifen and Raloxifene (STAR) trial. Look for results of this important study in 2014. Check back here for updates before then.
Fifteen Natural Ways to Prevent Breast Cancer
October is Breast Cancer Awareness Month, a time to reflect on the disease many women fear most. In the last decade, medicine has advanced a long way toward preventing breast cancer. Ten years ago, most experts considered the disease virtually unpreventable. Today, researchers know a great deal more about how to prevent it — or at least reduce risk. In fact, there are 17 ways to reduce breast cancer risk, two from mainstream medicine, and 15 largely from alternative therapies.
First, the mainstream approaches:
A drug for preventing the disease
Women at high risk — breast cancer survivors or those with at least two close relatives (mother or sisters) — can take tamoxifen. The National Cancer Institute sponsored a six-year study of 13,388 high-risk women. Compared with those who did not take tamoxifen, those who did were 45% less likely to develop breast cancer.  Tamoxifen works because it blocks the tumor-promoting effects of women’s own estrogen. Tamoxifen itself is a weak estrogen; it binds to estrogen receptors in breast tissue, in effect locking out the woman’s own much stronger estrogen. There is one caveat to consider, however. The study also showed that tamoxifen can slightly raise the risk for endometrial (uterine) cancer, stroke, and deep vein blood clots in the legs.
Mastectomy-before cancer strikes
For women in the small number of families at very high genetic risk, there is a prophylactic mastectomy. It’s a radical approach to be sure, but it works for most women who undergo the procedure. (Prophylactic mastectomy removes most, but not all, breast tissue, so the disease may still develop.) Mayo Clinic researchers have performed prophylactic mastectomies on 2,500 women since 1960. In a 1997 report, they estimated that 76 would have developed breast cancer if they’d kept their breasts. But only seven developed the disease, a risk reduction of 91%. 
Natural approaches to prevention
But what about the vast majority of women who are looking for less invasive and extreme prevention methods? Fifteen other natural approaches also show significant protective benefits.
Many studies show that as physical activity increases, breast cancer risk decreases considerably. At the University of Tromso, Norwegian researchers tracked the health of more than 25,000 women for an average of 14 years. Compared with the least active women, those who exercised at least four hours a week — just 35 minutes a day — were 37% less likely to develop breast cancer. Exercise reduces the amount of estrogen a woman’s body produces, which lowers her risk of breast cancer (estrogen exposure increases risk of the disease). 
Avoid some fats. Enjoy others
No doubt you’re familiar with the controversy over dietary fat and breast cancer. Some studies show that a low-fat diet helps prevent breast cancer.  Other studies show no fat-cancer link.  The latest research shows that the amount of fat you eat may be less important than the type of fat. Fats that promote breast cancer include the saturated fat in meats,  butter, and whole-milk dairy foods, and the trans-fatty acids in margarine.  Fats that help prevent breast cancer include the monounsaturated fat in olive oil,  and the omega-3 fatty acids found in salmon and other cold-water fish. 
Mounting evidence supports the type of fat as a key dietary risk factor for breast cancer. In the last few years, studies by researchers in Massachusetts, Michigan, Uruguay, and Spain show that as meat consumption increases, so does breast cancer risk.  The Massachusetts report, from researchers at the University of Massachusetts Medical School in Worcester, showed that compared with women who eat no red meat, those who have it once a day double their risk, with more frequent red-meat consumption raising risk even more.  And a study by Harvard researchers published in the Journal of the National Cancer Institute shows that margarine increases risk, while olive oil reduces it. 
Why would the type of fat make such a difference? The saturated fat in meats and dairy products and the trans-fatty acids in margarine increase blood levels of estrogen, while the monounsaturated fat in olive oil and the omega-3 fatty acids in cold-water fish do not.
If you eat meat, shun well-done
Independent of its saturated fat, the way you cook meat affects your breast cancer risk. Cooking meats create carcinogenic compounds (heterocyclic amines). As cooking time increases, so do levels of these compounds. The highest levels develop in well-done grilled meat that has a blackened, charred crust. In a study in the Journal of the National Cancer Institute, the University of South Carolina researchers surveyed 273 women with breast cancer and 657 women who were cancer-free about how they cooked their meat. Compared with those who preferred their meat rare or medium, the women who ate it well-done had more than four times the breast cancer risk. 
Eat more fruits and vegetables.
As fruit and vegetable consumption increases, the risk of all cancers — including breast cancer — drops considerably. Gladys Block, Ph.D., a professor of epidemiology and nutrition at the University of California, Berkeley, School of Public Health, reviewed 156 studies of diet and cancer risk. The vast majority of them (128) showed statistically significant cancer-protective benefits for fruit and vegetable consumption, and the other 28 showed a definite trend in that direction.  “That’s about as close to unanimity as you ever get in epidemiology,” Block explains. When she focused on breast cancer specifically, Block’s findings were “consistent and significant”: The more fruits and vegetables a woman eats, the lower her risk.
Plant foods are high in antioxidant nutrients, among them vitamins A, C, E, and the mineral selenium, all of which prevent the cell damage that can lead to cancer. The National Cancer Institute (NCI) recommends eating at least five servings of fruits and vegetables every day. “Nutritionally, it doesn’t matter much whether they’re fresh, frozen, dried, or canned,” says Gloria Staples, R.D., director of the NCI’s “Five a Day for Better Health” program. “Just stay away from fruits and vegetables that come with a lot of fat, for example, french-fried potatoes or banana cream pie. Their high-fat content cancels their cancer-preventive benefits.”
Take an antioxidant supplement
Supplements don’t replace fruits and vegetables, but an antioxidant formula can give you an extra little boost of the nutrients that help prevent breast cancer. Andrew Weil, M.D., a noted advocate of nutritional medicine, recommends these daily doses: 1,000 to 2,000 mg of vitamin C at breakfast, and 25,000 IU of beta-carotene or preferably mixed carotenes, 400 to 800 IU of vitamin E, 200 micrograms of selenium, and another 1,000 to 2,000 mg of vitamin C at dinner. 
Eat more fiber
In addition to their antioxidant content, fruits and vegetables are also high in fiber. Dietary fiber binds to estrogen in the digestive tract, reducing circulating levels of the hormone. In a study in the American Journal of Clinical Nutrition, researchers at the American Health Foundation in Valhalla, New York, studied 62 premenopausal women whose fiber intake averaged 15 grams (about one-half ounce) a day. The women took a wheat bran supplement that doubled their daily fiber consumption to 30 g. After two months on the high-fiber diet, they had significantly lower estrogen levels. 
An easy way to boost your bran intake is to start your day with bran cereal. Depending on the brand, they contain from 5 to 13 grams of fiber per half-cup serving.  Top your cereal with fruit, and you get even more fiber. Then eat at least five servings of fruits and vegetables during the day to get all the fiber you need.
Eat more tofu and soy foods
Soy foods are high in plant estrogens (phytoestrogens). Like the drug tamoxifen, these compounds are similar to the body’s estrogen, only much weaker. Phytoestrogens bind to the same cellular receptors as the body’s own estrogen, locking some of it out of breast cells, and reducing its breast cancer-promoting effect.  In a study published in the British medical journal Lancet, Australian researchers analyzed the phytoestrogen intake of 146 women. As their phytoestrogen consumption increased, their breast cancer risk plummeted. The researchers concluded: “There is a substantial reduction in breast cancer risk among women with a high intake of phytoestrogens.” 
Biochemist Donna Dixon Shanies, Ph.D., a professor at the New York College of Osteopathic Medicine, makes a point of eating soy foods: “In addition to blocking biological estrogen’s access to cell receptors, soy foods also appear to speed estrogen’s elimination from the body, which would also help prevent breast cancer.”  Soy foods include tofu and many items made with soy protein — for example, vegetarian burgers. Dr. Shanies suggests eating several servings of soy foods weekly.