25 tips to reduce your risk
of breast cancer

Over 25% of breast cancer cases are preventable (1,2).  By making simple changes to your lifestyle you can help reduce your risk of getting breast cancer.  Want to know what changes can make a difference? Here are 25 tips to help you on your way.

1. Get moving! Follow new WHO physical activity guidelines of 150-300 minutes of moderate, or 75-150 minutes of vigorous physical activity every week, along with regular muscle-strengthening activity, is ideal for reducing your risk. You can easily achieve this if, for example, you take a brisk walk for between half an hour to an hour in the evening five times a week or go running for 25 minutes 3-6 times a week. There are a number of reasons why physical activity may help reduce breast cancer risk. One is that it can lower circulating hormone levels in the body (such as oestrogen, testosterone and insulin) which help reduce risk.

Food

2. Eat as much as you need to keep a healthy weight. You will maintain your healthy weight if you don’t consume more calories than you burn. One approach to monitoring this is to write down what you eat every day for a week and record your weight. If you gain weight noticeably, say more than 2kg, then it may be time to eat less. You can calculate how many calories your body needs every day and then track them with an app.

If you are post-menopausal, maintaining the right weight for your height is a key part of ensuring you reduce your risk of breast cancer. Fat cells produce oestrogen, so extra fat cells mean more oestrogen in the body, and higher levels of oestrogen increase breast cancer risk and can encourage certain types of breast cancers to develop and grow.

3. Avoid processed food whenever possible. The problem with processed food is its high calorie count, as well as its high sugar, fat and salt content. Having a bit of chocolate once a day or even a pizza once a week won’t have a huge impact on your weight. But it can become a problem if you eat a lot of processed food regularly and throughout the day. You will be more likely to gain weight which is a significant risk factor for post-menopausal breast cancer.

4. Eat as little processed meat as possible. Processed meats include bacon, sausages, hot dogs, canned meat and other cured meats like salami. If you want to have some meat, consider, for example, organic chicken, turkey or fish such as salmon, which are all good sources of protein. Larger supermarkets also have a range of meat substitutes. The association between processed meat and an increased risk of breast cancer is due to a combination of factors, such as high levels of saturated fat, cholesterol, N-nitroso compounds and haem iron, which may promote the development of breast cancer.

5. More fibre, please! More fibre, please! Consider two simple generalisations:1) Plants have dietary fibre, animals don’t. 2) The more natural plant-based foods are, the more dietary fibre they usually have. Most dietary fibre is found in whole grains, legumes like beans or peas, fruit and vegetables, nuts and seeds like sunflower or flaxseed. Fibre may decrease breast cancer risk in several ways. For example, it may reduce circulating levels of oestrogen in our body. Oestrogen is a hormone that can encourage breast cancers to develop and grow.

6. Eat at least 5 servings of fruit and vegetables a day. Finding it hard to eat your five a day? Here are some simple tips: 1. Always serve vegetables as a side dish with a hot meal. If you’re pushed for time, frozen vegetables are also an option. 2. Add a starter to your lunch or dinner by including a small salad. 3. Raw vegetable sticks are a good snack in between meals – you can dunk them into a homemade dip, (try healthy low-fat yogurt with herbs and onions – yum). 4. Swap your chocolate bar or dessert after lunch with your favourite fruit.

7. Eat the traffic lights! Sounds a bit odd? It simply means eat plenty of red, yellow, orange and green leafy vegetables. They are a great source of carotenoids, which are known for their positive health benefits. Examples are tomatoes, carrots, sweet potatoes, pumpkins but also spinach. Coloured fruits like apricots and mangoes are a great source of carotenoids too. Carotenoids are thought to have anti-cancer properties and can help prevent the development and spread of breast tumours.

8. Eat lots of non-starchy vegetables. Non-starchy vegetables contain smaller amounts of carbohydrates – for example courgettes, mushrooms, tomatoes, broccoli, aubergine or spinach (see a list here). Eating non-starchy vegetables decreases the risk of oestrogen-receptor negative breast cancer. Many non-starchy vegetables contain vitamins C and E, minerals, fibre and other bioactive compounds, which could help prevent cancer.

9. Eat some dairy (or soy-based alternatives) every day. To get maximum benefit from dairy products, opt for natural products with no added sugar, for example organic natural yogurt or cottage cheese. The World Cancer Research Fund recommends around 200g/day. A nice snack idea is natural yogurt with some berries and a bit of honey. Unsweetened calcium-fortified dairy alternatives like soya milks and soya yoghurts also count as part of this food group and can make good alternatives to dairy products. There is some evidence that dairy products, which contain high levels of calcium, might be beneficial in reducing the risk of pre-menopausal breast cancer. Probiotics (live microorganisms) and fermented products, such as miso, yoghurt and kimchi, may also be beneficial.

10. Drink less alcohol or better still none. The bad news is: Drinking alcohol is a serious risk factor for breast cancer. The good news is: There are some great alcohol free mocktail ideas out there but equally delicious. How about “Cheat’s ginger beer” or a Summer cup mocktail? Pay attention though, mocktails can be calorie bombs. Try to avoid cream and syrups to save calories and sugar. If you really feel like having that glass of wine, then have it, but make your second drink a non-alcoholic one.

Unfortunately, drinking any amount of alcohol increases breast cancer risk. The higher the intake the greater the risk. Several reasons may help explain this; for example, alcohol breakdown products can damage DNA which increases the risk of cancers and alcohol increases levels of circulating oestrogen, which can increase breast cancer risk.

11. Live like an Italian! Although there is no ideal diet for breast cancer prevention, the Mediterranean diet is one to consider adopting. It is known for being high in olive oil, vegetables, fruit, plant protein, fish and other seafood, whole grains, nuts, and low-fat dairy, accompanied by moderate alcohol intake and low red meat consumption. It can serve as a guidance, is easy to stick to, is healthy, and contains many of the foods that are linked to a decreased breast cancer risk.

So how about for dinner tonight having some yummy “Pasta con verdure” (Pasta with vegetables) and fruit salad as a dessert?

As well as being a healthy, well balanced diet, there is evidence that following a Mediterranean diet improves your chances of survival following a breast cancer diagnosis.

12. Eat organic if you can. Organic foods contain fewer pesticides and studies have shown that switching to an organic diet can reduce the levels of pesticides in your body. Many pesticides are known or suspected endocrine disrupting chemicals and some are suspected carcinogens. Long term exposure to certain pesticide may increase your breast cancer risk. Organic produce can be costlier but here are a few ways to keep the price down.: 1. Buy seasonal produce. Organic produce can cost a lot less if you buy at the right time. For example, organic strawberries in the summer are cheaper than in winter. 2. Buy from your local farmers’ market. 3. Grow your own organic food in your garden or on a sunny windowsill.

13. Soak up the sun. Our body creates vitamin D from direct sunlight on our skin when we’re outdoors. Those with breast cancer often have low levels of vitamin D. We don’t know if this is a cause or consequence. Either way; it’s important to get sufficient vitamin D to maintain good health. But don’t stay in the sun unprotected for too long, as it’s important to avoid sunburn. Check out our website for more information on vitamin D and advice on use of sunscreens.

Food packaging and plastic

14. Avoid packaged food: buy fresh food and fewer take-aways. Food packaging may contain EDCs such as phthalates, PFAS or even bisphenols, which may increase breast cancer risk. If you can’t avoid it, try choosing paper and cardboard over plastic packaging; remove packaging and store food in glass or ceramic containers.

15. Say ‘no’ to single use plastics. Avoid single use plastics where possible, for example purchase a stainless-steel reusable water bottle and use your own reusable bags when grocery shopping. Select loose, unpackaged fruit and vegetables, and avoid putting produce in plastic bags – use cloth bags instead. Reuse free containers and bags; use beeswax wrappers instead of plastic film, store food in glassware with silicone lids or porcelain containers and avoid using plastic cutlery, cups and plates. Single use plastics may contain toxic chemicals or EDCs such as phthalates which may increase breast cancer risk. By staying away from single use plastics you will also contribute to a better environment.

16. Choose PFAS-free cookware and greaseproof paper. Per- and poly-fluorinated alkyl substances (PFAS) are used widely in everyday products, including non-stick cookware and food packaging, as well as furniture, cosmetics and clothing. Several PFAS (e.g. PFOA and PFOS) have been linked to serious health concerns, including breast cancer. If you buy non-stick cookware look for PFAS-free labels; e.g. PFOA-free, or choose ceramic cookware. This table can also help as a guide to brands, products and retailers that are PFAS-free.

17. Look for plastic recycling codes 2, 4 or 5. Avoid plastics made from recycling codes 3, 6 and 7; as these plastics are difficult to recycle and may contain toxic chemicals or EDCs such as phthalates or bisphenols. Recycling code 1 plastics (PET) are generally considered safe for single use only. Follow this link to see how the recycling code works.

Cosmetics

18. Check cosmetics ingredients before purchase. In the UK cosmetics ingredients must be listed and often the lists are very long! Try to buy cosmetics and personal care products that contain fewer ingredients and try to avoid those that contain potentially harmful EDCs such as parabens, UV filters, triclosan and phthalates. For a full list of ingredients we recommend you should avoid see here.

Everyday products

19. Say ‘no’ to receipts if they aren’t needed. These often contain bisphenols which can leach onto our hands, then transfer to our bloodstream and increase breast cancer risk. If you do need a receipt (e.g. till receipts, tickets, or bank statements), don’t handle it more than necessary, as bisphenols easily come off the paper.

20. Avoid scented candles and air fresheners that contain phthalates or synthetic musks. Although they leave our home smelling nice, many scented candles and air fresheners contain phthalates or synthetic musks (e.g. galaxolide, musk ketone) as fragrance. These are oestrogenic EDCs which may increase breast cancer risk. How about making your own air fresheners??

21. Choose fragrance-free or naturally fragranced cleaning products. Fragranced products may contain phthalates such as diethyl phthalate or synthetic musks, such as galaxolide. Some of these are oestrogenic and may increase breast cancer risk. Making your own cleaning products is a great way to reduce plastic pollution and avoid harmful chemicals in your home. Check out these DIY cleaning products here.

22. Avoid household products that contain antimicrobial agents such as triclosan or triclocarban. These may be found in chopping boards or clothes. They are often described as being anti-bacterial, or anti-microbial. Triclosan and triclocarban are oestrogenic EDCs which may increase breast cancer risk. Their use in everyday products has no health benefit and increases antibiotic resistance in bacterial populations – meaning bacterial infections harder to treat.

Lifestyle

23. Stop smoking. There is a modest increase in breast cancer risk for women who smoke, with more significant effects seen in pre-menopausal women and those who started smoking young. Tobacco smoke contains numerous carcinogens, several of which are known to cause breast cancer. Smoking also increases the risk of at least 15 other types of cancer. Check out the 10 self-help tips to stop smoking.

24. Breastfeed your child if you can. The longer the better. There is considerable evidence to show breastfeeding reduces risk of breast cancer. Breastfeeding isn’t easy for everyone but the NHS guide on Breastfeeding is a good place to start.

Exercise to finish on Oct 25

25. Build daily exercise into your life to help maintain a healthy immune system. Keeping up regular, daily exercise during the global pandemic and throughout our lifetime can play an important role in helping to maintain a healthy immune system. This in turn will help prevent cancers, including breast cancer.

References

1. Brown et al. (2018). The fraction of cancer attributable to modifiable risk factors in England, Wales, Scotland, Northern Ireland, and the United Kingdom in 2015. British Journal of Cancer https://www.nature.com/articles/s41416-018-0029-6 118: 1130–1141.
2. Soerjomataram et al. (2018) Cancers related to lifestyle and environmental factors in France in 2015. European Journal of Cancer 105: 103-113. https://www.ejcancer.com/article/S0959-8049(18)31379-0/fulltext

Tip 1: Get moving:

Cancer Australia (2018): Risk factors for breast cancer: A review of the evidence. https://www.canceraustralia.gov.au/sites/default/files/publications/risk-factors-breast-cancer-review-evidence-2018/pdf/rfbcr_risk_factors_for_breast_cancer_a_review_of_the_evidence_2018_report.pdf (Accessed August 25, 2020)

Tip 2: Eat as much as you need rather than as much as you want, to keep a healthy weight:

Cancer Australia (2018): Risk factors for breast cancer: A review of the evidence. https://www.canceraustralia.gov.au/sites/default/files/publications/risk-factors-breast-cancer-review-evidence-2018/pdf/rfbcr_risk_factors_for_breast_cancer_a_review_of_the_evidence_2018_report.pdf (Accessed August 25, 2020)

Tip 3: Avoid processed food whenever possible:

Cancer Australia (2018): Risk factors for breast cancer: A review of the evidence. https://www.canceraustralia.gov.au/sites/default/files/publications/risk-factors-breast-cancer-review-evidence-2018/pdf/rfbcr_risk_factors_for_breast_cancer_a_review_of_the_evidence_2018_report.pdf (Accessed August 25, 2020)

NHS. Eating processed foods. https://www.nhs.uk/live-well/eat-well/what-are-processed-foods/ (Accessed 26 August, 2020).

Tip 4: Try to eat as little processed meat as possible:

Cancer Australia (2018): Risk factors for breast cancer: A review of the evidence. https://www.canceraustralia.gov.au/sites/default/files/publications/risk-factors-breast-cancer-review-evidence-2018/pdf/rfbcr_risk_factors_for_breast_cancer_a_review_of_the_evidence_2018_report.pdf (Accessed August 25, 2020)

Tip 5: More fibre please:

Farvid, M. S. et al., 2020. Fiber consumption and breast cancer incidence: A systematic review and meta-analysis of prospective studies. Cancer: 13 126: 3061–3075. https://acsjournals.onlinelibrary.wiley.com/doi/abs/10.1002/cncr.32816

Tip 6: Eat at least 5 serves of fruit and vegetables a day:

NHS. 5 A Day. What Is 5 A Day? Change4Life. https://www.nhs.uk/change4life/food-facts/five-a-day (Accessed 25 August, 2020).

Tip 7: Eat the traffic lights!

Eliassen, A. H. et al., 2015. Plasma carotenoids and risk of breast cancer over 20 y of follow-up. The American Journal of Clinical Nutrition: 6 101: 1197–1205. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4441811/

Tip 8: Have more non-starchy vegetables:

AICR/WCRF (2018): Diet, nutrition, physical activity and breast cancer: https://www.wcrf.org/sites/default/files/Breast-Cancer-2017-Report.pdf (Accessed August 25, 2020)

Tip 9: Have some dairy or soy-based alternatives each day:

Cancer Australia (2018): Risk factors for breast cancer: A review of the evidence. https://www.canceraustralia.gov.au/sites/default/files/publications/risk-factors-breast-cancer-review-evidence-2018/pdf/rfbcr_risk_factors_for_breast_cancer_a_review_of_the_evidence_2018_report.pdf (Accessed August 25, 2020)

Tip 10: Drink less alcohol or better still none:

Cancer Australia (2018): Risk factors for breast cancer: A review of the evidence. https://www.canceraustralia.gov.au/sites/default/files/publications/risk-factors-breast-cancer-review-evidence-2018/pdf/rfbcr_risk_factors_for_breast_cancer_a_review_of_the_evidence_2018_report.pdf (Accessed August 25, 2020)

Tip 11. Live like an Italian! NHS.

What is a Mediterranean diet? (2017). https://www.nhs.uk/live-well/eat-well/what-is-a-mediterranean-diet/ (Accessed 25 August, 2020)

Morze, J. et al. (2020). An updated systematic review and meta‑analysis on adherence to mediterranean diet and risk of cancer. European Journal of Nutrition 2020 Aug 8. Online ahead of print.  https://link.springer.com/content/pdf/10.1007/s00394-020-02346-6.pdf

Tip 12. Eat organic if you can.

Kass, L. et al. (2020). Relationship Between Agrochemical Compounds and Mammary Gland Development and Breast Cancer. Molecular and Cellular Endocrinology 508: 110789 https://pubmed.ncbi.nlm.nih.gov/32165172/

Fagan, J. et al. (2020). Organic diet intervention significantly reduces urinary glyphosate levels in U.S. children and adults. Environmental Research 2020 Jul 31;109898. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/32797996/

Tip 13. Soak up the sun.

NHS https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/ (accessed August 26, 2020)

McDonnell, S. L. et al. (2018). Breast cancer risk markedly lower with serum 25-hydroxyvitamin D concentrations ≥60 vs <20 ng/ml (150 vs 50 nmol/L): Pooled analysis of two randomized trials and a prospective cohort. PLoS 13(6): e0199265. https://pubmed.ncbi.nlm.nih.gov/29906273/

Tip 14. Avoid packaged food. Buy fresh food and fewer take-aways

Chem Trust policy briefing (2016). Chemicals in food contact materials: A gap in the internal market, a failure in public protection. https://www.chemtrust.org/wp-content/uploads/chemtrust-foodcontactchemicals.pdf (Accessed August 26, 2020)

Darbre, P. D. (2020). Chemical components of plastics as endocrine disruptors: Overview and commentary. Birth Defects Research 2020 Jul 28.doi: 10.1002/bdr2.1778. Online ahead of print https://pubmed.ncbi.nlm.nih.gov/32720473/

Tip 15. Say ‘no’ to single use plastics

Darbre, P. D. (2020). Chemical components of plastics as endocrine disruptors: Overview and commentary. Birth Defects Research 2020 Jul 28.doi: 10.1002/bdr2.1778. Online ahead of print https://pubmed.ncbi.nlm.nih.gov/32720473/

Tip 16. Choose PFAS-free cookware

Chem Trust (2019). PFAS the ‘Forever Chemicals. https://chemtrust.org/wp-content/uploads/PFAS_Brief_CHEMTrust_2019.pdf (Accessed August 26, 2020).

Mancini, F. R. et al. (2019). Perfluorinated alkylated substances serum concentration and breast cancer risk: Evidence from a nested case-control study in the French E3N cohort. International Journal of Cancer 146(4):917-928. .https://www.ncbi.nlm.nih.gov/pubmed/31008526

Tip 17. Choose plastic recycling codes 2, 4 or 5

Darbre, P. D. (2020). Chemical components of plastics as endocrine disruptors: Overview and commentary. Birth Defects Research 2020 Jul 28.doi: 10.1002/bdr2.1778. Online ahead of print https://pubmed.ncbi.nlm.nih.gov/32720473/

Breast Cancer Prevention Partners https://www.breastcancer.org/risk/factors/plastic (Accessed August 24, 2020)

Tip 18. Check cosmetics ingredients before purchase.

Breast Cancer UK Ingredients in Cosmetics we recommend you avoid (2019). https://cdn.breastcanceruk.org.uk/uploads/2020/08/Ingredients-in-cosmetics-we-recommend-you-avoid.pdf

Tip 19. Say no to receipts if they aren’t needed.

Wang Z. et al. (2017). Low-Dose Bisphenol A Exposure: A Seemingly Instigating Carcinogenic Effect on Breast Cancer. Advanced Science (Wein.) 4(2): 1600248. https://www.ncbi.nlm.nih.gov/pubmed/28251049

Mesnage, R. et al. (2017). Editor’s Highlight: Transcriptome Profiling Reveals Bisphenol A Alternatives Activate Estrogen Receptor Alpha in Human Breast Cancer Cells. Toxicological Sciences 158(2): 431-443. https://www.ncbi.nlm.nih.gov/pubmed/28591870

Tip 20. Avoid scented candles and air fresheners that contain phthalates or synthetic musks

Gomez, E. et al. (2005). Estrogenic activity of cosmetic components in reporter cell lines: parabens, UV screens, and musks. Journal of toxicology and environmental health 68(4): 239-51. https://www.ncbi.nlm.nih.gov/pubmed/15799449

Tip 21. Choose fragrance-free or naturally fragranced cleaning products

Hsieh, T.- H. et al. (2012). Phthalates induce proliferation and invasiveness of estrogen receptor-negative breast cancer through the AhR/HDAC6/c-Myc signaling pathway. FASEB Journal 26(2): 778 –787. https://www.ncbi.nlm.nih.gov/pubmed/22049059

Bitsch, N. et al. (2002). Estrogenic activity of musk fragrances detected by the E-screen assay using human mcf-7 cells. Archives of Environmental Contamination and Toxicology. 43: 257-264. www.ncbi.nlm.nih.gov/pubmed/12202919

Tip 22. Avoid household products that contain antimicrobial agents

Li, H. et al. (2017). Triclocarban and Triclosan Inhibit Human Aromatase via Different Mechanisms. Biomed Research International 2017:8284097. https://www.ncbi.nlm.nih.gov/pubmed/29376079

Giuliano, C. A. and Rybak, M. J. (2015). Efficacy of triclosan as an antimicrobial hand soap and its potential impact on antimicrobial resistance: a focused review. Pharmacotherapy. 35(3): 328-336. https://www.ncbi.nlm.nih.gov/pubmed/25809180

Tip 23 Stop smoking

Jones, C. et al. (2017). Smoking and the risk of breast cancer in the generations study cohort. Breast Cancer Research 19(1): 118. https://www.ncbi.nlm.nih.gov/pubmed/29162146

Cancer Research UK. How does smoking cause cancer? https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/smoking-and-cancer/how-does-smoking-cause-cancer#smoking_facts1 (Accessed 22.8.20).

Tip 24. Breastfeed your child

Islami, F. et al. (2015). Breastfeeding and breast cancer risk by receptor status – a systematic review and meta-analysis. Annals of Oncology 26: 2398-2407. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4855244/pdf/mdv379.pdf

Victoria, C. G. et al. (2016). Breastfeeding into the 21^st Century: epidemiology, mechanisms, and lifelong effect. The Lancet 387: 475-490. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)01024-7/fulltext

Tip 25: Daily exercise helps maintain a healthy immune system:

McTiernan, A. (2008). Mechanisms linking physical activity with cancer. Nature Reviews Cancer 8(3): 205–211. https://www.ncbi.nlm.nih.gov/pubmed/18235448

Regular exercise benefits immunity – even in isolation. 2020. https://www.bath.ac.uk/announcements/regular-exercise-benefits-immunity-even-in-isolation/ (Accessed 25 August, 2020).