It is estimated that about half of all breast cancer cases in the United States could be prevented or postponed if women kept a normal weight, ate healthy foods, drank less alcohol, exercised more, smoked fewer cigarettes or did not smoke at all, and breastfed their babies. Many doctors are quick to send a patient for a mammography (see who can benefit from testing and who does not), yet few take the time to explain or give out a handout sheet on ways women can reduce their risk.

Exercise, physical activity, movement, natural way to reduce occurrence
Risk of breast cancer decreases in women who are physically active. Even moderate physical activity -- for example brisk walking for 2 miles three times a week -- over the course of a lifetime can significantly reduce a woman's risk.

Diet and breast cancer, what kind of foods help prevent or aid in the treatment of breast cancer? Does diet make a difference?
The diet of preschoolers influences the risk of breast cancer during adulthood which indicates that tumor formation is influenced by diet decades before it becomes clinically apparent.

Overweight and obese women who eat a Western-style diet develop more dense breast tissue, possibly increasing their risk for breast cancer, Aug. 8, 2016, Obstetrics and Gynecology.

A high fiber diet reduces the risk.

Brassica vegetables like broccoli, cauliflower and cabbage might be protective. Data on Chinese breast cancer survivors age 20-75 who were diagnosed with stage one to stage four breast cancer and who were part of the Shanghai Breast Cancer Survival study indicates those who ate cabbage, broccoli and leafy greens saw improved survival rates.

Women with early-stage breast cancer may live longer if they maintain a diet rich in vegetables, whole grains, fruits, and low-fat dairy, along with reduced intake of refined foods and sweets. Regularly eating oily fish such as salmon, tuna or sardines is suggested, 2013, BMJ, online. Women who frequently consume hamburgers, steaks and other red meat have a slightly higher risk of breast cancer

The role of fats is controversial and still being evaluated, but it is a good idea to consume a higher proportion of good fats rather than bad ones. Good fats are found in raw nuts and seeds, fish, olive oil, flax oil, hemp oil, coconut oil, and dark leafy greens. Less desirable fats are found in lard, meats and high-fat dairy products. Bad fats are formed when vegetable oils are partially hydrogenated to make them more stable and solid. They are usually found in commercially baked goods such as cookies, crackers, cakes, French fries, onion rings, donuts, processed foods, etc.     

Eating beans or lentils at least twice a week may reduce the risk. Women are recommended to eat healthy amounts of plant foods rich in lignans. American Journal of Clinical Nutrition, May 12, 2010. A high-fiber diet is of benefit.

Eating mushrooms may lower the risk. A study of more than 2,000 Chinese women found that the more fresh and dried mushrooms the women ate, the lower was their breast cancer risk. The risk was lower still among those who also drank green tea everyday. Mushroom extracts have anti-tumor properties and can stimulate the immune system's cancer defenses.

Green tea contains antioxidant compounds called polyphenols that have been shown to fight breast tumors in animals. Dry green tea leaves, which are about 40% polyphenols by weight, may also reduce the risk of cancer of the stomach, lung, colon, rectum, liver and pancreas. One or two cups a day is fine, drinking more may cause shallow sleep. Or you can take a green tea extract pill. International Journal of Cancer, March 15, 2009.

Eat more garlic and other culinary herbs and spices. The benefits of garlic are underestimated by physicians in the United States. Diallyl disulfide (found in garlic) inhibits growth and metastatic potential of human triple-negative breast cancer cells through inactivation of the β-catenin signaling pathway. Mol Nutr Food Res. 2015.

Soy products
I know there are many people out there who have a negative viewpoint regarding soy products, often due to reading articles on the internet that blast soy and unfairly blame all kinds of health issues as a consequence of its ingestion, but I think we should take a reasoned and balanced approach. The bottom line, in my opinion, is that some people are sensitive or are allergic to it and do not tolerate it well and thus should not consume it. However, most women benefit from organic fermented soy consumption (non-GMO), at least in small amounts, as part of a diet that has a variety of foods and there is no reason for women who have had breast cancer to avoid it.

Cancer, 2017. Dietary isoflavone intake and all-cause mortality in breast cancer survivors: The Breast Cancer Family Registry. Soy foods, isoflavones, and breast cancer. In this large, ethnically diverse cohort of women with breast cancer living in North America, a higher dietary intake of isoflavone was associated with reduced all-cause mortality.

CMAJ. 2010. Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. Department of Medical Oncology, Cancer Hospital of Harbin Medical University, Harbin, China. High dietary intake of soy isoflavones was associated with lower risk of recurrence among post-menopausal patients with breast cancer positive for estrogen and progesterone receptor and those who were receiving anastrozole as endocrine therapy.
  
J Nutr. 2010; Comprehensive Cancer Center, Georgetown University, Washington, DC, USA. Lifetime soy consumption at a moderate level may prevent breast cancer recurrence through mechanisms that change the biology of tumors; e.g. women who consumed soy during childhood develop breast cancers that express significantly reduced Human epidermal growth factor receptor 2 levels. More research is needed to understand why soy intake during early life may both reduce breast cancer risk and risk of recurrence. Is soy consumption good or bad for the breast?
  
Nutrition Cancer. 2008. Eating soy regularly as a young girl may help protect against the development of breast cancer later on in life due to the presence of phytoestrogens. Scientists at Hanyang University in Korea compared 362 women diagnosed with breast cancer with an equal number of healthy women matched for age and menopausal status. Individuals were interviewed concerning their diets, which included tofu, soybean paste, and soy milk. Among premenopausal women whose intake of soy protein was among the top 20% of participants, there was a lower risk of breast cancer compared with those in the lowest 20%.
  
Canadian Medical Association Journal, online October 18, 2010. Among more than 500 women in China whose breast cancer was driven by the hormones estrogen or progesterone (or both), those who had gone through menopause and ate the most soy were less likely to experience a recurrence of their disease over about 5 years.

Premenopausal women who eat large amounts of red meat appear to have an increased risk of developing breast cancer with receptors that are positive for estrogen and progesterone. Post-menopausal Chinese women who eat a Western-style diet heavy in meat and sweets face a higher risk of breast cancer than their counterparts who stick to a typical Chinese diet loaded with vegetables and soy.

High-carb diets (with a high intake of simple carbohydrates) increase the risk. The amount of carbohydrates a woman eats, as well as the overall "glycemic load" of her diet, impact her chances of developing breast cancer. The concept of glycemic load is based on the fact that different carbohydrates have different effects on blood sugar. White bread and potatoes have a high glycemic index, which means they tend to cause a rapid surge in blood sugar. Other carbs, such as high-fiber cereals or beans, create a more gradual change and are considered to have a low glycemic index. International Journal of Cancer, July 2009.
 
A set of risk factors for heart disease and type 2 diabetes, known as the metabolic syndrome x, increases the risk of breast cancer in post-menopausal women. People with the syndrome have excess fat around their middle, high levels of glucose in their blood, resistance to the blood-glucose-lowering hormone insulin, high cholesterol, and high blood pressure.

Natural supplements for breast cancer prevention or treatment
Research in the field of prevention or treatment of breast cancer with supplements, vitamins, herbs or alternative methods is very early and no firm answers can be given at this time. However I wanted to mention a few compounds that have been studied. These supplements have not been extensively tested in humans and at this point it is best to use conventional breast cancer treatment and use these herbs only as a supplement, not as a complete alternative. Discuss with your doctor before use. Click each link for more information and research studies. They are listed in alphabetical order.

Curcumin is extracted from the spice turmeric, often found in the mixed spice blend curry.
   Oncol Rep. 2018. Curcumin and paclitaxel induce cell death in breast cancer cell lines.

Fish oil supplement use may be of benefit. In a study of more than 35,000 postmenopausal women, those who regularly used fish oil supplements were one-third less likely than non-users to develop breast cancer over the next six years. Cancer Epidemiology, Biomarkers & Prevention, July 2010.
Genistein, one of the isoflavones, has weak estrogenic and antiestrogenic properties. It may be one of the the components in the soy-based Asian diet that helps prevent breast cancer by its effects on biochemistry early in life. Reduced caloric consumption by Asians may be another reason for the lower rate. Soy isoflavone genistein induces cell death in breast cancer cells. Department of Biochemistry, Faculty of Life Sciences, AMU, Aligarh, India. Mol Nutr Food Res. 2010.
Indole-3-Carbinol has been studied as a possible treatment for breast cancer, it is found in cabbage.
   Cell Cycle. 2014. Indole-3-carbinol and its N-alkoxy derivatives preferentially target ERα-positive breast cancer cells.
IP6 has in vivo and in vitro anti- cancer activity. Patients receiving chemotherapy, along with IP6 and Inositol have better quality of life and functional status and are able to perform their daily activities.
Mangosteen fruit and rind has xanthones that have strong antiproliferation effects and can induce apoptosis.

Maitake mushroom
   Nutr Cancer. 2017. Antitumoral Effects of D-Fraction from Grifola Frondosa (Maitake) Mushroom in Breast Cancer.

Black cohosh herb has certain compounds that kill estrogen receptor positive MCF-7 as well as estrogen receptor negative MDA-MB231 cells by activation of caspases and induction of apoptosis.
Bitter melon extract has been shown in lab studies to fight breast cancer cells in vitro.
Cat's claw herb has anticancer properties.
Melatonin is a hormone supplement used for sleep.
Reishi is a mushroom that may be helpful.
Resveratrol has been found helpful in mouse studies. Resveratrol  is an interesting molecule that has a lot of potential.
Saw palmetto may slow the growth of breast cancer cells.
Sulforaphane, found in broccoli and Brussels sprouts, hinders the growth of human breast cancer cells in the lab. It does so by apparently disrupting the action of protein microtubules within the cells, which are vital for the success of cell division. A study in rats showed that oral sulforaphane blocked the formation of breast tumors, and scientists have found that the chemical can push colon cancer cells to commit suicide.
Vitamin D may reduce breast cancer risk. In vitro studies indicate that it can inhibit cell proliferation and promote apoptosis and cell differentiation in breast tumor tissue. Results from analytic studies of sunlight exposure and dietary intake generally support a modestly protective role of vitamin D, at least in some population subgroups. My suggestion is to take between 400 and 2000 iu a day depending on how much sun you get on a regular basis.

Post breast cancer nutritional treatment and natural therapy
Breast cancer survivors who stay lean are less likely to die from this condition than those who gain a lot of weight. Pumping iron may help survivors improve the quality of their lives, as well as strengthen their bodies. Women who lift weights report feeling more self-confident and stronger, sleeping better and have more energy. Physical activity increases a woman's chances of surviving breast cancer -- regardless of her level of physical activity before the diagnosis.

CoQ10 may be helpful in breast cancer patients undergoing tamoxifen therapy. Ameliorating effect of coenzyme Q10, riboflavin and niacin in tamoxifen-treated postmenopausal breast cancer patients with special reference to lipids and lipoproteins. Clin Biochem. 2007.

Cordyceps sinensis, in a study, was found to reduce lung metastases after surgical excision of the primary tumor.

This study included 524 women who were followed for an average of 5 years. High dietary intake of soy isoflavones was associated with a significantly lower risk of recurrence in post-menopausal women with estrogen and progesterone receptor positive breast cancer and those who were receiving hormone therapy. Effect of soy isoflavones on breast cancer recurrence and death for patients receiving adjuvant endocrine therapy. CMAJ. Nov 2010.

Ginseng has been associated with longer survival in women with breast cancer and leads to a better quality of life after treatment. Use low amounts to avoid insomnia.

Vanillin extract is beginning to be studied.

Yoga is valuable in helping to achieve relaxation and diminish stress, improve performance of daily activities, and increase the quality of life in cancer patients.

Coffee
Women with BRCA1 gene mutations, which confer a high risk, might decrease their risk by drinking coffee, which may be due to antioxidants present in coffee. It is likely that certain teas would also be helpful in reducing the risk.

Alcohol
Moderate or heavy alcohol consumption raises the risk among postmenopausal women on hormone replacement therapy.

Young women who drink alcohol frequently put themselves at higher risk of developing breast disease that is a known risk factor for cancer.

Hormone levels
Elevated levels of hormones increase risk in postmenopausal women, and as the number of different elevated hormones rises. These include estrogens (estrone and estrogen), prolactin, and androgens (testosterone, androstenedione, DHEA, or DHEA-sulfate).

Stress
Young women who experience more than one stressful life event are at greater risk, but a general feeling of happiness and optimism may reduce the risk. BMC Cancer, August 21, 2008.

Implants
Women with cosmetic breast implants do not appear to have a higher-than-average risk of any cancer years after having the surgery. International Journal of Cancer, January 15, 2009.

Prohylactic healthy breast removal
For most women with breast cancer there doesn't seem to be a significant survival benefit from having their healthy breast removed as well. In recent years more women with cancer in one breast have been choosing to have the other breast removed as a precaution -- known as a prophylactic or preventive mastectomy. A study finds that over 20 years, the survival benefit between women who've had a preventive mastectomy and those who kept their healthy breast was less than 1 percent. The study is published July 16 2014 in JNCI: Journal of the National Cancer Institute.

Estrogen and breast cancer
Following reports that the use of estrogen hormone replacement after menopause could perhaps increase the incidence, the reduction in the use of estrogen hormone (such as Premarin)  by post menopausal women will lead to fewer cases of breast cancer being diagnosed.
   Women who take birth control pills could increase their risk of cervical and breast cancer.
   As little as 3 years of using combined estrogen and progestin menopausal hormone therapy substantially increases the risk of developing lobular breast carcinoma.
   Detecting breast cancer with mammography and biopsy is more difficult in women who use estrogen and progestin hormone therapy.
   Breast cancer rates among postmenopausal women in Canada dropped after news of a big study in 2002 that found taking hormone replacement therapy could increase the risk.

Androgens
High levels of 'male' hormones, or androgens, in young women apparently raise their risk. Androgens are normally present in women, albeit at much lower levels than in men. Elevated androgen levels have been linked with breast cancer in studies of postmenopausal women, but it was unclear if this also applied to premenopausal women. In the Journal of the National Cancer Institute, Dr. Rudolf Kaaks, from the International Agency for Research on Cancer in Lyon, France, and colleagues compared androgen levels in 370 premenopausal women who were later diagnosed with breast cancer with levels found in 726 similar women without breast cancer. The likelihood of developing of breast increased significantly as levels of testosterone and androstenedione rose. The absolute risks of women younger than 40 years developing breast cancer over a 10-year period ranged from 2.6 percent for those with the highest testosterone levels to 1.5 percent among those with the lowest levels. The study "provides strong evidence that the risk of breast cancer among premenopausal women is directly related to circulating levels of testosterone and androstenedione," Kaaks' team concludes.
     Dr. Sahelian says: It would be prudent for women who have a family history of breast cancer or other risk factors to avoid the use of androgens, including DHEA, or to use them for only brief periods.

Underarm antiperspirants, metals
Underarm antiperspirants may contribute to the risk because they contain aluminum salts with metal ions that mimic the effect of estrogen.
    Metals including aluminum salts and cadmium have been shown to exert estrogen-like effects, while some also promote the growth of breast cancer cells in the laboratory. Given the wide variety of other substances that can mimic estrogen, including certain pesticides, cosmetics and detergents, it is possible that aluminum salts and other inorganic estrogen-related compounds called "metalloestrogens" can further disrupt normal hormonal signaling within the breast.  What is particularly concerning about aluminium is the fact that it is applied to the underarm, close to the breast, and left on the skin. Deodorants also are frequently used after shaving, making it easier for aluminium salts to enter the blood stream. Studies also have demonstrated that aluminium salts can penetrate human underarm skin even if it is unbroken. People can reduce their exposure to cadmium by quitting smoking. Journal of Applied Toxicology, March, 2006.

Risk factors for breast cancer
Many risk factors cannot be controlled -- such as genetic mutations, age, and family history -- others are associated with lifestyle choices. The following lifestyle factors may increase a woman's risk: Having no children, using oral contraceptives, using post-menopausal hormone replacement therapy (HRT), overuse of alcohol, being obese, eating an unhealthy diet, and getting inadequate physical activity.
   Use of the heart drug digoxin appears to increase the risk in postmenopausal women. Digoxin helps the heart pump stronger and is used to treat heart failure.
   There is a higher risk with early menarche and late menopause. The more a woman breast feeds, the more she is protected. There is also a higher risk with the long term use of androstenedione, dihydroepiandrosterone (DHEA) and testosterone. Women who already have breast cancer should not take additional hormone replacement, particularly estrogens.
   Women who work night shifts have a higher rate.
   Having an abortion or miscarriage does not increase a woman's risk of suffering from breast cancer later in life.
   Exposure to the environmental estrogen 4-nonylphenol increases the risk of breast cancer in mice. Estrogen-like chemicals in the environment have the ability to cause cancer. Many environmental factors increase a woman's level of the female hormone estrogen, which is thought to be a major contributing factor to the disease. 4-nonylphenol is released from cleaning agents, textiles, paper, plastic, personal care products and agricultural chemicals. BBP (n-butyl benzyl phthalate), a chemical additive used in pipes, vinyl floor tiles, carpet-backing, and other household items, may affect mammary gland development and perhaps may increase susceptibility. See parabens for another source of concern.
  There is no good evidence at this time that wearing bras compromises the lymphatic system and thus has any influence.
  Having multiple cardiac and chest CT scans increases the chances.

Statin drugs
Statins and Breast Cancer in Postmenopausal Women without Hormone Therap; Anticancer Research (2009).
A hospital-based case-control study was conducted in Fargo, ND, USA. This observational study found an increased risk of breast cancer related to duration of statins use and progesterone receptor-negative among postmenopausal women.

Breast self-exam -- is it worth the trouble?
Breast self-exams have not been found to be helpful. They increase the number of false positive results. These may result in follow-up testing or invasive procedures such as biopsies, leading to anxiety, inconvenience, discomfort, and additional medical expenses.

Breast cancer post surgical survival and treatment
Younger breast cancer patients seem to suffer more serious side effects from chemotherapy than previously thought. Roughly one in six of those women wind up at the emergency room or hospitalized because of such side effects as infection, low blood counts, dehydration or nausea.
   Postmenopausal women who have survived early breast cancer face a higher than average risk of osteoporosis. Aromatase inhibitors -- Arimidex (anastrozole), Femara (letrozole), and (Aromasin) exemestane, which are used to suppress estrogen in women whose tumors are hormone driven -- have been associated with changes in bone mineral density. Hot flashes and other unpleasant side effects are a major reason many patients do not start or do not complete their recommended hormone-blocking therapy.
   Women who survive a bout with breast cancer are at increased risk of developing cancers of the lung, stomach, and colon, among several others. The elevated risk of other cancers could be due to the treatment given to fight the breast cancer, or perhaps to a genetic predisposition. They are also at a higher risk for heart disease or failure. Women who are treated with the cancer drug Herceptin have more long-term cardiac problems.
   Women who develop arm swelling following surgery for breast cancer -- a bothersome condition known as lymphedema -- derive significant benefits from participating in a slowly progressive weight lifting program.
   Women seeking help from menopausal symptoms and diminished sex drive by taking testosterone as well as estrogen face a higher risk of breast cancer than with estrogen alone.
   Approximately one third of women treated for breast cancer experience fatigue for the first five years after treatment, and for about two thirds of those, the fatigue will persist.
   Survivors who take aspirin regularly may live longer and be less likely to see their disease return. Journal of Clinical Oncology, online February 16, 2010.

Drug therapy and prevention
Tamoxifen and other drugs used to help prevent breast cancer in women at high risk for the disease carry their own potential health risks. For women with a close family history of the disease, doctors sometimes prescribe tamoxifen, raloxifene or tibolone to help reduce their risk of getting the condition. These drugs are effective in reducing the risk of breast cancer. Relative to placebo, tamoxifen, raloxifene, and tibolone reduce the risk by 30 percent, 56 percent, and 68 percent, respectively. This equates to 7 to 10 fewer cases of breast cancer per 1,000 women per year. However, tamoxifen and raloxifene increase the risk of blood clots, tamoxifen ups the risk of endometrial cancer, and tibolone raises the risk of stroke.
   The popular antidepressant drug Paxil may interfere with breast cancer treatments, making patients more likely to relapse and die. Women who took GlaxoSmithKline's Paxil while taking tamoxifen at the same time were more likely to die of their breast cancer.

Radiation therapy
This is a treatment that uses high-energy x-rays or other types of radiation to kill cancer cells. There are two types: External radiation therapy uses a machine outside the body to send radiation toward the cancer. Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
   Cancer patients undergoing radiation treatment may want to sip some red wine before treatment. Drinking red wine can help limit the toxic effects of radiation therapy.  International Journal of Radiation Oncology Biology and Physics, 2009.
   Women who have breast cancer on the left side of the body and who are treated with radiation therapy have a higher risk of developing narrowing of the arteries that lead to the heart thus raising the risk for heart disease.

Many studies have affirmed that a newer, shorter course of radiation therapy for early-stage breast cancer works just as well as a longer course. University of Pennsylvania, news release, Dec. 10, 2014.

Breast cancer treatment
Four types of standard surgical treatment are used:
Surgery - Most patients with breast cancer have surgery to remove the cancer from the breast. Some of the lymph nodes under the arm are usually taken out and looked at under a microscope to see if they contain cancer cells. Breast-conserving surgery, an operation to remove the cancer but not the breast itself, includes the following:
* Lumpectomy: A surgical procedure to remove a tumor (lump) and a small amount of normal tissue around it.
* Partial mastectomy: A surgical procedure to remove the part of the breast that contains cancer and some normal tissue around it. Patients who are treated with breast-conserving surgery may also have some of the lymph nodes under the arm removed for biopsy. This procedure is called lymph node dissection. It may be done at the same time as the breast-conserving surgery or after.
* Total mastectomy: A surgical procedure to remove the whole breast that contains cancer. This procedure is also called a simple mastectomy. Some of the lymph nodes under the arm may be removed for biopsy at the same time as the breast surgery or after.
* Modified radical mastectomy: A surgical procedure to remove the whole breast that contains cancer, many of the lymph nodes under the arm, the lining over the chest muscles, and sometimes, part of the chest wall muscles.

Emails
I read with interest your supplement research update newsletter - vol. 2, issue 7 - in which you voice your concerns about elevated androgens in women's breast cancer. I hope that much more research continues into the lives of us "old geezers" (I'm 69) who fight the good fight against andropause! Very depressing, that. (I'm currently and happily taking point-5 mg of Arimidex three times a week - BIG improvement! smile serum estradiol levels have gone from 43 to 26 and free testosterone has risen from 102 to 169 after six weeks of use). I find on your web site and in your newsletters many interesting and mind-expanding ideas, many of which lead me to even further study and thought.
   A. We appreciate the feedback. We suspect both estrogen and androgens have an influence on breast cancer.

Additional articles or notes of interest
Amentoflavone induces cell-cycle arrest and apoptosis in MCF-7 human breast cancer cells via mitochondria-dependent pathway. Department of Pediatrics, TaoYuan General Hospital, Department of Health, Taiwan, TaoYuan, Taiwan, R.O.C.. Amentoflavone, isolated from an ethyl acetate extract of the whole plant of Selaginella tamariscina, a traditional herb, may exhibit antitumor activity. In Vivo. 2012.
Breast enhancement web page
Murraya koenigii leaf extract inhibits proteasome activity and induces cell death in breast cancer cells. BMC Complement Altern Med. 2013.
Ovarian cancer information