If girls and women of all ages adopted healthier lifestyle behaviors and the highest-risk women took preventive drugs like tamoxifen, the authors of a new report say fully half of breast cancers in the U.S. might be avoided.
Women need to have better access to understanding how breast cancer risk accumulates and how these lifestyle factors add up over the years to increase risk, one of the researchers stated.
In addition to researching effective treatments and methods of catching cancers early, the researchers argue that more emphasis should be on using what's already known about what raises breast cancer risk.
For instance, just a small fraction of women who could benefit from the breast-cancer-preventing medications tamoxifen and raloxifene actually take them, the researchers note in their report.
Women can slash their breast cancer risk by avoiding alcohol or drinking very moderately; maintaining a healthy weight; being physically active; eating plenty of fruits, vegetables and whole grains; and, if they have children, breastfeeding them.
The risk associated with lifestyle factors begins to accumulate in early life, the researchers point out, and there is evidence that the time between a girl's first period and her first pregnancy may be particularly important in determining breast cancer risk.
For example, research has found that teens who don't drink alcohol at all may reduce their future risk of breast cancer by 20 percent to 30 percent compared to their peers who had at least one drink in the past 30 days.
And young adult women who drink less than one drink a day have a 20 percent to 30 percent lower risk than their peers who drink at least four drinks a week.
Young people who eat plenty of fruits, vegetables and whole grains are already reducing their future risk of several types of cancer - including breast cancer, according to the analysis.
Physical activity has the most breast-cancer-preventing benefit when women sustain it throughout their lifetimes. However, the researchers emphasize it's never too late to start.
Being obese after menopause is a key risk factor for breast cancer, he noted, but women who are able to lose weight in their post-menopausal years will bring down their risk of the disease.
Many women who could benefit from chemoprevention may shy away due to the complex risk-benefit profile associated with the drugs, they noted. For example, tamoxifen increases the risk of endometrial cancer and dangerous blood clots.
The field is pretty comfortable that those tradeoff issues are part of the reason we have substantially lower use in older women than one might expect given the magnitude of benefit that taking these preventive drugs actually conveys," the researcher said, noting that the medications will cut an individual woman's risk of cancer in half.
One study found that the benefits of breast cancer chemoprevention outweigh the risks for nearly 8 million U.S. women in their 50s and 60s. But fewer than 120,000 women aged 35 to 79 in the U.S. are actually on tamoxifen or raloxifene.
Source: CA: The Cancer Journal for Clinicians, online March 19, 2014.
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