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Even though heart disease is the number one killer of women, breast cancer is the disease that continues to scare us the most. Research shows that 90% of women hugely overestimate their chances of getting it—most guess that their risk is nearly 50%, which is more than three times the actual likelihood of 14%. To ease your fears, we've sorted through the latest findings and consulted cancer experts and researchers to determine how you can lower your odds even further. "If a woman implements a variety of strategies, she can significantly impact her overall risk," says Marisa C. Weiss, M.D., an oncologist in Philadelphia and founder and president of breastcancer.org. Plus, most of these anticancer strategies keep you healthier overall, so put them on your must-do list today.
1. Get moving. High levels of estrogen are strongly linked to an increased risk of breast cancer, but regular exercise reduces the amount of the hormone in your body. Dedicating as little as an hour and 20 minutes per week to physical activity slashes your risk of developing the disease by 18%, according to research from the University of Southern California/Norris Comprehensive Cancer Center in Los Angeles. But more is better, says study author Leslie Bernstein, Ph.D. "I recommend that women get at least three to four hours weekly (about 30 minutes a day) to reduce their risk by 30% to 40%."
2. Maintain your weight. A recent study of 44,000 postmenopausal women found that those who gained more than 60 pounds after age 18 tripled their risk of getting breast cancer compared with those who gained 20 pounds or less. Even more worrisome: Weight gain was associated with an increased likelihood of developing a faster-spreading cancer. Having a body mass index (BMI) over 25 seems to increase the amount of estrogen in the body as well as insulin levels, which has also been implicated in breast cancer. Don't know your BMI? Calculate it at cdc.gov/bmi.
3. Veg out. Carotenoids, the antioxidants in brightly colored produce, fight cell damage by eliminating cancer-causing substances, says cancer researcher Archana Jaiswal McEligot, Ph.D, an associate professor of health sciences at California State University at Fullerton. And fiber found in fruits and vegetables may defeat cancer cells by regulating insulin and fighting inflammation, which has recently been linked to everything from Alzheimer's and arthritis to heart disease and cancer. Strive for seven servings of fruits and veggies daily. Dark green, leafy vegetables like kale and spinach, and cruciferous types, such as broccoli, are most beneficial. The lycopene in tomatoes also has a protective effect—surprisingly, processed tomato sauce and ketchup contain more of the antioxidant than the raw fruit.
4. Eat healthy fats. Omega-3 fatty acids decrease the strength of estrogen in the breast tissue, and they also subdue inflammation, says Christine Horner, M.D., author of Waking the Warrior Goddess: Dr. Christine Horner's Program to Protect Against and Fight Breast Cancer (Basic Health). Boost your daily intake by sprinkling 2 to 3 tablespoons of ground flaxseed on cereal, yogurt, or veggies daily. (As an added bonus, flaxseed also contains phytochemicals called lignans, which are thought to help thwart the growth of tumor-feeding blood vessels and reduce fat cells' production of estrogen.) Olive oil, too, should be a regular in your kitchen—people who consume this and other Mediterranean diet staples tend to have lower rates of breast cancer.
5. Be a "teatotaler." Antioxidant-rich green tea offers a potential triple threat against breast cancer, says Dr. Horner: It may decrease the production of estrogen, may help prevent the hormone from settling in the breast, and may shut off the blood supply to tumors. Some studies show that women who drink the most green tea have the lowest likelihood of getting the disease. If the preventive prescription of 6 to 10 cups daily sounds daunting, you can take a green tea extract supplement (available online or at health food stores). If you're brewing green tea, opt for an organic version to avoid pesticides.
6. Think twice about HRT. "It appears that taking combination hormone replacement therapy—estrogen and progesterone—for five years or longer is associated with a small but real increased risk of developing breast cancer," says Dr. Weiss. Women who have had a hysterectomy have the option of taking estrogen alone. That's a benefit, since a recent study found that while estrogen on its own does up women's risk, it takes 20 years to do so. Talk to your doctor to determine the best regimen for you; there are a variety of alternative ways to control menopausal symptoms, and other drugs that yield the bone-preserving benefits of estrogen.
7. Restrain yourself at happy hour. Research has identified a connection between alcohol consumption and breast cancer, probably because alcohol increases hormone levels. If you drink more than a modest amount (it's best to have five or fewer cocktails weekly) and also have low levels of folate, you may be particularly at risk, says Mary B. Daly, M.D., director of the family risk assessment program at Fox Chase Cancer Center in Philadelphia. Research shows that folate—a B vitamin found in beans, oranges, leafy vegetables, and enriched breads and cereals—helps to regulate normal DNA function. Damaged DNA is implicated in the start of cancer.
8. Spice up your life. Turmeric, an ingredient in curry powder, contains the powerful phytochemical curcumin, which preliminary studies have shown fights inflammation and inhibits tumor cell growth, says Bharat B. Aggarwal, Ph.D, a professor of cancer research at the University of Texas M.D. Anderson Cancer Center in Houston. Statistics comparing breast cancer incidence in Americans and Indians, who consume a curry-rich diet, is also telling: Recent data counts 101 new cases per 100,000 people in the U.S., versus just 19 per 100,000 in Indians. If you don't like this spice, Aggarwal suggests a 500-milligram curcumin supplement (which you can buy online or at a health food store). If you're on a blood thinner, such as Coumadin, beware of this supplement since curcumin further reduces clot formation.
9. Breastfeed your babies. An analysis of 47 studies in the journal the Lancet found that women who nursed for at least 15 months over their lifetime reduced their breast cancer risk by about 4%. The reason? "It could be because breastfeeding reduces a woman's total number of menstrual cycles—and that means less exposure to estrogen," says Lisa C. Richardson, M.D., a medical officer at the Centers for Disease Control and Prevention. "It's a small benefit—but it is a benefit."
10. Study your family tree. "Knowing your history on both your mother's and father's side is very important," says Dr. Weiss. "If you find out you're at increased risk—meaning you have two or more close relatives who have had breast and/or ovarian cancer, especially if the cancer was diagnosed before age 50—there are definite measures you can take." Some women get tested to find out if they have mutated BRCA1 and BRCA2 genes; others take the drug tamoxifen; and others (if risk is very high) have surgery to remove the breasts and ovaries.