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Breast Cancer Risks and Prevention

Chapter 14: Diet and Life Style & Breast Cancer Risk
How we live our lives and the choices we make concerning what we consume, what habits we keep, how we control our fertility and decide if and when to have children, how much we exercise, and even how long we stay in school and our career choices all influence our risk of breast cancer.
Diet
Diets that are high in phytoestrogens, especially as teenagers, can lower breast cancer risk. Phytoestrogens are plant estrogens that can block our estrogen receptors. These phytoestrogens do not stimulate our breast cells to proliferate as much as our own body's estrogens do. Teenagers who eat soy products have lower breast cancer rates. Phytoestrogens are found in many vegetables. 

Indole-3-carbinol is found in cruciferous vegetables such as cauliflower and broccoli. This chemical is converted by the stomach to DIM, which causes estrogen to be metabolized into an inactive estrogen that does not stimulate breast tissue to proliferate and thereby reduces breast cancer risk. DIM is also widely available in pill form, as a nutritional supplement. 

Countries which have diets high in omega-3 fatty acids, such as those found in deep water fish oils, have populations which develop breast cancer at an older age than countries with diets low in these oils. Olive oil has been found to decrease breast cancer risk in postmenopausal women. Canola, flax seed and walnut oils are also rich in omega-3 fatty acids.

A diet too high in calories, which leads to obesity, increases breast cancer risk. Postmenopausal obesity increases breast cancer risk because the aromataseenzyme system in fat cells causes more estrogen to be formed. Children who are obese develop menstrual cycles an early age, also increasing breast cancer risk.
Drinking alcohol in any form, beer, wine or spirits, increases breast cancer risk through its effect upon the liver. The liver metabolizes estrogen and can change it into an inactive form. A liver impaired by alcohol lets estrogen build to higher levels, thereby stimulating the breast. For example, men who are alcoholics develop increased breast tissue, called gynecomastia, from elevated estrogen levels.

Lifestyle habits
Recent studies suggest that cigarette smoking before having children-especially among teenagers-also increases premenopausal breast cancer risk substantially. Benzopyrenes in cigarette smoke act as direct carcinogens to cells lining the milk ducts.

Exercise is also important in reducing breast cancer risk. Overall, moderate exercise can reduce breast cancer risk by 30%. Exercise also can prevent obesity, which increases breast cancer risk. Exercise can delay the onset of a woman's first menstrual cycle, menarche, which also decreases breast cancer risk. Exercise may result in anovulatory, and therefore, low-estrogen menstrual cycles, thus decreasing risk.

The method a woman chooses to control her fertility also greatly affects her breast cancer risk. While synthetic steroid drugs in the form of birth control pills, patches, vaginal rings, IUDs or injectable progestins can increase breast cancer risk by up to 1,000%, as one study showed, the use of natural family planning(NFP) will not cause any increase in breast cancer risk. Natural family planning teaches a woman to reliably determine her fertile days by recognizing her own bodily changes during her fertile and infertile days of her menstrual cycle. Studies have shown efficacy rates similar to those of "the pill" without the cost and side effects. NFP is NOT the "rhythm method" and can be used effectively by women with regular or irregular menstrual cycles. There are several NFP methods in wide use, including the Billings Ovulatory Method, and NaProTechnology, which is based on the Creighton model. These methods are also used by women to overcome infertility, thus avoiding the use of synthetic fertility drugs such as Clomid. 

The age at which a woman chooses to have children also determines breast cancer risk. Compared to a woman who gives birth at 30, a woman who has a full-term pregnancy before age 20 has only one-third the risk of breast cancer. By having children early in their reproductive life, women can greatly reduce their breast cancer risk. Women also avoid the risk of infertility, which advancing age brings, by having children when they are young. By avoiding infertility, a woman avoids exposure to hormonal fertility drugs. Choosing to end a pregnancy through an induced abortion, especially the first pregnancy as a teenager, significantly increases breast cancer risk. 

Breast feeding your children will also decrease breast cancer risk. Breast feeding fully matures the breast and often results in anovulatory or missed cycles.

High socioeconomic status and a high level of education are also presently associated with higher breast cancer risk. Women, who have high socioeconomic status, more commonly have children late in their reproductive life or remain childless, well established risks for breast cancer. Women who achieve high levels of education through college and postgraduate levels also tend to delay childbearing or remain childless. They commonly accomplish this through hormonal birth control (contraceptive steroids in pill, patch or injectable form). In 1975 only 10% of women between 40 and 45 were childless, now it is 18% according to the US 2000 census data.

Making informed health care choices
Don't take hormones for conditions which are not necessarily abnormal, such as irregular menstrual cycles in teenagers. In fact, teenagers who do not experience regular menstrual cycles until 5 years after menarche, have a decreased breast cancer risk compared to those who cycle regularly right after menarche.

Don't take hormones for disease treatments for which other non-hormonal treatments are equally effective. Actonel, Fosamax, calcium supplements and exercise can reduce osteoporosis without the need for estrogen. DHEA(dehydroepiandrosterone), a normal metabolic intermediate substance produced by the adrenal gland, but which declines with age, is widely available as a nutritional supplement. While not itself an active hormone, DHEA can be converted to active hormones by certain tissues. For example, it can be converted to estrogen by bone and vaginal lining, but not uterine lining. Thus it does not increase the risk of uterine cancer, but it can prevent or reverse bone loss and other menopausal symptoms. (DHEA cannot be converted to testosterone by muscle tissue or cause an increase in muscle mass.) Acne can be treated with antibiotics. There are effective methods of birth control (such as NFP) that do not rely on hormones. Menstrual cramps can be treated with non-steroidal anti-inflammatory drugs such as ibuprophen.
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