What Are the Best Ways to Prevent Breast Cancer?

Many people with breasts fear a breast cancer diagnosis. Statistics tell us that as many as 1 in 8 women will get this diagnosis. Here’s the good news: If you know you’re at higher risk of having breast cancer, there are steps you can take to lower your risk. This may be as simple as making changes to your lifestyle and behaviors, like getting regular exercise and avoiding heavy alcohol consumption. It could also mean taking medication. For some, it may mean deciding to have a prophylactic mastectomy. Read on to learn what you can do to lower your risk of breast cancer.

How do I know if I’m at higher risk for breast cancer?

There are many risk factors for breast cancer. You may be able to control some. But many of the risks are out of your control, such as your family history or age. The risk factors for breast cancer include:

• Age — most breast cancers happen in women over the age of 50

• Family history and genetics, including known genetic mutations like BRCA1 and BRCA2

• Age of first period and age of menopause, with increased risk with women starting periods before age 12, or going through menopause after age 55

• Dense breasts

• History of breast disease or prior breast cancer

• History of radiation treatment to the chest or breasts

• Having a pregnancy after age 30 or not at all

• Not breastfeeding

• Having overweight or obesity

• Heavy alcohol use (more than 2 drinks per day)

It’s important to have a discussion with your healthcare provider about your personal risk of breast cancer. Your doctor may use a breast cancer risk tool to help you understand your risk. Knowing your personal risk can help you make better decisions on breast cancer screening and other preventive steps you can take. 

Should I do genetic testing?

Some women with a strong family history of breast or other cancers may benefit from doing genetic testing. There are many genes that can increase cancer risk, and the most common ones for breast cancer are mutations in the BRCA1 or BRCA2 genes.

It’s important to think about the risks and benefits of genetic testing. For some, learning genetic history may help with decisions on screening or preventive treatments. This may also help other family members to be aware of their own risk. For others, genetic testing may not provide helpful information, or the answers may increase stress or anxiety. It’s worth a discussion with your healthcare team.

What can I do to lower my risk of breast cancer? 

There are simple lifestyle changes that can help reduce your risk of breast cancer. And you might want to think carefully about your birth control choices or other hormonal treatments. 

What can I do to prevent breast cancer naturally?

There are steps you can take in your lifestyle that can lower your risk of developing breast cancer. These include:

• Exercise: Staying physically active and exercising are associated with a lower risk of breast cancer. Have a goal of exercising at least 30 minutes a day. 

• Have a healthy weight: Gaining weight during adulthood increases the risk of breast cancer.

• Limit alcohol: Having more than 1 to 2 drinks of alcohol daily is linked with a 30 to 50% increased risk of breast cancer.

• Avoid smoking: The relationship is still unclear, but research suggests that smoking may increase breast cancer risk.

• Nursing: If possible, breastfeeding for more than a year decreases the risk of breast cancer.

Does my birth control matter?

Many people who menstruate take birth control at some point during their lives and may wonder if and how this impacts their risk of breast cancer. Studies have shown that hormonal birth control (such as birth control pills and progesterone-containing IUDs) may slightly increase risk of breast cancer while taking it. This risk decreases after stopping hormonal birth control, and it appears there’s no increased risk 10 years after stopping it. If you’re worried about high risk of breast cancer, consider talking with your provider about alternatives such as a non-hormonal copper IUD.

What about hormone replacement therapy in menopause?

Menopausal hormone therapy (MHT, also known as HRT) may be used to treat menopausal symptoms, such as hot flashes or vaginal symptoms, and to lower the risk of heart disease. There may be an increased risk of breast cancer while taking this medication. The increased risk depends on how long you use MHT, how far out from menopause you’re when taking it, and which type of hormone is used (there’s higher risk for certain types of progesterone).

What is the breast cancer risk for transgender people on hormone therapy?

Transgender women who are taking taking feminizing hormone therapy have a small increased risk of breast cancer when compared to an average man’s risk. This risk is lower than an average woman’s risk of breast cancer. Transgender men who are taking masculine hormones also have a lower risk of breast cancer when compared to the average woman.

If I am at higher risk, what are early treatments to prevent breast cancer?

If you know you’re at higher risk of getting breast cancer — such as if you have a strong family history or a known genetic mutation — there are more aggressive steps you can take to lower your risk. This may include more frequent breast cancer screening with mammograms and/or breast MRIs, medications, or even surgery with a prophylactic mastectomy.

Are there medications to help prevent breast cancer?

For some women with high risk, you may want to talk with your healthcare provider about medications that may help lower your risk of developing breast cancer. These may include:

• Nolvadex (Tamoxifen)

• Raloxifene

• Aromatase inhibitors, such as anastrozole (Arimidex) or exemestane (Aromasin)

Should I have a prophylactic mastectomy?

If there’s a very high risk of breast cancer, such as having the BRCA gene mutation, some women may want to consider prophylactic mastectomy or prophylactic removal of ovaries. These procedures have their own risks and side effects, and it’s something to fully discuss with your doctor.

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Written by:

Christina Palmer, MD

Christina Palmer, MD, is a board-certified family physician with a special interest in chronic care management, women’s health, mental health, and preventive care. She has over 10 years of experience in primary care research, innovation, and practice.

Edited by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Reviewed by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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