See what those in the know—from oncologists and breast surgeons to Pilates instructors and survivors—are doing to reduce their risk of this deadly disease.
by A.J. Hanley
Ask any group of women about the health problem they fear most, and you’re likely to hear a chorus of “breast cancer!” And who can blame us for pinpointing a disease that will claim more than 40,000 deaths this year alone? If that weren’t enough, there’s that oft-repeated stat—one in eight women will develop breast cancer in her lifetime—to keep us feeling uneasy about the future.
But as scary as these numbers sound, there’s actually a lot of good news about breast cancer these days. Mortality rates have been decreasing steadily since 1990, thanks to improved detection and treatment options, and increased awareness about the disease. If caught early, the five-year survival rate is more than 95 percent. Plus, mounting research shows there are many things you can do to tip the odds in your favor. “You can’t change your age or genetics [two of the major risk factors], but you can control certain lifestyle factors, such as exercise and what you eat and drink,” says Stephanie Bernik, MD, chief of surgical oncology at Lenox Hill Hospital in NYC. There’s no downside, she adds, since these behaviors will benefit your overall well-being as well.
We went to those on the front lines—from cancer specialists like Dr. Bernik to Pilates pros who have firsthand knowledge of the disease. Their tips will help boost your chances of maintaining your breast health.
1. Watch your weight.
Carrying extra pounds around does more than force you out of your skinny jeans—it triggers estrogen production. “High circulating levels of the estrogen hormone can increase the risk of diagnosis and recurrence of breast cancer,” says Doreen Puglisi, MS, an exercise physiologist and founder of the Pink
Ribbon Program, an exercise-based therapy plan aimed at survivors.
And that risk increases as you get older: Middle-aged women who gain as little as two pounds a year have a 9 percent greater chance of a breast cancer diagnosis by age 50 than those whose weight stays stable, according to research published last year in the International Journal of Cancer. “After menopause, the majority of estrogen is produced in the fatty tissues,” explains M. Lisa Attebery, DO, a breast surgeon in Paoli, PA. “Hence, the more fatty tissue, the higher the estrogen environment.”
Puglisi, who underwent treatment for breast cancer 10 years ago, now maintains a healthy weight to reduce her risk of recurrence, which studies have shown can increase when a woman is overweight.
“Instead of being a slave to the scale, I focus on how my clothes fit,” says Tara Roscioli, a Pilates teacher and the co-owner of The Align Wellness Studio in Millburn, NJ. “If they start to feel tight, I know I need to get back to clean eating.”
Knowing your family’s medical history can help you and your doctor devise a prevention plan. “My mother and maternal grandmother were diagnosed with breast cancer at a relatively young age—which puts me at a higher-than-average risk of developing it myself,” says Halle Moore, MD, an oncologist at the Cleveland Clinic in OH. “However, it’s not the very high risk linked with a family history of BRCA-associated breast cancer. Women who test positive for that genetic mutation are candidates for more intensive screening and even preventive surgeries.”
When visiting loved ones, ask about breast cancer in the family. Having one first-degree relative—a mother, sister or daughter—with a diagnosis may double your odds. But also look at your second-degree relatives, like your grandmothers, aunts and cousins. If there’s a lot of cancer in general, it could be a red flag for genetic mutations, says Dr. Bernik. In that case, you should meet with a genetic counselor to determine whether your history warrants a DNA test. (Find a counselor at www.nsgc.org.)
3. Nix the nicotine.
“Studies associating smoking with a higher breast cancer risk have been mixed,” Dr. Moore says. Still, there are plenty of other reasons to stop puffing—among them, lung cancer, stroke and heart disease.
“I quit smoking before I had my son,” Riscioli says. “After watching my father die as a result of COPD
and emphysema three years ago, I also do everything possible to even avoid secondhand smoke.” Need help putting down the butts? Go to www.smokefree.gov, which offers a free quit plan, educational materials and referrals to local resources.
“Four mornings a week, I jog or do a resistance-based workout with a trainer,” says Paula Klein, MD, an oncologist at Mount Sinai Beth Israel and Mount Sinai St. Luke’s Roosevelt Hospitals in NYC. “And because I live in Manhattan, I walk everywhere.”
It all adds up: Research shows that staying active can reduce your breast cancer risk by up to 20 percent. As a result, the American Cancer Society and many doctors recommend that women exercise regularly—about four to five hours per week at a moderate intensity level. (Brisk walking fits the moderate-intensity bill.) Staying active bolsters your immune system and keeps the pounds from piling on.
Pilates pros recommend combining the method with other activities. “Because it’s easy on the joints, Pilates is a very sustainable form of exercise,” says Jill Hinson, owner of Core Studio Pilates and Yoga in Monroe, NC. She complements her Pilates practice with two weekly yoga classes and three HIIT (high-intensity interval training) sessions that incorporate running stairs and stationary cycling. “I’ve learned that cross-training keeps my mind and my body from getting bored.”
Puglisi stays fit with lots of cardio exercise, including hiking, rock-climbing and Rollerblading. It was Pilates, however, that helped her get back on her feet during her recovery from breast cancer. “It’s a gentle, low-impact exercise that helps patients regain strength, endurance and range of motion,” she says.