How To Prevent Breast Cancer

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Breast cancer occurs when abnormal cells in the breast grow uncontrollably, forming tumors. If not detected and treated early, such cells can metastasize (spread) to nearby tissues and other parts of your body, causing more harm.¹

About one in three cancers that occur in people assigned female at birth (AFAB) each year is attributed to breast cancer, according to the American Cancer Society (ACS). It is also estimated that about 310,720 new cases of invasive breast cancer—the most common type of breast cancer— will be diagnosed in AFAB in 2024.^2,3

There is no surefire way to prevent breast cancer completely, but there are things you can do to reduce your risk of developing this condition, such as going for routine screenings and making some lifestyle changes.

Who Is Most at Risk?

Breast cancer can occur at any point in life and can affect anyone. But some people are at a greater risk of developing it—such as people assigned female at birth and those with a family history of breast cancer.⁴

Sex and Gender Factors

An estimated 99% of breast cancers occur in females, as opposed to 0.5-1% in males.¹ Available evidence suggests this may be because females have more breast cells that are vulnerable to the female reproductive hormones estrogen and progesterone.⁵

At this time, only a few research studies have looked into how breast cancer risk differs for transgender people compared to cisgender people. However, more research on how breast cancer affects trans people is ongoing.

One study, which included 2260 adult trans women and 1229 adult trans men, found an increased risk of breast cancer in trans women compared to cisgender men and a reduced risk in transgender men compared to cisgender women. The study also observed an increase in breast cancer risk during a relatively short duration of hormone treatment in the trans women group, further highlighting the role hormones may play in breast cancer development.⁶

Age-Related Factors

Also notable, only a small number of breast cancer cases are found in people under the age of 45, indicating this type of cancer is more common in middle-aged and older women. This implies that age is also a risk factor for this condition.³

Other Risk Factors

Additional risk factors for breast cancer may include:^7,5,1

• Having a personal or family history of breast disease, breast cancer, or ovarian cancer
• Possessing mutations in the BRCA genes
• Living with dense breast tissue
• Undergoing breast therapy
• Getting your period at an early age (before 12 years)
• Giving birth for the first time after 30 years of age or never giving birth
• Taking contraceptives (e.g., birth control)
• Using hormone replacement therapy (HRT)

How To Reduce Risk

Factors like family history, age, and sex are non-modifiable, meaning you have no control over them. However, you can change other lifestyle risk factors. Consider the following prevention strategies.

Getting Screened

Routine breast cancer screening is recommended for people assigned female at birth starting at age 40. Some common breast cancer screening tests include:^7,8

• A mammogram, which takes an x-ray of the breast
• Breast magnetic resonance imaging (MRI)
• Breast ultrasound
• Clinical breast examination to check for lumps or any changes in the breast
• Genetic testing to check if you have the BRCA gene, which increases your breast cancer risk

While these screenings can help detect breast cancer early, there are some downsides. For example, there are risks of overdiagnosis or false positive results where the test detects something that looks like cancer but is not.⁸ However, providers still recommend getting a mammogram every other year after age 40.

Updated Screening Guidelines

In 2024, the U.S. Preventive Services Task Force (USPSTF) released new guidelines recommending that women get screened for breast cancer every other year between the ages of 40 and 74. Some women may need an annual screening, especially if you're at a higher risk of breast cancer or if you have dense breast tissue.⁹

Making Lifestyle Changes

Your daily lifestyle habits can affect your health and influence your risk of developing medical conditions like cancer. To minimize your risk of breast cancer, consider making the following lifestyle and dietary adjustments:

• Increase physical activity: A 2022 study suggests that exercising regularly may reduce the risk of breast cancer, especially in people living with obesity or going through menopause.¹⁰ The ACS recommends getting at least 150-300 minutes of moderate-intensity exercise, ideally spread throughout the week.¹¹
• Limit alcohol intake: Health experts advise women not to drink more than one alcoholic drink in a day, but even small amounts of alcohol are linked to an increased risk of breast cancer. So, if you are at high risk of developing breast cancer, it may help to avoid alcoholic drinks completely.¹¹
• Choose medications wisely: Certain medications, like diethylstilbestrol (a type of non-steroidal estrogen), oral contraceptives, and HRT are linked to an elevated risk of breast cancer.^12,5 Speak to your healthcare provider about possible risks and if these medications are right for you. If you have a high risk of developing breast cancer, they will most likely prescribe alternative medications. 
• Eat nutritious foods: While the link between diet and cancer is controversial, some studies suggest that eating enough fruits, vegetables, and calcium-rich dairy products while reducing red and processed meat consumption can help lower the risk of breast cancer.¹¹ It may also help to avoid other processed and ultra-processed foods high in fat, sodium, and sugar.⁵
• Avoid smoking: Cigarettes contain carcinogens that can increase the possibility of mutations in the breast tissue. If you smoke, quitting can help lower your risk of several cancers, including breast cancer. If you find it challenging to stop, consider seeking support from your healthcare provider, mental health provider, and loved ones.
• Maintain a weight that's right for you: Obesity is linked to an elevated risk of breast cancer, especially in people going through menopause or postmenopause. Dietary changes and increased physical activity can treat obesity, but it's a good idea to ask your healthcare provider for a personalized treatment plan to maintain a weight that is safe for your body and needs.¹³

Taking Medications

Certain prescription medications may help reduce the risk of breast cancer in high-risk people:^14,11

• Evista (raloxifene): Blocks the action of estrogen on breast tissue, making it less vulnerable to the female hormone
• Soltamox (tamoxifen): Acts similarly to Evista, but is more commonly prescribed for people who are undergoing menopause
• Aromatase inhibitors (AIs): AIs like Aromasin (exemestane) and Arimidex (anastrozole) may reduce the risk of breast cancer in postmenopausal women

Surgery and Procedures

Some people with a high risk of breast cancer (e.g., those with a BRCA gene mutation) may benefit from preventive surgery. The surgery may involve removing the ovaries (the primary organs that secrete estrogen) or removing the breast (known as a prophylactic mastectomy).¹¹

These procedures are not 100% preventative and may have side effects. Discuss with your healthcare team whether these procedures are safe and right for you. 

Close Observation

Healthcare providers sometimes place people with high cancer risk on surveillance or close observation. This is to regularly observe and assess your health status, which requires you to see your provider every 6-12 months for breast examination appointments. These appointments will typically involve screenings like a mammography and breast MRI.¹¹

Discuss With Your Healthcare Provider

Most people do not know whether or not they have a high risk of developing breast cancer. If you are unsure, consider speaking with a healthcare provider as they can help you assess your breast cancer risk by asking you the right questions and recommending some screening tests for you. It’s important to provide as much useful information as possible, such as your lifestyle habits, personal history, and symptoms. Now is a good time to also ask them any questions or concerns you have.¹³

If you already know your breast cancer risk status, it’s still important to work with a healthcare team to ensure you keep your risk of developing this condition at a minimum. Your healthcare provider is in the best position to recommend and prescribe medications (if you need any) to reduce your cancer risk. Also, discuss if the medications you're receiving are the best options for your body and if there are any risks to taking them.¹⁵

Your healthcare provider can also help by referring you to other healthcare providers that may assist you in reducing your breast cancer risk. For example, if you need support eating nutritious foods, they can recommend a registered dietitian (RD) who can help you create a personalized meal plan that targets your specific health needs. If you're looking to quit alcohol or tobacco, a mental health provider who specializes in substance use can be helpful in your health journey.¹⁵

A Quick Review

Breast cancer is one of the most common cancers, especially in people assigned female at birth. Factors like older age, family history of breast cancer, and tobacco and alcohol use can increase your risk of this cancer. While there aren't surefire ways to completely prevent breast cancer, prevention tips like eating nutritious foods and exercising can help you lower your risk of breast cancer.

It can be worrisome to know you're at risk of cancer. Seek care from your healthcare provider if you're looking for support on how to lower your risk or need someone to answer your questions.

Sources:

1. World Health Organization. Breast cancer.
2. American Cancer Society. Invasive breast cancer (IDC/ILC).
3. American Cancer Society. Key statistics for breast cancer.
4. Centers for Disease Control and Prevention. Breast Cancer in Men.
5. Łukasiewicz S Czeczelewski M, Forma A, Baj J, Sitarz R, Stanisławek A. Breast Cancer-Epidemiology, Risk Factors, Classification, Prognostic Markers, and Current Treatment Strategies-An Updated Review. Cancers, 2021;13(17):4287. doi:10.3390/cancers13174287
6. de Blok C J M, Wiepjes C M, Nota N M, et al. Breast cancer risk in transgender people receiving hormone treatment: Nationwide cohort study in the Netherlands. BMJ 2019;365:l1652 doi:10.1136/bmj.l1652
7. Centers for Disease Control and Prevention. What Are the Risk Factors for Breast Cancer?.
8. Centers for Disease Control and Prevention. What is breast cancer screening?.
9. U.S. Preventive Services Task Force (Task Force). Breast cancer: Screening.
10. Boraka Ö, Klintman M, Rosendahl AH. Physical Activity and Long-Term Risk of Breast Cancer, Associations with Time in Life and Body Composition in the Prospective Malmö Diet and Cancer Study. Cancers (Basel). 2022;14(8):1960. doi:10.3390/cancers14081960
11. American Cancer Society. Can I lower my risk of breast cancer?.
12. Centers for Disease Control and Prevention. What can I do to reduce my breast cancer risk?.
13. American Cancer Society. Five ways to help reduce your breast cancer risk.
14. Colditz GA. Patient education: Medications for the prevention of breast cancer (Beyond the Basics). In: Vora SR, Hayes, DF, eds. UpToDate. UpToDate; 2023.
15. American Cancer Society. Questions to Ask Your Doctor About Breast Cancer.

Important Notice: This article was aslo published at www.health.com by Joy Emeh where all credits are due. Medically reviewed by Doru Paul, MD. Edited by Sukhman Rekhi.

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