Breast cancer is the most common form of cancer among american women. The role genetics plays in who gets breast cancer has been reported a lot recently. But there are also other risk factors. This week on WRVO's health and wellness show "Take Care," hosts Lorraine Rapp and Linda Lowen speak with oncologist Dr. Ann Partridge of the Dana Farber Institute about the lifestyle changes women can make to help reduce their risk.
Lorraine Rapp: Let’s talk briefly about who is at most risk for getting breast cancer in the general population -- not genetics, not family history.
Dr. Ann Partridge: Sure. Well, there are a number of factors that have been shown over and over again to be associated with increased risk of breast cancer. I first want to state that we, scientists and researchers, are really good at looking at big populations and saying ‘What proportion of women will get breast cancer and what are those risk factors?’ But we, as doctors and health care recommenders, are terrible at predicting which individual woman will get breast cancer.
So, what are the modifiable risk factors for breast cancer? Well there are environmental risk factors: like exposer to different kinds of toxins, which people in general don’t have their own ability to change, but we can change as a society, like get carcinogens out of certain places and avoid estrogen if it’s not going to help you – like hormone replacement therapy (which we were doing for everybody, but now we only do if people really, really need it, because it can increase risk of breast cancer). And then there are these individual choices and individual risks that we can modify, and those things are the following:
Women who are overweight, especially after age 18 and beyond, but especially after menopause, have a higher risk of developing breast cancer. Common sense would dictate that it would be good for those women to lose weight, and try and get to an ideal body mass index for their height and their weight.
Second big risk factor is exercise, and of course that’s related. Women who exercise on a regular basis, those women had lower risk of developing breast cancer.
Rapp: What is it about being overweight that increases a woman’s risk?
Dr. Partridge: Sure, that’s a great question and we’re not really sure. A lot of scientists are looking into it, but what we think it has to do with is what’s been termed energy balance – so it’s kind of the input and the output. And that’s the diet and the exercise and what you want to do is achieve good balance where someone’s not net gaining weight or overweight. We think it probably has to do with both hormones, and women who are overweight often have higher levels of estrogen; and it probably also has to do with the hormone insulin, and women who are overweight tend to have higher levels of insulin, and people who don’t exercise also tend to have higher levels.
So, we’re really trying to work out the actual mechanisms, but we think it has to do with the hormonal milieu, or the hormonal environment, so to speak, for people who don’t exercise or who gain weight and have excess body mass.
Linda Lowen: Now in terms of exercise, which could be 30 minutes of walking five times a week, but that basically has to be steady state because if you stop the exercising, the benefits drop off. You have to incorporate this as a regular lifestyle change, correct?
Dr. Partridge: Correct. It’s good for prevention of other solid tumors and cancer, prevention of diabetes, and so I think exercise is kind of a no-brainer. And it’s really tough in our society. We live in what one of my colleagues has called an ‘obesegenic’ society. So, everything’s convenience and our lifestyles have made it very difficult I think for many people to get the recommended exercise and that may be part of why we see increasing rates of breast cancer.
More of this interview can be heard on "Take Care," WRVO's health and wellness show Sunday at 6:30 p.m. Support for this story comes from the Health Foundation for Western and Central New York.