Understanding your epigenetics: How lifestyle can impact breast cancer risk and recurrence
Factors such as diet, physical activity and stress levels can all impact our health. But how are they directly linked to breast cancer and recurrence risk, and how can we manage them?
To provide more guidance, we sat down with Prof. Kandace McGuire, MD and Kristalyn Gallagher, DO and asked them the need-to-know questions on how best to minimize your breast cancer risk through understanding your epigenetics.
Q. How important is exercise when it comes to breast cancer?
KM: One of the benefits of exercise is that it increases adherence to medical therapy for breast cancer patients because it reduces the side effects, or at least increases your tolerance of the side effects.
For those who have previously had breast cancer, research shows that training for 30 minutes, three times weekly, decreases your risk of recurrence by 30%.
KG: Taking a brisk walk outdoors can be a simple and effective way to stay active. Any activity that raises your heart rate and helps you maintain a healthy body mass index (BMI) will help reduce your risk of breast cancer.
Initiatives like the MagTeam 10 Day Challenge are a great way to not only get moving, but to also raise money for worthy causes.
Q. Can your diet have an effect on risk levels?
KG: It certainly can. A low-fat, heart-healthy diet with an emphasis on green leafy vegetables and fresh fruits can help lower the risk of breast cancer. Limiting the intake of sweets and alcohol is also recommended.
KM: Our nutritionist recommends a primarily plant-based diet. Now that does not mean vegan or vegetarian. What it means is when you look at your plate that half of it is filled with vegetables. I think that's incredibly important to remember.
I also think the myths that surround diet are that you have to eliminate sugar. You don't have to eliminate sugar. They'll say, “sugar feeds cancer”, but sugar feeds everything so you cannot simply eliminate sugar from your diet.
Is alcohol consumption something to take into account?
KG: Typically we say for a woman of average height and weight, a glass a day is the limit. Multiple studies have shown that consuming more than that can be associated with a higher breast cancer risk.
KM: Which I think is very reasonable. If you exercise every day, maintain healthy body habits, don’t smoke and don’t eat processed foods every day, the occasional glass of wine is not going to be the cause of your breast cancer. It’s important to note that everything has to be in balance.
You mentioned smoking – is this a big risk factor for breast cancer?
KM: It’s not as strong as other links, but it exists. I think considering the weak to moderate link between breast cancer and smoking, and all the other negative effects of smoking, it’s a fair assumption that quitting would be beneficial.
KG: As Kandace mentioned, smoking has a lot of other risks. It can directly affect the blood supply to breast tissues and skin, which in turn can increase the risk of recurring infections like breast abscesses, and slow down the healing process.
Smoking may also limit the breast reconstruction options available to women who need a mastectomy.
Women don't realize how much smoking impacts their breasts,. It’s easy to only think about the lungs, but it also directly impacts the breast tissue. So, whether you have cancer or not, if you can quit smoking, it would be very good for your overall health - especially your breast health.
Is there any link between stress levels and breast cancer risk?
KG: The research on stress and breast cancer risk is mixed. Anxiety and sleep deprivation can leave us feeling run down and may lead to poor eating choices and a sedentary lifestyle, which is associated with breast cancer risk. Activities like yoga, exercise, and mindfulness are helpful in managing stress and make us feel better.
KM: Regulating your circadian rhythms, is also important. So, people who don't have that regular sleep cycle may be at an increased risk.
What about the factors I can’t control, such as family history of breast cancer?
KG: We always encourage breast cancer screening to those who are eligible or concerned. Adhere to the recommended guidelines and get your mammograms regularly.
Additionally, get to know your body. Know what your breast feels like so if you feel something new that is growing, you can identify it early and bring it to the attention of your provider.
KM: Exactly. When it comes to family history, I definitely wouldn't suggest that it’s necessary for every woman go out and get a genetic test. But If you do have family history, I think it's worthwhile to talk to a genetic counsellor and see if you're eligible for genetic testing.
Alternatively, just talking to your primary care doctor and share your concerns with them so they can explore further options with you.
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