More Evidence to Support Primary Prevention in Breast Cancer

By Dr. Nancy A. Palermo, MD

Edited by: Thrive Carolinas

A recent landmark study published in BMJ Oncology by researchers from the University of Edinburgh examined the incidence of 29 cancers in individuals aged 14 to 49 across 200 countries over a 30-year period. The findings were alarming: the incidence of cancers in those under 50 rose by 79%, accounting for over 3.26 million cases. The researchers suggested that this increase is not due to genetic factors but rather to environmental influences like poor diet (high in processed foods and added sugars), alcohol consumption, smoking, physical inactivity, obesity, and exposure to environmental toxins. Our genes haven’t changed in the last 30 years, but our environment has—highlighting the need for lifestyle changes to address this growing issue. The researchers estimate that, if current trends continue, early-onset cancer cases will rise by 31%, and related deaths by 21%, by 2030. The highest-risk group will be people in their 40s, with breast cancer as the leading cause of cases and deaths. Other cancers with high death tolls include lung, stomach, bowel, kidney, and ovarian cancers, with North America, Oceania, and Western Europe experiencing the highest early-onset cancer rates.

Historically, cancer has been seen as a disease of older populations, but this study has caught the attention of healthcare professionals, especially those in functional medicine. The data points to the significant influence of diet and lifestyle, suggesting that primary prevention can help reverse this trend.

Primary Prevention vs. Early Detection

October is Breast Cancer Awareness Month, and while screening methods like mammograms, thermography, and HER2 scans are crucial for early detection, they fall under secondary prevention. Early diagnosis can certainly improve survival rates, but solely relying on these methods won’t change the overall cancer trend. We must also emphasize primary prevention—addressing and modifying the environmental and lifestyle factors that are driving the rise in breast cancer cases.

Hereditary factors account for only 5-10% of breast cancers, while 90% are due to other influences. This highlights the potential impact of lifestyle changes and preventive measures. Below are some key strategies for primary prevention:

1. Optimize Vitamin D Levels

Research suggests that women with low vitamin D levels have a higher risk of developing breast cancer. Vitamin D plays a role in controlling normal breast cell growth and may help prevent cancer cells from growing. Beyond its importance for bone health, vitamin D also supports immune function and reduces inflammation. Most women are deficient in vitamin D; it is estimated that if all women had normal levels, there would be 50,000 fewer breast cancer cases annually. Aim for daily sunlight exposure and consider supplementing with 2,000–3,000 units of Vitamin D3 per day. Blood levels should be checked yearly, with an optimal range of 50–80 ng/mL.

2. Balance Hormone Levels

Hormonal imbalances, particularly around menopause, can increase breast cancer risk. Excess estrogen production, often unopposed by progesterone, is a key factor. New tests like the DUTCH test offer insights into hormone metabolism, helping identify genetic mutations and nutrient deficiencies that may impede hormone detoxification. Optimizing liver and gut function supports hormone balance and reduces estrogen excess, which is a known driver of breast cancer.

3. Improve Dietary Habits

A whole-food, plant-based diet rich in cruciferous vegetables can significantly reduce breast cancer risk. Cruciferous vegetables, like broccoli and kale, contain antioxidants and compounds that support detoxification processes, aiding in hormone breakdown and reducing oxidative stress. Always opt for organic produce to minimize exposure to harmful pesticides and chemicals, which can accumulate in fat cells, including those in breast tissue.

Avoid trans fats and hydrogenated oils commonly found in processed foods, as they have been linked to increased cancer risk. Instead, prioritize healthy fats, particularly omega-3 fatty acids from sources like salmon, sardines, flaxseed, and chia seeds. Omega-3s reduce inflammation and inhibit tumor growth. Since most people are deficient, consider supplements of DHA (200-400 mg/day) or purified fish oil (1,000-3,000 mg/day).

4. Reduce Sugar and Refined Carbohydrates

High sugar intake and refined carbs can lead to elevated insulin levels, which, in turn, increase IGF-1, a growth factor linked to breast cell proliferation and cancer risk. Elevated insulin also promotes inflammation and reduces sex hormone-binding globulin (SHBG), leading to higher circulating estrogen levels. Limiting sugars and refined carbs can help regulate insulin and reduce cancer risk.

5. Prioritize Physical Activity

Exercise plays a critical role in breast cancer prevention. Studies show that engaging in moderate to strenuous exercise for at least one hour, four times a week, can reduce breast cancer risk by 37%. Physical activity helps manage blood sugar, reduce body fat, and lower insulin levels. It also acts as a powerful stress reducer, lowering cortisol levels and minimizing inflammation. Strength training, in particular, is effective for reducing body fat, which is a source of estrogen production.

6. Minimize Exposure to Environmental Toxins

Avoid BPA: Bisphenol A (BPA), originally developed as a synthetic estrogen, is now found in plastics and food can linings. BPA acts as an endocrine disruptor, mimicking estrogen and increasing breast cancer risk. Avoid cooking in plastic containers and switch to glass or metal. Opt for BPA-free products whenever possible.

Check Skincare and Cosmetics: Many personal care products contain harmful chemicals like cadmium, phthalates, and parabens, which are linked to breast cancer. Use the EWG’s Healthy Living app to find safer, organic options free from these harmful substances.

7. Limit Alcohol Consumption

Alcohol is classified as a Group 1 carcinogen and is linked to an increased risk of breast cancer. Studies show that consuming one or more drinks per day can increase breast cancer risk by up to 60%. Alcohol impairs liver function, affecting hormone detoxification and allowing excess estrogen to circulate. Aim to limit alcohol to less than two drinks per week. While red wine contains resveratrol, a potent antioxidant, no alcohol is ultimately safer than any alcohol. Recent studies have shown that even moderate consumption can raise breast cancer risk by 15% compared to non-drinkers, with an additional 10% increase for each extra drink consumed per day.

Beyond Early Detection

Breast cancer prevention goes beyond early detection—it requires a proactive approach focused on optimizing health through lifestyle and dietary changes. Addressing environmental and dietary factors can significantly reduce breast cancer risk and improve overall well-being. If you have concerns or would like to learn more about primary prevention strategies, schedule a consultation with your healthcare provider to create a personalized plan for breast health.