How Can I Lower My Breast Cancer Risk?

A doctor explains how to improve your odds of avoiding breast cancer, even for those who have a family history

Adam Rosenbluth, M.D.,

AARP

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Published October 21, 2024

illustrated gif of a woman doing a breast cancer check

James Yates

My mother and grandmother both had breast cancer. Are there things I can do to lower my risk?

What I love about this question is that you’re being proactive with your future health. It’s important to take a forward-looking approach to our healthcare rather than just waiting around for things to happen. In your case, knowing your family’s medical history has alerted you, and your doctor, to your risk for developing breast cancer.

Your doctor may recommend genetic testing as your next step. Genetic testing is usually done with a blood sample, but bodily fluid or tissue can also be used. The test looks for genetic changes, sometimes called mutations or variants in your DNA. Genetic changes can increase your risk of disease or other health issues.

When I’ve suggested genetic testing to my patients, some have told me: “Adam, I don’t want to do it — because I don’t want to know.” I understand if someone prefers not to be tested for something we can’t treat. But we’ve made enormous strides in breast cancer treatments and diagnoses in the last 20 years. The 5-year survival rate in the United States for all types and stages of breast cancer combined is 91 percent according to the National Breast Cancer Foundation. When a patient is diagnosed early with breast cancer and receives effective treatment right away, survival rates jump to as high as 99 percent.

Genetic testing can help lead to an early diagnosis. It specifically looks for mutations in genes, such as BRCA1 and BRCA2. (Genetic testing also looks at other genes; BRCA is the most well known right now, but it’s not the only one) If someone has either of these mutations, it increases their risk of developing breast cancer. This is true for both men and women. Although breast cancer in men is relatively rare, it does happen. These gene mutations also increase the risk of ovarian cancer in women, prostate cancer in men, and pancreatic cancer in both men and women.

When you’re empowered with the knowledge of your genetics, you and your medical team can come up with a more informed plan together. Going forward, your doctor might suggest increasing the frequency of diagnostic testing and perhaps include additional tests. These days, we have several different screening options for breast cancer. Not only can you take a mammogram, but there’s also sonogram, ultrasound, and MRI options. If you have dense breasts, your mammography facility will let you know. Because dense breast tissue can make it more difficult to detect cancer, you might want to discuss what type of imaging you should have with your doctor.

In addition to getting regular mammograms, there are things you can do right now. Living a healthy lifestyle is always a good idea, but if you’re genetically predisposed to certain diseases, you’ll want to be especially mindful of making good choices, such as eating a healthy diet, reducing or eliminating alcohol consumption, and not smoking.

Since obesity is a major contributing factor to many types of cancer and other diseases, I can’t stress enough how important it is to be physically active. Several studies show that women who get regular exercise have a 10 to 20 percent lower risk of getting breast cancer than those who don’t exercise. This benefit is most often seen in post-menopausal women. Even exercising a little bit is a step in the right direction.

If you do find out that you have the BRCA1 or BRCA2 gene mutation and your risk of breast cancer is increased, you might consider several different preventative options. The most effective approach in some cases is surgery to remove both breasts (mastectomy) and surgery to remove the ovaries and fallopian tubes. There are also medications such as Tamoxifen and Raloxifene, which are FDA-approved for people who are at high risk for breast cancer.

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These drugs block the estrogen receptors in breast cells which increase the risk of cancer-causing mutations. That said, none of these options are a guarantee that you won’t develop breast cancer in the future.

Armed with this information, you will want to decide on a path forward after consulting with members of your healthcare team, which might include your primary care physician, geneticist, gynecologist and surgeon. How you choose to deal with your particular situation is a very personal decision. That’s why it’s so important to gather all the information you can before choosing a course of action. But right now, you should know you’ve taken the most important first step. You’ve brought your family’s medical history to light, empowering better care for yourself and your family members.

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