What If... Breast Cancer? Dr. Sara's Top 10 Ways to Reduce Your Risk of Breast Cancer

With every mammogram, I think about what I would do if diagnosed this time with breast cancer. First, I'd wig. A woman's risk of a breast cancer diagnosis is one in eight over her lifetime. Second, I'd call the five people who matter the most: Darling Husband, Mom, Sisters, and BFF.

Then I'd get all empowered and put on my big girl face, and get down to the business of breast cancer prevention.

It's timely to chat about breast cancer prevention because the National Cancer Institute announced recently that there will be a 50 percent increased risk of new cases of breast cancer diagnosis by the year 2030. (1) No wonder we are so concerned and scared! Breast cancer—especially the hormone-driven type of breast cancer that’s related to what you eat and drink—is on the rise. Patients and friends have asked me to post on this topic, usually because they've received a breast cancer diagnosis, or diagnosis of pre-cancer (ductal carcinoma in situ or atypical hyperplasia), or have an increased risk based on family history, or . . . are just female and appropriately concerned.

Our Thinking About Breast Cancer Has Changed

When I went through my medical training, the prevailing theory was that you'd get one mutated breast cancer cell in your breast tissue, and it would divide into daughter cells. Over time (say, two years), it would develop into a breast cancer mass on a mammogram or thermogram or MRI, and eventually a lump that you or your clinician would feel. But we don't think that anymore. The latest thinking is that all of us run around with cancer cells, but the key is what type of neighborhood we provide. Do you have a bad neighborhood with drive-by shootings and gang violence--such as from eating too much sugar, drinking too much alcohol (more than 3 servings per week), and/or high stress? (2) Or do you cultivate a good neighborhood by eating 80 percent veggies on your plate, healing your gut, and getting the right dose of love, empathy, forgiveness, and extra dark chocolate?

Long story short, we all have aberrant cells or oncogenes looking for some action. While we don't fully understand all the ins and outs, it's basically your lifestyle, genetics, immune functioning and nutrition that determine whether those cancer cells grow or get removed by your personal army of immune cells. Even more important is the role of your gut flora (microbiota) and their DNA (microbiome), and the subset of the microbiome that controls estrogen levels called the estrobolome. (3)

But don't wait for the wake-up call of a breast cancer diagnosis to get with the program, or step up to a better program of breast cancer diagnosis. If you've already received a breast cancer diagnosis, don't wait around powerless and fretting for a diagnosis of breast cancer recurrence. Step into sacred action.

Prevention Is Real: Don't Be Disempowered by Your Doctor

I can't sit by and listen to my patients tell me of the disempowering message from breast surgeons which goes something like this: "There, there, I've taken out your cancer, now you go on and live your life."

To that I would say, "But what can I do to turn the tide on my tendency toward breast cancer? There must be nutritional, hormonal, environmental risks that I can modify."

At that point, Breast Surgeon rolls their eyes and wishes I would go away.

Fortunately, there are many things you can do to turn the tide on breast cancer. It's all about prevention: radical prevention of your first breast cancer diagnosis, prevention of breast cancer recurrence, using food as medicine, modifying your risk factors, and most importantly but often neglected, monitoring your progress.

Top 10 Breast Cancer Prevention Tips

1. Check your estrogen metabolism, including the 2/16 ratio. This is a measure of how you are metabolizing estrogen. Are you making more of the good, protective estrogens or more of the nasties that increase your risk of a breast cancer diagnosis? The key is to prevent estrogen from doing a back flip in the body and wreaking havoc. There's good science to support estrogen metabolism as a key marker of your risk of breast cancer, and since there's a dearth of markers for breast cancer survivors (and their female relatives) to follow, this is a good one to measure periodically. If I had a breast cancer diagnosis, I'd check it every 3 to 6 months. Here are three labs (Precision Hormones, Genova, and Meridian Valley) I typically use to run the test. Keep in mind that you need to work with a trusted and collaborative guide, such as a seasoned doctor or other health professional, to interpret the results and help you.
2. Perform my 21-Day Hormone Reset Diet. It's designed to remove the triggers of breast cancer, including red meat, sugar, excess fructose, grains, dairy, and toxins. It's designed for breast cancer prevention, because all women need that.
3. How's your insulin and blood sugar? I routinely test my patients fasting glucose (want 70 to 85 mg/dL) and insulin (want less than 5). High blood glucose feeds cancer cells. My glucose was elevated 6 years ago (even though I'm lean - that's because of my adrenal problems, see below) when I first started getting insulin-obsessed and I reversed it in 6 months.
4. While we're talking sugar, across the board, the white stuff is pretty bad. White flour, white sugar. Either avoid it (best) or use stevia, xylitol, agave nectar, and gluten-free flours.
5. Minimum: Eat one pound of vegetables per day, divided among meals. Do you know how rare this is? Frightening. Yet those anti-oxidants are preventing mutation. Bite into your kale chips. If you have a tough time with this one, do your boobs a favor and order a hormone reset shake powder.
6. Check your Vitamin D. Based on observational studies, I recommend a level of 52-90.
7. It's all about inflammation - reduce it, Friend. Measure your C-Reactive Protein to track inflammation. Sprinkle turmeric on your food, the world's most potent anti-inflammatory. Keep yourself on the alkaline side of the tracks (Note to self: before you go all Paleo on me, recall that cancer loves acid environment - meats, coffee, peanuts). Alkalinizing foods: pumpkin seeds, persimmons, brocoflower, seaweed, kambucha, just to name a few.
8. Pamper your adrenals. Those little endocrine glands that sit on top of your adrenals like hats and they run the "fight/flight/collapse" show? Yes, those guys. Calm 'em down. Daily. Meditation, yoga, massage, tai chi, whatever it takes. High or low cortisol is a pro-cancer environment and increases the risk of breast cancer mortality. (4) That means paying attention to your inner clock and getting to bed by 10 pm, so that a disrupted circadian rhythm doesn't create a bad neighborhood for your cells. (5)
9. Iodine. Most of us are deficient. It's not a glamorous nutrient but give it the notice it deserves. Check your level, and eat iodine-rich foods if needed such as seaweed. Crucial to breast health (and your thyroid). But if you have autoimmune thyroiditis or Hashimoto's, take care as iodine can trigger problems. You want the Goldilock's dose of not too much and not too little.
10. Speaking of thyroid - stay on top of that sweet butterfly-shaped gland in your neck. Ideal is TSH between 0.3-1.5. Underactive thyroid has been linked with greater risk of breast cancer.

Hope that helps. Don't wait for a breast cancer diagnosis to get you on the path to radical wellness. Act now. With what credentials do I write these tips? As a gynecologist who saw her first patient in 1989. As a breast cancer prevention researcher. As a woman living through an epidemic of breast cancer. As a human slogging my way through the toxic soup we live in. Who isn't fearful of breast cancer? Best antidote to the anxiety of breast problems? Knowledge. Humor. Greens.