Here’s how to reduce your risk of breast cancer

Yvonne Meyers didn’t need a lot of persuading when her physician recommended she lose weight. It was a year after her surgery for breast cancer.

She remembers Dr. Cristina Lopez-Peñalver, a board-certified breast surgeon at The Breast Center at Miami Cancer Institute, part of Baptist Health South Florida, telling her: “‘You have to lose weight, and I’m going to help you.’”

Losing weight was important, Lopez-Peñalver told her, because the weight loss would lower her risk of the cancer coming back, perhaps by as much as 20 percent.

“I wanted to feel better,’’ said Meyers, 67, who was diagnosed with breast cancer on Dec. 22, 2014. “I wanted to lower the risk. I wanted to do as much as I could not to have to go through this ever again.”

Lopez-Peñalver recommended Meyers enroll in a breast cancer program focused on changes in nutrition and exercise. Meyers, who attended the program from March to June, has lost 27 pounds, going from 224 pounds to 197, on her 5-foot, 8-inch frame.

“I feel so much better,” said Meyers, a Kendall sales representative for a half dozen companies selling health food products. “I was so fat and I didn’t like the way I looked.”

While many factors impact breast cancer, including your genes and family history, experts point to a healthy lifestyle for reducing the risk of getting the disease and preventing its return.

“When you talk about lifestyle, you talk about the way you eat, how you exercise and how much activity you have, whether you smoke, whether you drink or have a lot of stress,” said Alice Pereira, a registered dietitian in oncology nutrition with the Miami Cancer Institute who worked with Meyers in the weight-loss program. “All those things contribute to lifestyle.”

Meyers learned to read labels, cut out sugar and fats and switch to foods low in simple carbs (sweets, pasta, white rice) and high in fiber.

“I used to have guava pie, Key lime pie, ice cream,” said Meyers, who is originally from Puerto Rico. “I don’t even buy any of it anymore. I also learned to reduce the amount of food I eat. It’s a matter of redirecting quantities.”

She also walks three miles every other day, mostly with her three dachshunds: Canela, Coco and Chanel.

“Patients often ask what changes they can make in their diet and general lifestyle to improve their outcome after a breast cancer diagnosis,” said breast medical oncologist Dr. Reshma Mahtani, assistant professor of medicine at the Sylvester Comprehensive Cancer Center at U-Health. “Lifestyle modification can be an empowering and effective way to boost physical and mental health in breast cancer survivors.”

Mahtani said researchers “are accumulating increasing data that suggests exercise, maintaining a normal BMI (body mass index) and minimization of alcohol intake are associated with a reduced risk of breast cancer recurrence and death in breast cancer survivors.”

Body mass index (BMI) is a measure of body fat based on your weight in relation to your height. You can calculate your BMI with the help of many online calculators, including this one from the Centers for Disease Control and Prevention, http://bit.ly/2cda8Ev, which will let you know whether the number falls into the normal or overweight category. Generally, a preferable BMI is 25 or less, but be sure to discuss the results with your physician.

“We know that with a body mass of 30 or higher, there’s a higher risk of the cancer coming back,” said Dr. Thomas Samuel, breast medical oncologist at the Maroone Cancer Center at Cleveland Clinic Florida in Weston. “With a body mass of 25 to 30, you tend to have a lower cancer rate.”

The benefits of diet and exercise “cannot be understated,” Mahtani said. “I tell my patients this is part of their actual treatment plan for cancer.”

Cynthia Wigutow, a registered dietitian board certified in oncology nutrition at the Memorial Cancer Institute, part of Memorial Healthcare System, said she doesn’t advocate dieting as much as adopting a healthier lifestyle.

She encourages patients to follow more of a plant-based diet “of vegetables, fruits, whole grains, legumes and beans” and reduce big portions of red meat, opting instead for fish, chicken or leaner cuts of beef, pork or lamb.

The American Institute for Cancer Research recommends eating no more than 18 ounces of red meat per week. That’s up to three ounces (cooked), about the size of a deck of cards, six times per week, which Wigutow said is preferable to eating a big portion of meat at one sitting.

Here are other suggestions:

▪ Avoid processed meats, Wigutow said. Studies show that meat preserved by smoking, curing or salting or by adding preservatives can form cancer-causing substances.

▪  Limit refined sugar found in sodas, candy and other sweets.

▪  Eat foods with carotenoids, associated with reducing the risk of breast cancer. Examples include carrots, pumpkin, winter squash, plantains, collard greens, leafy greens, sweet potatoes, cantaloupe, tomatoes, papaya, grapefruit, watermelon, Brussels sprouts, yellow corn, sweet peppers and oranges.

▪ Incorporate a variety of whole grains including amaranth, spelt, faro, barley and quinoa.

▪  Divide your plate: Half of it should be vegetables, a quarter whole grains and a quarter lean protein or beans.

▪  Avoid foods with processed soy like soy protein isolate used as a filler.

▪  Eat foods with calcium, like yogurt and low-fat milk, plus Vitamin D, which helps the body absorb calcium, for bone health.

“There’s a right way and a wrong way to lose weight,” Pereira said. “Quick weight loss is not always the best way. Some people diet and then go back to the way they were eating. We’re not talking about dieting. We’re talking about changing habits to healthier habits.”

Those healthy habits include watching alcohol consumption.

There is a link between alcohol and the increased risk of breast cancer, the American Cancer Society reports. Those who have two to five drinks daily have about 1½ times the risk of women who don’t drink alcohol.

The Society recommends that women have no more than one alcoholic drink a day. A drink is 12 ounces of regular beer, five ounces of wine, or 1.5 ounces of 80-proof distilled spirits.

Adding exercise is another essential part of trimming cancer risks. Doctors recommend at least 30 minutes of moderate to vigorous exercise at least five days a week.

Aside from promoting weight management, exercise can help women during and after treatment fight fatigue and help improve “anxiety, depression and body image,” Mahtini said.

Meyers is convinced that her outlook since her diagnosis has made a big difference in her health, along with her new healthy eating and exercise.

“I have a very good sense of positivism, and I have faith in God,” she said. “Those two things have really helped me a lot.”

This story was originally published September 23, 2016 at 8:00 AM with the headline "Here’s how to reduce your risk of breast cancer."