About 1 in 8 women will develop breast cancer at some point during her life.
Breast cancer is the most common cancer in American women, behind skin cancer.
Detecting breast cancer early is the best way to beat the disease
While one can’t change some risk factors such as genetics and aging, there are certain things one can do that may lower one’s risk for breast cancer.
Listen to City of Hope Radio as Dr. Linda Bosserman, prominent medical oncologist at City of Hope in Rancho Cucamonga, discuss ways one can help prevent and reduce their risk of getting the disease.
Breast Cancer Prevention – How To Reduce Your Risk
Featured Speaker:
Linda Bosserman, MD
Linda Bosserman, MD, is a premier medical oncologist at City of Hope – Rancho Cucamonga. Her primary interests include women's cancer care, cancer prevention, clinical trials and quality cancer care delivery in community practice. While Medical Director of the Robert and Beverly Lewis Family Cancer Care Center in Pomona, California, she pioneered an integrated psychosocial oncology program and established the Breast Health Center for diagnostic services. She also directed the Comprehensive Breast Health Task Force, a multidisciplinary community coalition to evaluate and promote high quality, coordinated breast health for the diverse and multicultural residents of the Inland and Pomona Valleys. Transcription:
Breast Cancer Prevention – How To Reduce Your Risk
Melanie Cole (Host): About one in eight women will develop breast cancer at some point during her life. While one can’t change in some respect, such as genetics and ageing, there are certain things one can do that may lower your risk for breast cancer. My guest today is Dr. Linda Bosserman. She’s a premier medical oncologist at City of Hope, Rancho Cucomonga. Welcome to the show, Dr. Bosserman. Tell us about the risk factors for breast cancer, the ones that we cannot change, genetics and such. Let’s start with those.
Dr. Linda Bosserman (Guest): Well, the fact that we’re women, we know that one in eight women are at risk to get breast cancer if you live to age 90. It’s still a disease that increases after age 50 and 60. Everyone shouldn’t walk around worrying about it, but we want to be aware of our family history and our own physical body exam. Genetically, some families are at higher risk to get breast cancer and particularly at younger ages, and that may be associated with breast and ovary cancer or other cancers. Everyone should know their family history and talk to their doctor and have an assessment if they might be at higher risk than just the background risk of our population. The other risk really has to do with health factors we can control, and that’s diet, exercise, and our weight. We need to really be aware of that and take an active approach to our health.
Melanie: Let’s start with exercise to use it as a prevention for, not only breast cancer, but other types of cancer as well. What do you recommend that people do, exercise-wise, to help reduce that risk?
Dr. Bosserman: Well, the main data shows that if women will exercise 45 minutes at least five days a week, you lower your breast cancer risk, you lower your risk of heart disease and stroke, which we shouldn’t forget are still the number one cause of death in women. You also, after a cancer diagnosis, especially breast cancer, lower your risk of recurrence, which is still important.
Melanie: Okay, we’re talking about a combination of cardiovascular exercise and weight training, just general exercise. Is taking a walk enough for you?
Dr. Bosserman: Well, ideally, the aerobic exercise helps two or three times a week, as well as overall fitness and toning. If you can’t do anything except walk, that’s a good start, but it has to be at a pace that really gets your heart rate up for a period of time. Walking is acceptable. I tell women, if you can’t do anything else, buy a dog and walk four miles a day. It’ll keep your weight under control and you’ll improve your fitness. Ideally, you develop a more well-rounded program that balances cardiovascular and general body fitness and some weight training, especially for osteoporosis prevention, which also goes along as women age and is common in the breast cancer population, especially after breast cancer.
Melanie: What about diet? Because we are hearing more and more in the media today, Dr. Bosserman, about diet and how foods can actually help you fight off so many of these cancers. Can you tell us about certain cancer-fighting foods and other healthy habits that can dramatically lower our risk?
Dr. Bosserman: Yes, food should be our main medicine. Food, if we look at diet information, the healthy diet has to have a foundation that is plant-based. That means emphasizing fruits, vegetables, legumes, nuts, beans, and whole grains. That should be our main foundation. Of course, grains, although important, may increase your carbohydrate load, so you have to be selective in using grains, but they’re very important for nutrient. When we get to vegetables, we know that the main cruciferous vegetables, which are broccoli, Brussels sprouts, kale, and cauliflower, have very important nutrients that help fight cancer; so do fruits. Again, depending on our weight goals, we want to have fruits that don’t have immediate release of sugars. We have to tailor the fruit to… we’ll look at our weight goal. It can’t be used using a lot of juices, which can release a lot of immediate sugar. In fact, I advise my patients to blend smoothies. We get all the fiber that helps slow glucose absorption and really has more nutrients and you get all the fiber with it, or eat the whole orange, eat the whole apple. I don’t really promote juices as much as eating the whole fruit and vegetable.
Melanie: Dr. Bosserman, we’ve heard that alcohol use can increase the risk of breast cancer and that even folic acid may reduce that risk of the risk that’s increased with alcohol consumption. Tell us about that.
Dr. Bosserman: The issue of alcohol can be complex. There’s no simple answer, but overall, alcohol is a significant cancer-causing agent, not just breast cancer but other cancers. We know in women, we should limit daily alcohol intake, if you drink daily, to no more than one alcoholic beverage a day and that’s two ounces of alcohol. Often these wonderful wine glasses with eight ounces are more than one glass equivalent. Certainly, if you have one or two drinks or glasses of wine on a weekend, that’s not going to increase your risks significantly; but daily alcohol intake, more than one drink a day for women and more than two a day for men, starts to increase your risk of cancer. There is data that having folic acid daily can help lower that. Folic acid is important in our diet and to be obtained from, again, a fresh diet of fruits and vegetables. But I think we really have to look at alcohol as we get older and people start drinking more every day, that’s not good for our health and it certainly can start to increase the cancer risk.
Melanie: Dr. Bosserman, what about hormone therapy? There’s been a lot of controversy about that as a risk for breast cancer.
Dr. Bosserman: Yes, it still remains very controversial. The first irony is, of course, that as women age and go into menopause, that’s when the breast cancer risk increases. We know that complex hormone replacement like Premarin, that was horse urine with many kinds of estrogens in it, increased the breast cancer risk over time, especially combined with chemically synthetic progestin that was used in the Prempro combination. Again, it’s a low risk, but it’s significant especially in longer term use. If you look at using estradiol alone, one of the main estrogens, that is a very small increased risk of breast cancer, and overall it lowers your mortality because it helps prevent heart disease. Every woman needs to talk to their doctor about symptoms of menopause, and depending on those symptoms, hormone therapy used within the first five years of menopause below age 60, certainly is a benefit to women if you need treatment. It still remains controversial in women who may have a high-risk family history. We don’t really know the answer, whether we can tailor it to bio identical hormones that are more natural, maybe absorbed through the skin and not through the stomach that may have less side effects and can be customized with the combination of the estradiol or Estrace and natural progesterone. We really need more studies and that information isn’t exact and may not increase breast cancer risk.
Melanie: What about our weight? This is a controllable risk factor for breast cancer, Dr. Bosserman, and when people hear controlling your weight and being overweight, we deceive ourselves a little. “Oh, I’m not that much overweight,” or “I only have a few pounds to lose.” What do you really think is an ideal weight? How can we figure out our ideal weight so that we are really reducing our risk for breast cancer where weight is related?
Dr. Bosserman: Well, we know if we increase weight, we increase the fat content in upper body and fat tends to release and certainly women hold more of the toxic estrogen, estrone, and certainly increases the risk of cancer as well as heart disease. It’s definitely toxic to have excess fat, especially as you get older, and put that fat in our central abdominal area. I think it’s really important that we maintain a healthy weight if we want to lower our risk of cancer and heart disease.
Melanie: In just the last minute and a half or so, Dr. Bosserman, tell people why they should come to City of Hope for their breast cancer care.
Dr. Bosserman: City of Hope is really unique in having reached out from this nationally known academic national comprehensive cancer center to build an extensive community network where all of us have the advantage of a multidisciplinary team that can take every patient’s unique presentation with cancer or a concern for cancer and make sure they have a comprehensive treatment plan that includes every option for their best long-term health and outcome. That’s really now available throughout all the counties in Southern California as well as people around the world who can come to this center and to the networks to make sure that each patient has access to the best treatment plan, but also to the latest research and availability of clinical trials to test new ideas in addition to all the standard treatments as we continue to improve the survival rate and cure rate for women with breast cancer and other cancers.
Melanie: Thank you so much, Dr. Linda Bosserman. You are listening to City of Hope Radio. For more information, you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks for listening.
Breast Cancer Prevention – How To Reduce Your Risk
Melanie Cole (Host): About one in eight women will develop breast cancer at some point during her life. While one can’t change in some respect, such as genetics and ageing, there are certain things one can do that may lower your risk for breast cancer. My guest today is Dr. Linda Bosserman. She’s a premier medical oncologist at City of Hope, Rancho Cucomonga. Welcome to the show, Dr. Bosserman. Tell us about the risk factors for breast cancer, the ones that we cannot change, genetics and such. Let’s start with those.
Dr. Linda Bosserman (Guest): Well, the fact that we’re women, we know that one in eight women are at risk to get breast cancer if you live to age 90. It’s still a disease that increases after age 50 and 60. Everyone shouldn’t walk around worrying about it, but we want to be aware of our family history and our own physical body exam. Genetically, some families are at higher risk to get breast cancer and particularly at younger ages, and that may be associated with breast and ovary cancer or other cancers. Everyone should know their family history and talk to their doctor and have an assessment if they might be at higher risk than just the background risk of our population. The other risk really has to do with health factors we can control, and that’s diet, exercise, and our weight. We need to really be aware of that and take an active approach to our health.
Melanie: Let’s start with exercise to use it as a prevention for, not only breast cancer, but other types of cancer as well. What do you recommend that people do, exercise-wise, to help reduce that risk?
Dr. Bosserman: Well, the main data shows that if women will exercise 45 minutes at least five days a week, you lower your breast cancer risk, you lower your risk of heart disease and stroke, which we shouldn’t forget are still the number one cause of death in women. You also, after a cancer diagnosis, especially breast cancer, lower your risk of recurrence, which is still important.
Melanie: Okay, we’re talking about a combination of cardiovascular exercise and weight training, just general exercise. Is taking a walk enough for you?
Dr. Bosserman: Well, ideally, the aerobic exercise helps two or three times a week, as well as overall fitness and toning. If you can’t do anything except walk, that’s a good start, but it has to be at a pace that really gets your heart rate up for a period of time. Walking is acceptable. I tell women, if you can’t do anything else, buy a dog and walk four miles a day. It’ll keep your weight under control and you’ll improve your fitness. Ideally, you develop a more well-rounded program that balances cardiovascular and general body fitness and some weight training, especially for osteoporosis prevention, which also goes along as women age and is common in the breast cancer population, especially after breast cancer.
Melanie: What about diet? Because we are hearing more and more in the media today, Dr. Bosserman, about diet and how foods can actually help you fight off so many of these cancers. Can you tell us about certain cancer-fighting foods and other healthy habits that can dramatically lower our risk?
Dr. Bosserman: Yes, food should be our main medicine. Food, if we look at diet information, the healthy diet has to have a foundation that is plant-based. That means emphasizing fruits, vegetables, legumes, nuts, beans, and whole grains. That should be our main foundation. Of course, grains, although important, may increase your carbohydrate load, so you have to be selective in using grains, but they’re very important for nutrient. When we get to vegetables, we know that the main cruciferous vegetables, which are broccoli, Brussels sprouts, kale, and cauliflower, have very important nutrients that help fight cancer; so do fruits. Again, depending on our weight goals, we want to have fruits that don’t have immediate release of sugars. We have to tailor the fruit to… we’ll look at our weight goal. It can’t be used using a lot of juices, which can release a lot of immediate sugar. In fact, I advise my patients to blend smoothies. We get all the fiber that helps slow glucose absorption and really has more nutrients and you get all the fiber with it, or eat the whole orange, eat the whole apple. I don’t really promote juices as much as eating the whole fruit and vegetable.
Melanie: Dr. Bosserman, we’ve heard that alcohol use can increase the risk of breast cancer and that even folic acid may reduce that risk of the risk that’s increased with alcohol consumption. Tell us about that.
Dr. Bosserman: The issue of alcohol can be complex. There’s no simple answer, but overall, alcohol is a significant cancer-causing agent, not just breast cancer but other cancers. We know in women, we should limit daily alcohol intake, if you drink daily, to no more than one alcoholic beverage a day and that’s two ounces of alcohol. Often these wonderful wine glasses with eight ounces are more than one glass equivalent. Certainly, if you have one or two drinks or glasses of wine on a weekend, that’s not going to increase your risks significantly; but daily alcohol intake, more than one drink a day for women and more than two a day for men, starts to increase your risk of cancer. There is data that having folic acid daily can help lower that. Folic acid is important in our diet and to be obtained from, again, a fresh diet of fruits and vegetables. But I think we really have to look at alcohol as we get older and people start drinking more every day, that’s not good for our health and it certainly can start to increase the cancer risk.
Melanie: Dr. Bosserman, what about hormone therapy? There’s been a lot of controversy about that as a risk for breast cancer.
Dr. Bosserman: Yes, it still remains very controversial. The first irony is, of course, that as women age and go into menopause, that’s when the breast cancer risk increases. We know that complex hormone replacement like Premarin, that was horse urine with many kinds of estrogens in it, increased the breast cancer risk over time, especially combined with chemically synthetic progestin that was used in the Prempro combination. Again, it’s a low risk, but it’s significant especially in longer term use. If you look at using estradiol alone, one of the main estrogens, that is a very small increased risk of breast cancer, and overall it lowers your mortality because it helps prevent heart disease. Every woman needs to talk to their doctor about symptoms of menopause, and depending on those symptoms, hormone therapy used within the first five years of menopause below age 60, certainly is a benefit to women if you need treatment. It still remains controversial in women who may have a high-risk family history. We don’t really know the answer, whether we can tailor it to bio identical hormones that are more natural, maybe absorbed through the skin and not through the stomach that may have less side effects and can be customized with the combination of the estradiol or Estrace and natural progesterone. We really need more studies and that information isn’t exact and may not increase breast cancer risk.
Melanie: What about our weight? This is a controllable risk factor for breast cancer, Dr. Bosserman, and when people hear controlling your weight and being overweight, we deceive ourselves a little. “Oh, I’m not that much overweight,” or “I only have a few pounds to lose.” What do you really think is an ideal weight? How can we figure out our ideal weight so that we are really reducing our risk for breast cancer where weight is related?
Dr. Bosserman: Well, we know if we increase weight, we increase the fat content in upper body and fat tends to release and certainly women hold more of the toxic estrogen, estrone, and certainly increases the risk of cancer as well as heart disease. It’s definitely toxic to have excess fat, especially as you get older, and put that fat in our central abdominal area. I think it’s really important that we maintain a healthy weight if we want to lower our risk of cancer and heart disease.
Melanie: In just the last minute and a half or so, Dr. Bosserman, tell people why they should come to City of Hope for their breast cancer care.
Dr. Bosserman: City of Hope is really unique in having reached out from this nationally known academic national comprehensive cancer center to build an extensive community network where all of us have the advantage of a multidisciplinary team that can take every patient’s unique presentation with cancer or a concern for cancer and make sure they have a comprehensive treatment plan that includes every option for their best long-term health and outcome. That’s really now available throughout all the counties in Southern California as well as people around the world who can come to this center and to the networks to make sure that each patient has access to the best treatment plan, but also to the latest research and availability of clinical trials to test new ideas in addition to all the standard treatments as we continue to improve the survival rate and cure rate for women with breast cancer and other cancers.
Melanie: Thank you so much, Dr. Linda Bosserman. You are listening to City of Hope Radio. For more information, you can go to cityofhope.org. That’s cityofhope.org. This is Melanie Cole. Thanks for listening.