There is no certain way to prevent breast cancer, but there are ways to lower the risk of getting the disease.

Chemoprevention

Chemoprevention is the use of certain drugs to reduce the likelihood of developing breast cancer. Two drugs that are often used for this purpose are tamoxifen and raloxifene, both selective estrogen receptor modulators (SERMs).

• Tamoxifen (Nolvadex) is used as a preventive agent in women age 35 and older who are at elevated risk for developing breast cancer. Risk reduction is about one-third for noninvasive breast cancer and one-half for invasive breast cancer.
• Raloxifene (Evista) is used to help prevent breast cancer in postmenopausal women at high risk of the disease, and it is also used to help treat osteoporosis.

Preventive Surgery

Prophylactic (preventive) surgery prevents or reduces the chance of breast cancer.

• Prophylactic mastectomy removes one or both of the breasts. This is an option that women may wish to consider if they are at high risk: for instance, if they have tested positive for inherited genetic mutations, such as those of the BRCA1 and BRCA2 genes; if they have a family history of breast cancer; if they've already had cancer in one breast; or if there are early signs of cancer in a breast.
• Prophylactic oophorectomy is the surgical removal of the ovaries. Having an oophorectomy before menopause reduces the risk of breast cancer.

Lifestyle Measures

There are a number of dietary and other lifestyle factors that can affect the chances of getting breast cancer:

• Alcohol. Having more than one alcoholic drink a day increases breast cancer risk.
  
• Weight. There's a strong link between obesity and breast cancer, especially if weight is gained after menopause.
• Physical activity. Being physically fit may offer some protection against breast cancer and help reduce the risk of recurrence. Exercise helps to reduce body fat, which lowers levels of estrogen. Women should exercise for at least 30 minutes a day, 5 days a week.
• Aspirin. Taking aspirin once a week may help prevent breast cancer, but women with a history of gastrointestinal disorders should not use it.
• Long-term hormone therapy. Studies on the dangers of hormone therapy have had mixed results. Estrogen exposure contributes to breast cancer risk, but the risk is likely to be small, especially in the absence of other risk factors. Hormones can probably be taken safely for as long as 4-5 years to relieve the symptoms of menopause, but should not be taken for longer than that, or after the age of 60.
• Fiber. Eating plentiful amounts of fiber has numerous benefits, including reducing the amount of estrogen in the bloodstream. About 20-30 grams of fiber should be consumed daily, about twice the amount in the average American diet. Whole grains, fruits, vegetables, and beans are all high in fiber.
• Olive oil. Women should use olive oil in place of most other oils. Oleic acid, the chief fatty acid in olive oil, has been shown to suppress the action of the most important gene involved in the development of breast cancer. Oleic acid also seems to increase the effectiveness of the drug Herceptin.
• Calcium and vitamin D. Eating plentiful amounts of foods rich in calcium and vitamin D (such as milk and yogurt) may slightly reduce the risk of breast cancer in premenopausal women.
• Red meat. Some studies have shown that eating large amounts of red meat on a daily basis raises breast cancer risk.
• Pesticides. Exposure to pesticides should be avoided. The molecular structure of some pesticides closely resembles that of estrogen. Studies have found that women with elevated levels of pesticides in their breast tissue have an increased risk of breast cancer.

Exercise and the Breast Cancer Survivor

Exercise reduces the risk of getting cancer or having it come back. This may be because exercise can lower the amount of estrogen in a woman's body, and estrogen promotes the growth of some breast cancers.

Exercise has other benefits as well. It can boost the immune system, limit weight gain, and ease treatment side effects. It can have psychological benefits as well, improving mood, increasing self-esteem, and decreasing fatigue and anxiety.

Postsurgical Exercise

Any form of breast surgery - biopsy, lumpectomy, lymphectomy, or mastectomycan have lasting, serious effects on a woman's health and well being. Exercise is particularly important for women who have radiation therapy, in order to keep the arm and shoulder flexible. Radiation therapy may affect these areas for 6-9 months after it is completed. Back and neck pain, frozen shoulder, and lymphedema are all common ailments for breast cancer survivors.

But these problems can dealt with by beginning a focused exercise program the first week after surgery. Starting to exercise almost immediately is important for two reasons: first, because even very light activity can combat fatigue, and second, because scar tissue begins to form almost immediately after surgical incisions are made. A woman's range of motion can be come so constricted by scar tissue that it may become difficult for her even to lift her arm. By doing exercises designed to maintain flexibility and movement, this tightness and constriction can be avoided.

Doctors and physical therapists can design programs that address the needs of the patient individually. Exercise programs proceed in phases to complement and accelerate the breast cancer survivor's healing process:

• In the first 6 weeks after surgery, very gentle exercises are performed to relieve pain and prevent scar tissue from forming. Exercises should emphasize flexibility, mild strengthening, and breathing. Focusing on the breath can help to ease pain.
• The second phase of exercise focuses on increasing strength and on general conditioning.
• Additional phases of exercise should address additional areas of the body, not just the arm.
• Developing good posture is key for improving overall fitness.