Breast Health In The Time Of COVID-19: Volume 4

In this volume, I am completing my list of 19 steps to improve your breast health, during this COVID-19 pandemic. The first volume was about mammograms. In the second volume, I touched on alcohol, smoking, weight gain, hormones, sleep, and pregnancy. The third volume  discussed exercise, vitamin D, the Mediterranean diet, pollutants, breast-feeding, and stress. Let’s finish up the list.

#13      Limit your fat intake.

I mentioned the Mediterranean diet in the last volume, which includes a limitation of fats. Conversely the keto diet is very high in fats.  There is a correlation between a high fat diet and breast cancer. While the keto diet may be effective for women for weight loss, it may not be worth the associated breast cancer risk. Try to eat no more than about 50 grams of fat per day and get no more than 10% of your calories from saturated fat (like pies, cakes, whole milk, cheddar cheese, butter, coconut and palm oil). Avoid trans fats, which are the fats found in shortening, stick (or hard) margarine, and many store-bought cookies, crackers, snack foods, fried foods, pastries, and other baked goods.

#14      Decrease your consumption of caffeine from coffee, tea, and chocolate

Let me say first that there is no evidence that drinking coffee increases your risk for breast cancer, in fact some data say it might be preventive.  Coffee has been associated with breast pain.  Breast pain is often associated cysts, and so many think the cysts must be related to drinking coffee, but this is NOT the case.  Pain from cysts is usually due to a single enlarging cyst, that may benefit from needle aspiration.  Pain related to caffeine intake is more likely to be more diffuse.  At any rate, if you suffer from breast pain and drink even moderate amounts of coffee, tea, and/or chocolate, you may experience relief by limiting your intake.

#15      Vitamin E

For those of you who are having breast pain, consider a vitamin E supplement.  The data is not strong, but there is very little downside to giving it a try. It is thought to be more likely to help those with cyclic breast pain, which is usually most severe in the week before menses. The typical dosage is 800 international units (IU) with meals. Dietary sources include olive oil, corn, soy, tomato, peanuts, spinach, almonds, and broccoli.

#16      Evening primrose oil (EPO)

One more option for those suffering with breast pain is evening primrose, a supplement you’ll find in most health food stores. As with vitamin E, the data is mixed, but there are a number of other purported benefits, so perhaps you can kill two birds with one stone. The typical recommended dosage is 1-3 grams daily.

#17      Be aware of your family history regarding cancer

I often note that when patients are initially diagnosed with breast cancer, they do not really know who in their family might have had breast cancer or other cancer. I know that a lot of people are spending time during this pandemic by looking through old photographs and getting back in touch with family and friends.  I would strongly recommend that you take some time to know your family’s medical history.  Regarding breast cancer risk, a family history of breast or ovarian cancer can be very significant.  Therefore, for anyone in your family who was diagnosed with cancer, ideally you should know what organ the cancer originated in, and how old they were when it was first diagnosed.  A history of other cancers can be significant as well.  There are websites devoted to keeping track of this information.  Here is one that looks fairly simple, I have no financial interest at all.

#18      Determine your individual risk for breast cancer

Your family history of breast or other cancers is one of many factors that can contribute to an increased risk for breast cancer.  Once again, there are several sites available online to simplify calculation of one’s individual risk for breast cancer.  Depending on your specific situation, one or the other may be more preferred.  For someone with a lot of family members with breast or ovarian cancer, particularly at an early age, this calculator that is focusing on BRCA mutations might be preferred.  The National Cancer Institute has a link that can be used as well.  Here is a link to another one called Tyrer-Cusick, one that has a lot of popularity with breast specialists.  It may be worthwhile to use more than one risk calculator and compare.  They all have their quirks, and your calculated risk may differ from one to the other.

If you do a calculation for your breast cancer risk, be sure to record it, and share it with your primary care physician and any other specialist you might see regarding any breast problems.

#19      If your risk for breast cancer is increased, consider chemoprevention with tamoxifen or raloxifene.

If you are postmenopausal, and your breast cancer risk is high enough, you could decrease your risk by taking tamoxifen or raloxifene. If you are interested this option, discuss it with your primary care doctor, or ask for referral to a breast specialist. The recommended treatment continues daily for 5 years.

With the final volume, I’ll circle back to mammograms with some more detailed information.   If you missed my first, second, and third  volumes, these are the links. I’d love some feedback. Feel free to comment, and stay safe!