Last updated: Sep 21, 2009
breast-cancer-prevention
We admit it: We have a love-hate relationship with our breasts. We show em off when theyre proud and perky, but freak the second they start to sag. We squeeze them into bras that dont fit, complain if they bob when we jog, and obsess over every little imperfection. But the minute we find a lump or feel a twinge of pain, we realize just how much we want them around—no matter their flaws. Thats why we created this A-to-Z Guide to help keep your breasts—and you—healthy.


A: Alcohol
The numbers dont lie: Alcohol is to blame for 11% of all breast cancers, according to data from the United Kingdoms Million Women Study. Thats because beer, wine, or cocktails—even just one or two drinks a day—hike your risk, and that risk increases with each additional drink. Scientists are still probing the alcohol-cancer connection but, for now, moderation is a must. “If you dont drink, dont start,” says Susan Love, MD, president of the Dr. Susan Love Research Foundation and clinical professor of surgery at UCLA. “If you do, three drinks a week or less is probably OK.”

B: Breast-feeding
Yes, babies are more likely to attend college if they nurse, but whats really surprising: Breast-feeding may save your life. Womens Health Initiative data suggests that moms who breast-feed 12 months or more throughout their lives have less heart disease than women who dont nurse. And a new study shows that women with a family history of breast cancer cut their risks of getting the disease before menopause if they breast-feed their kids.

C: Caffeine
Youve heard theres a link between caffeine and breast cancer? The truth: About 200 to 300 milligrams of the stimulant per day—the amount in two to three cups of coffee or (strong) tea, an energy drink or two, or about five diet sodas—probably wont hurt you, says Liz Applegate, PhD, director of sports nutrition at the University of California, Davis. But to be safe, dont overdo it.

D: Dècolletage
Theres a simple reason you see freckles, sun spots, and those dreaded vertical wrinkles on your cleavage—youre not using enough sunscreen on the delicate skin there. Baby your bosom with a high SPF, plus a moisturizer, says Amy Taub, MD, a Chicago-area dermatologist and assistant clinical professor at Northwestern University Feinberg School of Medicine. Try Aveeno Positively Radiant Daily Moisturizer with SPF 30 ($13.99). It offers sun protection and spot-reducing soy.


E: Eat right
Loading up on fruits and veggies and cutting back on fatty meat keep your whole body healthy. But which foods specifically help you fight breast cancer? Recent studies suggest you eat more: Cruciferous vegetables like broccoli, cauliflower, cabbage, and bok choy. They contain potential cancer-fighting compounds called isothiocyanates. Fish like salmon, tuna, and trout. Theyre rich in omega-3s and are a healthier protein source than meat. Bell peppers and broccoli Theyre full of flavonoids, a powerful good-for-you antioxidant. Kefir yogurt Its a yummy source of vitamin D and healthy bacteria (probiotics).

F: Fit
If youre like most women, youre wearing a bra that doesnt fit right. Blame the fact that your bust measurements change at least six times in your adult life. To make sure youre getting the right support, talk to a fitter in a department or lingerie store, or do your own sizing. Elisabeth Squires, author of Boobs: A Guide to Your Girls, swears by Size Me Up!, a doctor-designed system that measures the width of each breast to more accurately determine cup size. When all else fails, take the no-duh test: A bra that fits

G: Genes
Most women who get breast cancer dont carry the harmful gene mutations known as BRCA1 and BRCA2. Women who do (roughly 1 in 500) tend to get cancer under age 50 and may have multiple cases of breast and ovarian cancer in the family. Who should be gene-tested? If relatives (sisters or other women on your moms or dads side) have had breast or ovarian cancer, its most helpful for one of them to be tested before you. Testing costs about $3,000, and most insurers dont cover it. If a mutation doesnt show up, your risk is still higher because of your family history. But if your relative has the BRCA1 or BRCA2 gene mutation, your risk could be elevated even more, and you may want to talk with a genetic counselor about your own test.

H: Hormone therapy
If youre on hormone replacement therapy (HRT), its probably for a good reason: The treatment, usually a combo of estrogen and progesterone, can help relieve hot flashes, irritability, and night sweats. But many researchers are now convinced that using combo HRT for five years or more can double your breast cancer risk, which is why women should use the smallest effective dose for the shortest possible time. Fortunately, studies show that within two years of stopping hormones, your breast cancer risk goes back to normal.

I: Inflammatory breast cancer
If you dont know about IBC, you should. The five-year survival rate of this rare but aggressive disease is about half that of regular breast cancer. Symptoms can include redness and painful swelling around the breast; sometimes the skin feels warm and has the texture of an orange. If you have signs, see your doctor right away.

J: Jiggle
Too much jiggling can make you sag: According to one British study, breasts move during exercise up to 8 vertical inches, adding painful pressure on supporting ligaments. Solution: Make sure your sports bra is up to the job. Small-breasted women usually just need a compression, or “uniboob,” bra. If youre large, try encapsulating styles, which surround each breast separately. Champion makes good low-cost running bras, and sportswear companies like Title Nine even offer special rating systems for each bras support level.


K: Know em well
Take a good look in the mirror—is one breast bigger than the other? (Thats typical.) Are your nipples inverted? Does anything look or feel different? You need to know your breasts well so youll notice any changes during your monthly breast self-exam (BSE), which is an important way to catch abnormalities like lumps or swelling. Confused about the correct way to do BSE? Visit LINK: Health.com/bse.

L: Lumps
The vast majority of breast lumps are benign—and more than 60% of women have fibrocystic, or naturally lumpy, breasts. Still, you should get all lumps and bumps checked, especially if they change. “Women get into trouble when they ignore lumps because theyre afraid,” says Joan Bull, MD, director of the Division of Oncology at the University of Texas Medical School in Houston. The doc may recommend an ultrasound, mammogram, or biopsy to figure out what's up.

M: Mammograms
No one likes having her boobs squeezed flat in what feels like a refrigerator door. But its worth it: Early detection from regular mammograms is estimated to reduce the risk of death from breast cancer by at least 15%, according to a recent research review. Are there any downsides to recommended annual screening mammos? A report in the British Medical Journal suggested they could lead to overdiagnosis—detecting tumors that turn out to be harmless—and unnecessary treatment. But experts insist that the benefits far outweigh the potential costs.

N: Nipples
Smooth or bumpy, inverted or standing at attention on a chilly day, nipples seem to have a mind of their own. Together with the surrounding areola, they even change color during and after pregnancy. Here are some of the most common problems and how to, well, nip em in the bud.


  • Itchiness: Your laundry detergent could be irritating sensitive skin, so you may just need to switch soaps. Itchy skin can also be a sign of pre-menopause, or in rare cases, something more serious. If your itchiness doesnt go away, ask your doc for a breast exam.


  • Discharge: Leaky breasts can signal several things—pregnancy, thyroid conditions, or problems with certain meds. Get it checked if you see discharge unexpectedly, especially on one side, or if its staining your clothes or sheets or contains blood.


  • Cracks and soreness: If youre nursing, soothe aching nipples with petroleum jelly, says Dr. Taub of Northwestern University Feinberg School of Medicine. Not only will it ease soreness, but it wont hurt your baby if she swallows a tiny bit.



  • O: Ouch!
    About 10% of us have breast pain more than five days a month. Usually the ache (also called mastalgia) goes in cycles, since monthly hormone changes can make breasts extra achy. If the pain is unbearable, try tracking when it hurts most. Then talk to your doctor, and, if youre over 35, consider a mammogram. The doc may recommend pain pills, birth control pills (if youre in your 20s), or possibly evening primrose oil, which might bring relief for some women. Talking to your doc may ease your fears, too, since many women worry that breast pain is always a sign of cancer. It isnt.

    P: Plastic surgery
    Even in a down economy, boob jobs arent sagging. But a lesser-known surgery is also on the rise: breast reduction. For top-heavy women, the surgery can bring much-needed relief from back, shoulder, and neck pain. If you want breast surgery—to get bigger or smaller—talk to the doc about scarring, healing time, and final appearance, says John Canady, MD, president of the American Society of Plastic Surgeons.


    Q: Number-one question to ask your doc: “Are my breasts dense?”
    Women with dense breasts are five times more likely to develop breast cancer, Dr. Love of UCLA says, although its unclear why. The only way to find out density is after a mammogram—the info is in the results. Bring it up with your doc after the test or have the report mailed to you.

    R: Rest
    One more reason to get your sleep: Getting enough zzzs may help protect you from cancer. In a recent study of nearly 24,000 Japanese women, those who slept six hours or less each night were 62% more likely to have breast cancer than the women who slept seven hours. Researchers think that the sleep hormone melatonin seems to regulate the release of estrogen.

    S: Soy
    Soy contains phytoestrogens, chemicals similar to estrogen. Docs say soy has many benefits, if you get it in natural forms like edamame. But concentrated forms found in supplements may be harmful—especially if youre at high risk for breast cancer, says Applegate, PhD, of UC Davis.

    T: Tomosynthesis
    Watch for the looming debut of this new digital imaging system, which allows doctors to slice and dice super-clear 3D pictures of the breast, while applying less pressure to your boobs than standard mammos (hooray!). Early research shows the new technique may more accurately spot tumors, especially in very dense breasts.

    U: Underwires are dangerous (and other myths)
    Relax—your sexy new number from Victorias Secret wont give you cancer. Experts say the notion that underwires trap toxins just doesnt hold up. Ditto for antiperspirants, living near power lines, and being hit in the chest. Theres no evidence that any of these things causes breast cancer, Dr. Love of UCLA says.

    V: Vaccine
    Stimuvax, a vaccine currently in testing, may help women who have inoperable breast cancer live longer. The drug is designed to juice up the immune system so it can kill malignant cells. Its also being eyed for lung, prostate, and colon cancers.


    W: Weight
    Women who gain 55 pounds or more after age 18 have nearly 1 1/2 times the risk of breast cancer compared with those who keep their weight steady. But losing the weight substantially lowers risk as you age.

    X: X-Rays
    Radiation can cause cancer. Thats why doctors say that younger women and girls should avoid unnecessary X-rays (a typical X-ray administers radiation at a higher dose than a mammogram). If your doctor recommends an X-ray for anything, ask how having it will change your treatment plan. If it wont, reconsider.

    Y: Yoga
    To keep “the girls” from sagging, Health expert Sara Ivanhoe, creator of the Yoga on the Edge DVD, recommends this Plank Sequence:


    1. Start with hands and knees on a mat, hands directly under shoulders and knees below hips. Firm your abs to support your lower back; extend right leg backward, curl toes and place them and on the ground; repeat with left leg. (Your body should be in a straight line from your head to your heels.) Hold for 5 full breaths.


  • On an exhale, slowly lower yourself to the floor, keeping your elbows tucked in. Your chest and belly should touch the floor at the same time.


  • On an inhale, push back to lean on your hands and knees; exhale into plank, hold for a full inhale, then exhale and lower again, then up into plank. Repeat 5 times.



  • Z: Zero!
    Thats the number of new breast cancer cases we all hope to see in our lifetimes—and a project launched by the Dr. Susan Love Research Foundation and Avon Foundation for Women may get us there. The Love and Avon Army of Womens mission: Recruit 1 million women to participate in life-saving research. Sign up online at ArmyOfWomen.org.