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Breast Surgeon and Cancer Researcher Discusses Factors That Affect Your Breast Cancer Risk

Some factors affect your risk of breast cancer more than others. Understanding the factors affecting your risk can help you work with your healthcare provider to develop a breast cancer screening plan that’s right for you.

To help us learn more about the risk factors for breast cancer, Dr. Dennis Holmes joined the Real Pink podcast. Dr. Holmes is the Associate Professor of Surgery at the John Wayne Cancer Institute in Santa Monica, California. As a world-renowned breast surgeon and longtime supporter of Susan G. Komen, Dr. Holmes has dedicated his career to breast cancer treatment and breast cancer research. Here is what he had to say:

Adam Walker: So, what are a few of the common factors that affect breast cancer risk?

Dr. Holmes: Well, Adam, it’s important to understand that breast cancer risk factors are physical, lifestyle or historical factors that influence a woman’s chances of getting breast cancer. So, it really is a range of things. It can be genetic things, like if you have genetic predisposition, because of maybe a BRCA mutation, it could be due to a family history. For example, if you have a first, second- or third-degree family member on the mother or father’s side with a history of breast cancer or ovarian cancer, those things impact [your] risk.

Breast density is something that we’ve recently learned is an important risk factor. Higher breast density is associated with an elevated risk of breast cancer. Of course, there’s increasing age, there’s issues of delayed childbirth, being overweight, lack of exercise, drinking excessive alcohol… that’s more than two glasses per day.

AW: You mentioned several things that are genetically, certainly beyond our control, but what about the things that are under our control? Can you talk a little more about that?

DH: Some risk factors are changeable, and some are unchangeable. Certainly, genetics and family history are things that you just can’t change. Your breast density is something that can’t be changed. It’s an individual trait that a woman has, and it differs from one woman to the next.

But there are things that you can do to reduce the risk. One of those things is exercise, another is maintaining a diet rich in fruits and vegetables. The third is reducing or maintaining lean body weight. If you’re overweight, reducing your weight. These are all things that one can do, including avoiding smoking. We know that hormones, particularly combination hormones that contain both estrogen and progesterone, increase risk of breast cancer over time. So, if you can avoid using it, that’s another way to reduce the risk.


AW: There’s obviously a large spectrum of very unhealthy to what I would maybe determine as hyper-healthy, and so where on that spectrum would you recommend women consider themselves to be in the more healthy, less risky area?

DH: Well, I guess everyone can be a little healthier. From starting from where you are, there’s always some room for improvement, but it’s actually been examined, sort of calculated, like what is necessary in terms of exercise, in order to achieve a measurable benefit in reducing your risk of breast cancer. So, for the average woman, exercising two and a half hours a week, doing some sort of cardio exercise, where their heart rate is increased, whether it’s running, walking, dancing, treadmill, whatever, that has been shown to be associated with a 20% reduction in their lifetime risk of breast cancer. So that’s two and a half hours a week. I tell my patients it’s thirty minutes a day, five days a week. If you can manage to get up to four hours a week, that reduces your lifetime risk by 40%.