The Who, What, Where, When and Sometimes, Why.

Healthy Lifestyle for Breast Cancer Survivors

It’s never too late to adopt a healthy lifestyle

Everyone can benefit from a healthy lifestyle. Making healthy choices can be physically and mentally rewarding at any age.

A healthy lifestyle includes:

For breast cancer survivors, some healthy behaviors may lower the risk of recurrence and improve survival. Others may not impact breast cancer survival, but are part of a lifestyle that may help protect against other cancers and diseases.

Body weight and BMI

Body mass index (BMI) is a measure used to help show whether or not a person has a healthy weight.

BMI includes a measure of height and weight. So, BMI is better than weight alone when making comparisons. Calculate your BMI or find your BMI in a table.

For people ages 20 and older, weight status categories are: 

BMI

Body weight status

18.5 to 24.9

Normal

25.0 to 29.9

Overweight

30.0 and greater

Obese

 

Being overweight

After treatment for breast cancer, being overweight or obese increases the risk of [155-160]:

  • Breast cancer mortality (death from breast cancer)
  • Overall mortality (death from any cause, not necessarily breast cancer) 

 

For a summary of research studies on body weight and breast cancer survival, visit the Breast Cancer Research Studies section.

 

Weight gain

Weight gain after breast cancer diagnosis may increase the risk of [155,161-163].

  • Breast cancer mortality
  • Overall mortality
quote_icon

Komen Perspectives

Read Komen’s perspective on body weight and
breast cancer survival
(September 2011).*

Other health risks

Maintaining a healthy weight is one of the best things you can do for your health.

Being overweight or obese causes [164-165]:

  • Heart disease
  • Stroke
  • Diabetes
  • Colon and rectal cancer
  • Endometrial (lining of the uterus) cancer
  • Esophageal cancer
  • Kidney cancer
  • Pancreatic cancer

Being overweight or obese may also increase this risk of [165]:

  • Gallbladder cancer
  • Liver cancer
  • Multiple myeloma
  • Non-Hodgkin lymphoma
  • Ovarian cancer
  • Prostate cancer

Regular exercise and eating a healthy diet are the best ways to maintain a healthy weight [166].

For more information on weight control and exercise, visit the National Heart, Lung, and Blood Institute.
 

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time. 

At this time, we don’t fully understand how diet affects survival after breast cancer.

Being overweight or obese (and weight gain) after a breast cancer diagnosis decreases survival [155-160]. However, there is no diet, dietary pattern or nutrient proven to improve breast cancer survival (or decrease survival).

Some dietary factors have been studied more than others. These include carotenoids, dietary fat and soy (see below).

A healthy diet is important for everyone, including breast cancer survivors.

Learn more about diet and breast cancer.

Healthy diet

Breast cancer survivors can benefit from the same healthy diet recommended for everyone [154].

This diet (outlined below) promotes overall health and may help protect against different types of cancer and other diseases [154,166].

  • Achieve and maintain a healthy weight. Survivors who are overweight or obese should limit high-calorie foods and beverages and increase physical activity to help with weight loss.
  • Eat at least 2 ½ cups of fruits and vegetables every day.
  • Choose 100 percent whole grain foods such as 100 percent whole grain breads and cereals, brown rice, millet and quinoa.
  • Limit red meat and processed meat. Choose chicken, fish or beans more often.
  • Limit “bad” fats (saturated and trans fats). These are found in foods such as red meat, fatty deli meats, poultry skin, full fat dairy, fried foods, margarine, donuts and microwave popcorn.
  • Eat “good” fats (polyunsaturated and monounsaturated fats). These are found in foods such as olive and canola oil, nuts and natural nut butters, avocado and olives.
  • Limit alcohol intake to less than 1 drink a day for women and fewer than 2 drinks a day for men.

Adapted from the American Cancer Society’s Guidelines on Nutrition and Physical Activity for Cancer Survivors [154].

Carotenoids (found in fruits and vegetables)

Carotenoids are natural orange-red food pigments found in foods such as carrots, sweet potatoes, squash and melons.

Many carotenoids, such as beta-carotene, are antioxidants and can be converted into vitamin A in the body.

Researchers can study carotenoids by measuring levels of carotenoids in the blood or through a person’s diet.

Studies of blood levels of carotenoids

A study of more than 3,000 breast cancer survivors found those with higher blood levels of carotenoids had better disease-free survival (survival without a breast cancer recurrence) than those with lower levels [167].

Studies of dietary intake of carotenoids

Data on dietary intake of carotenoids and survival among breast cancer survivors are limited.

One study found breast cancer mortality (death from breast cancer) and overall mortality (death from any cause) were the same for survivors with a high dietary intake of carotenoids as for those with a low dietary intake [168].

Note of caution on carotenoid supplements

Eating too much of certain carotenoids may have some health risks.

A few studies have found taking a daily supplement of the carotenoid beta-carotene can increase the risk of lung cancer and premature death in smokers [169-171].

In general, fruits and vegetables are the best sources of carotenoids (rather than supplements) and are part of a healthy diet.

Dietary fat

Researchers are studying whether eating a low-fat diet after a breast cancer diagnosis improves survival. Findings are mixed.

Findings from the Women’s Intervention Nutrition Study showed reducing dietary fat intake may improve disease-free survival (survival without a breast cancer recurrence) [172]. Women in this study who reduced their fat intake also lost weight, which may have played a role in their improved survival [172].

Findings from the Women’s Health Initiative study showed reducing dietary fat increased overall survival in women diagnosed with breast cancer [173].

Other studies have found no difference in survival after a breast cancer diagnosis for women who eat a diet low in fat compared to those who eat a diet high in fat [174-177].

 

For a summary of research studies on dietary fat and breast cancer survival, visit the Breast Cancer Research Studies section.

 

Soy

Soy foods

Current studies suggest eating moderate amounts of soy foods is safe for breast cancer survivors [178-180].

Some studies have found a diet high in soy may decrease the risk of breast cancer recurrence and breast cancer mortality (death from breast cancer) [178-180]. Most of these findings are from studies of Asian women, who tend to eat more soy throughout their lives (starting early in life) compared to other women [179-182].

One analysis combined data from 3 large studies of survivors from both Asian and Western countries. It found women who ate at least 10 mg of soy per day after a breast cancer diagnosis had a 25 percent lower risk of recurrence compared to those eating less than 4 mg per day [179].

However, soy is not recommended as a way to lower the risk of breast cancer recurrence. Questions remain about study findings. For example, women who regularly eat soy tend to be healthier than those who don’t, which may account for the benefits shown in studies [179].

Soy supplements

Most studies looking at soy and breast cancer have focused on soy foods rather than soy supplements [178-182].

In the lab, researchers can separate soy proteins into individual compounds, called isolates. Individual isolates don’t occur in nature.

This is similar to other supplements such as vitamin A. While many natural things contain vitamin A, pure vitamin A (alone) does not appear in nature. Isolates, like pure vitamin A, can only be created in a lab. Because soy supplements are created in a lab, they may contain individual soy protein isolates.

Some lab studies of cells have shown soy protein isolates may increase cancer growth [183]. So, soy supplements are not currently recommended for breast cancer survivors.

Soy and hot flashes

Overall, studies have not shown soy foods or soy supplements can reduce hot flashes [184].

Learn about ways for breast cancer survivors to treat hot flashes and other menopausal symptoms.

quote_icon

Komen Perspectives

Read our perspective on soy and breast cancer
(April 2015).*

Organic foods

At this time, research does not show organic foods are more nutritious or better for your health than foods farmed by conventional methods [145].

Learn more about organic foods.

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.

Some findings suggest drinking alcohol may increase the risk of [185]:

  • Breast cancer mortality (death from breast cancer)
  • Overall mortality (death from any cause, not necessarily breast cancer)

Other studies show no increased risk of death from breast cancer or any cause for survivors who drink alcohol [185-190].

One reason for these mixed findings may be that drinking in moderation has some health benefits. It may lower the risk of heart disease, high blood pressure and death [191-192].

Drinking low or moderate amounts of alcohol

No one should drink a lot of alcohol.

The American Cancer Society recommends that cancer survivors limit alcohol intake to less than 1 drink a day for women and fewer than 2 drinks a day for men [145]. Drinking more has no health benefits and many serious health risks.

After talking with your health care provider, make informed choices about drinking low to moderate amounts of alcohol.

 

For a summary of research studies on alcohol and breast cancer survival, visit the Breast Cancer Research Studies section.

 

quote_icon

Komen Perspectives

Read our perspective on alcohol and breast cancer
(March 2011).*

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.

 

Some studies suggest being active may lower the risk of [139,193-199]:

  • Breast cancer mortality (death from breast cancer)
  • Overall mortality (death from any cause, not necessarily breast cancer)

How is physical activity measured?

Researchers often use MET (metabolic equivalent) hours to assess the total amount of activity a person gets.

The more energy an activity needs, the higher its MET score. For example, 1 MET hour is the energy used to sit quietly for 1 hour, but walking for 1 hour scores from 2 ½ to 4 ½ MET hours (depending on how quickly you walk).

More vigorous activities, like playing tennis, biking or swimming for 1 hour, score higher.

Adding the MET scores of different activities gives a total number of MET hours.

How much activity gives a benefit?

A pooled analysis that combined data from over 13,000 breast cancer survivors found those who were more active had better survival [139].

For example, survivors who got 10 or more MET hours of activity a week (about 3 or more hours of moderate-paced walking) had a 30 percent lower overall mortality compared to less active survivors [139].

Breast cancer survivors may not need to do intense exercise to get a benefit though. One study found activity equal to a 30-minute brisk walk several times a week, improved survival [195].

The American Cancer Society recommends breast cancer survivors [145]:

  • Avoid inactivity and return to normal daily activity as soon as possible after diagnosis
  • Get regular physical activity
  • Aim for at least 150 minutes of exercise per week
  • Do strength training exercises at least twice a week

A meta-analysis that combined the findings from 16 studies showed breast cancer survivors who got this recommended 150 minutes of exercise per week had an [197]:

  • 11 percent lower risk of breast cancer mortality
  • 24 percent lower risk of overall mortality

 

For a summary of research studies on physical activity and breast cancer survival, visit the Breast Cancer Research Studies section.

Other benefits for survivors

Being physically active is one of the best things you can do for your health.

It helps you maintain a healthy weight and lowers your risk of heart disease, stroke and diabetes [193,200].

For breast cancer survivors, it can also [15-20,139-142,136-138,201-204]:

  • Improve body image
  • Improve mood
  • Improve physical condition and movement
  • Improve quality of life
  • Increase sexuality
  • Increase energy
  • Maintain bone health
  • Reduce fatigue
  • Reduce stress and anxiety
  • Reduce distress and depression
quote_icon

Komen Perspectives

Read our perspective on physical activity and
breast cancer survival
(December 2010).*

Physical activity and lymphedema

In the past, there was some concern exercise might increase the risk of lymphedema for breast cancer survivors and worsen symptoms in those who developed the condition.

However, after recovery from breast surgery, arm exercises (such as weight-lifting) don’t appear to increase the risk of lymphedema [39,44-46]. (It’s best to avoid strenuous exercise right after breast surgery though.)

Studies also show weight-lifting (moderate, in a supervised setting) can reduce symptoms in survivors with lymphedema, as well as improve body image, sexuality and physical strength [39,46-49].

Talk with your health care provider before starting an exercise program to manage lymphedema.

Learn more about lymphedema.

*Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.

There’s growing evidence smoking decreases survival for women diagnosed with breast cancer.

A pooled analysis that combined data from about 10,000 survivors found smoking increased the risk of [205]:

  • Breast cancer-specific mortality (death from breast cancer)
  • Overall mortality (death from any cause, not necessarily breast cancer)

The more women smoked, the higher these risks [205].

 

For a summary of research studies on smoking and breast cancer survival, visit the Breast Cancer Research Studies section.

 

quote_icon

Komen Perspectives

Read our perspective on smoking and breast cancer
(October 2012).*

Smoking and other health conditions

Stopping smoking, or never starting to smoke, is one of the best things you can do for your health.

Smoking causes [206]:

  • Heart disease
  • Stroke
  • Bladder cancer
  • Cervical cancer
  • Colon cancer
  • Diabetes
  • Esophageal cancer
  • Kidney cancer
  • Larynx cancer
  • Liver cancer
  • Lung cancer
  • Pancreatic cancer
  • Stomach cancer
  • Throat and mouth cancers

The benefits of quitting smoking

For smokers, it’s never too late to benefit from quitting.

The risk of heart disease goes down very quickly after stopping smoking. And, over time, the risk of lung and other cancers can drop to near that of someone who never smoked [206].

Talk with your health care provider about ways to quit.

There are many resources to help including:

American Cancer Society – Guide to Quitting Smoking
www.cancer.org/

American Lung Association – Freedom from Smoking
www.ffsonline.org

National Cancer Institute’s Free Help to Quit Smoking
www.cancer.gov/cancertopics/tobacco/smoking
1-877-44U-QUIT (1-877-448-7848)

National Cancer Institute’s Smokefree.gov
www.women.smokefree.gov

State Tobacco Quit Lines
1-800-QuitNow (1-800-784-8669)

U.S. Department of Defense – Quit Tobacco
www.ucanquit2.org

 

 *Please note, the information provided within Komen Perspectives articles is only current as of the date of posting. Therefore, some information may be out of date at this time.

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