Healthy Lifestyle for People Who’ve Had Breast Cancer

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 point in your life.

A healthy lifestyle includes:

• Maintaining a healthy weight
• Eating a healthy diet
• Limiting alcohol
• Getting physical activity (exercise)
• Not smoking

For breast cancer survivors, some healthy behaviors are linked to a lower risk of recurrence and improved survival. Others are part of a lifestyle linked to a lower risk other cancers and a lower risk of health conditions such as heart disease, diabetes and osteoporosis.

Watch our video of Komen Scholar Dr. Jennifer Ligibel who talks about living a healthy lifestyle after breast cancer treatment.

Maintaining a healthy weight

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 and survival

After treatment for breast cancer, being overweight or obese is linked to an increased risk of [176-180]:

• 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 and survival

Weight gain after breast cancer diagnosis may be linked to an increased risk of [181-183].

• Breast cancer mortality
• Overall mortality

Other health risks of being overweight or obese

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

Women who are overweight or obese have an increased risk of many cancers and other health conditions, including [184-185]:

Cancers

• Breast cancer
• Colon and rectal cancer
• Endometrial (lining of the uterus) cancer
• Esophageal cancer
• Gallbladder cancer
• Kidney cancer
• Liver cancer
• Meningioma (cancer in the lining of the brain and spinal cord)
• Multiple myeloma (cancer of the plasma cells)
• Ovarian cancer
• Pancreatic cancer
• Stomach cancer
• Thyroid cancer

Other health conditions

• Heart disease
• Stroke
• Type 2 diabetes

Women who are overweight or obese may also have an increased risk of [185]:

• Mouth, throat and voice box cancers
• Non-Hodgkin lymphoma

Regular exercise and eating a healthy diet are the best ways to achieve and maintain a healthy weight [185].

Achieving and maintaining a healthy weight can be hard. Your health care provider can help you find healthy ways to manage your weight.

Eating a healthy diet

Diet and survival

We don’t fully understand how diet is related to survival after breast cancer.

Women who are overweight or obese (and those who gain weight) after a breast cancer diagnosis have worse survival than those who are lean [176-183]. However, there’s no specific type of diet, dietary pattern or nutrient proven to be linked to breast cancer 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 people who’ve had breast cancer.

Learn more about diet and breast cancer.

Healthy diet

People who’ve had breast cancer can benefit from the same healthy diet recommended for everyone.

This diet outlined below is good for your overall health and may be linked to a lower risk of some cancers and other conditions such as heart disease, diabetes and osteoporosis.

• Achieve and maintain a healthy weight. People diagnosed with breast cancer who are overweight or obese should limit high-calorie foods and beverages and increase physical activity to help with weight loss.
• Eat at least 2½-3 cups of vegetables and 1½-2 cups of fruit every day. Eat a variety of vegetables and fruits. Include dark green, red and orange vegetables as well as legumes, such as beans, lentils, peas and soy foods.
• Choose 100% whole grain foods such as 100% whole grain breads and cereals, brown rice, millet and quinoa.
• Eat “good” fats (polyunsaturated and monounsaturated fats). These are found in foods such as olive and avocado oil, nuts and natural nut butters, olives and avocados.
• Limit or avoid red meat and processed meat, such as beef, bacon and sausage. Choose chicken, fish or beans more often for good sources of protein.
• Limit or avoid sugar-sweetened beverages. Choose water or unsweetened beverages more often.
• Limit or avoid highly processed foods and refined grain products, such as fast food, ready-to-heat foods, packaged snack foods, candy and other food high in added sugars.
• Avoid alcohol. For those who choose to drink alcohol, limit to less than 1 drink a day for women and fewer than 2 drinks a day for men.

Find a graphic of these guidelines.

Adapted from the American Cancer Society’s Nutrition and Physical Activity Guideline for Cancer Survivors [10].

Fred Hutchinson Cancer Center’s Cook for Your Life website offers recipes, cooking videos and nutrition and health information in English and Spanish.

Carotenoids (found in fruits and vegetables) and survival

Carotenoids are natural orange-red pigments found in fruits and vegetables such as melons, carrots and sweet potatoes. Dark, leafy green vegetables such as broccoli, spinach and kale also contain carotenoids. Many carotenoids, such as beta-carotene, are antioxidants and can be converted into vitamin A in the body.

Researchers can study carotenoids in a few ways. They can measure levels of carotenoids in a person’s blood or estimate carotenoids in a person’s diet.

Data on carotenoids and breast cancer survival are limited.

Learn about carotenoids and breast cancer risk.

Studies of blood levels of carotenoids

One 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 [186].

Studies of dietary intake of carotenoids

One study of more than 4,000 breast cancer survivors 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 [187].

Note of caution on carotenoid supplements

Carotenoid supplements, such as beta-carotene supplements, may have some health risks.

A few studies have found taking a daily beta-carotene supplement may be linked to an increased risk of lung cancer and early death in smokers [188-189].

Fruits and vegetables are the best sources of carotenoids (rather than supplements) and are part of a healthy diet.

Dietary fat and survival

Researchers are studying whether eating a low-fat diet after a breast cancer diagnosis is linked to improved survival. Findings are mixed.

Most studies (including 2 randomized controlled trials) show no difference in survival between women who ate a low-fat diet after a breast cancer diagnosis and women who ate a high-fat diet after diagnosis [187,190-192].

However, findings the Women’s Health Initiative Dietary Modification Trial (a randomized controlled trial) showed women who reduced dietary fat after a breast cancer diagnosis had better survival than women who did not reduce dietary fat [193]. Researchers are studying whether the improved survival in the low-fat diet group may have been due to weight loss.

Learn about dietary fat and breast cancer risk.

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

Fruits, vegetables and survival

Researchers are studying whether eating a lot of fruits and vegetables after a breast cancer diagnosis is linked to improved survival. Findings are mixed.

A few studies suggest a diet high in fruits and vegetables may be linked to a lower risk of breast cancer recurrence and improved survival [195-196]. Other studies show no link with eating fruits and vegetables and breast cancer survival (but a possible link between eating vegetables and overall survival) [197].

Learn about fruits, vegetables and breast cancer risk.

Soy and survival

Soy foods

Studies suggest eating moderate amounts of soy foods is safe for breast cancer survivors [197-201].

Some studies have found eating a diet high in soy may be linked to a decreased risk of breast cancer recurrence and breast cancer mortality (death from breast cancer) [197-199,201]. 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 [198,202-203].

One analysis combined data from 3 large studies of breast cancer survivors from 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% lower risk of breast cancer recurrence compared to those who ate little or no soy [198].

Eating soy isn’t recommended as a way to try and lower the risk of breast cancer recurrence.

Questions remain about study findings on soy and breast cancer survival. For example, women who regularly eat soy tend to be healthier than those who don’t, which may account for the survival benefit shown in some studies [198].

Learn about soy and breast cancer risk.

Soy supplements

Most studies looking at soy and breast cancer have focused on soy foods rather than soy supplements [197-203].

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) is not found in nature. Isolates, such as 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 [204-205]. So, soy supplements are not recommended for people who’ve had breast cancer.

Soy and hot flashes

Soy foods and soy supplements have been suggested as ways to relieve hot flashes.

Findings from randomized controlled trials are mixed. Some show soy can reduce hot flashes, while others do not [99-102].

Learn about ways for women who’ve had breast cancer to treat hot flashes and other menopausal symptoms.

Organic foods

Some people prefer to eat organic foods. However, according to the American Cancer Society’s Diet and Physical Activity Guidelines for Cancer Prevention, research shows organic foods are no more nutritious or better for you than foods farmed by conventional methods [173].

Fruits and vegetables (both organic and conventional) are part of a healthy diet. Buying fresh (or frozen) conventional produce and thoroughly washing and rinsing it before eating is always a good practice.

Learn more about organic foods.

Limiting alcohol

Alcohol and survival

Some findings suggest women who drink alcohol after a breast cancer diagnosis may have an increased risk of [206]:

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

However, most studies show no increased risk of death from breast cancer or any cause for breast cancer survivors who drink alcohol [207-212].

Drinking low or moderate amounts of alcohol

No one should drink a lot of alcohol.

Studies show drinking alcohol in moderation may be linked to a lower risk of heart disease, high blood pressure and death [213-214].

However, the American Cancer Society and the American Society of Clinical Oncology recommend cancer survivors limit alcohol intake to less than 1 drink a day for women and fewer than 2 drinks a day for men [1]. Drinking more alcohol than this has no health benefits and is linked to many serious health risks.

After talking with your health care provider, make informed choices about drinking alcohol.

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

 

Getting Physical Activity (Exercise)

Listen to our Real Pink podcast, Choices to Lower Breast Cancer Risk.

Physical activity and survival

Many studies show being active is linked to a lower risk of [215-223]:

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

Learn about physical activity and breast cancer risk.

How much activity gives a benefit?

The American Cancer Society recommends breast cancer survivors [10]:

• 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 pooled analysis that combined data from over 23,000 breast cancer survivors compared those who got the recommended 150 minutes of exercise per week to those who got less than 45 minutes of exercise per week. This study found survivors who got 150 minutes of exercise per week had a [222]:

• 30% lower risk of breast cancer mortality
• 40% lower risk of overall mortality

You may not need to do intense exercise to get some benefit. One study found activity equal to a 30-minute brisk walk several times a week, improved survival [215].

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

Other benefits of exercise

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 [224].

For breast cancer survivors, physical activity is linked to [7-13,137-138,159-160,165]:

• Improved body image
• Improved mood
• Improved physical condition and movement
• Improved quality of life
• Increased sexuality
• Increased energy
• Better bone health
• Reduced fatigue
• Reduced stress and anxiety
• Reduced distress and depression

Physical activity and lymphedema

In the past, there was some concern exercise might increase the risk of lymphedema after breast cancer surgery and worsen symptoms in those who already had lymphedema.

However, after recovery from breast surgery, arm exercises (such as weight-lifting) don’t appear to increase the risk of lymphedema [26-27,44-46]. (It’s best to avoid strenuous exercise right after breast surgery though.)

Studies also show moderate weight-lifting in a supervised setting can reduce symptoms of lymphedema in breast cancer survivors, as well as improve body image, sexuality and physical strength [47-50].

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

Learn more about lymphedema.

Tips to increase physical activity

Being active is good for your health, but it can be hard to find time to exercise.

Do any activity you enjoy that gets you moving (for example, dancing or gardening).

The tips below may help you become more active. If you can, [249]:

• Use stairs rather than an elevator.
• Walk or bike instead of driving.
• Park farther away from a store.
• Take your pet for a walk.
• Exercise at lunch or take a break to stretch.
• Take a quick walk.
• Plan active vacations.
• Wear a device every day to keep track of your steps.
• Join a recreational sports team.
• Use a stationary bicycle or treadmill while watching TV.

Not Smoking

Smoking and survival

Growing evidence suggests smoking is linked to a lower chance of survival for women with breast cancer [225-227].

A pooled analysis of data from about 10,000 women treated for breast cancer found smoking was linked to an increased risk of [226]:

• Breast cancer recurrence (a return of breast cancer)
• 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 tended to be [226].

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

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 is related to an increased risk of many cancers and other health conditions, including [228]:

Cancers

• Bladder cancer
• Breast cancer
• Cervical cancer
• Colon cancer
• Esophageal cancer
• Kidney cancer
• Larynx cancer
• Liver cancer
• Lung cancer
• Pancreatic cancer
• Stomach cancer
• Throat and mouth cancers

Other health conditions

• Diabetes
• Heart disease
• Stroke

The benefits of quitting smoking

For people who smoke, it’s never too late to benefit from quitting. Talk with your health care provider about ways to quit.

There are many resources to help including:

American Cancer Society – How to Quit Using Tobacco
www.cancer.org/

American Lung Association – Quit Smoking
www.lung.org/quit-smoking/

National Cancer Institute – Cigarette Smoking: Health Risks and How to Quit
www.cancer.gov/
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)