Breast Cancer Prevention Starts in Childhood

According to a recent interview with Dr. Graham Colditz published by Medscape in December 2014, at least 1/2 of breast cancer cases can be prevented, largely by promoting a healthy lifestyle in girls at a young age.  In fact, Dr. Colditz has challenged us to start prevention by age 2 years old!  I recently wrote about this topic in an October 2014 article,  Breast Cancer Prevention Begins in Childhood?, but it’s worth revisiting based on the sheer magnitude of impact that a few simple preventive strategies can yield.

“Cancer risk is accumulating from before the time a girl hits menarche,” says Dr. Colditz.  Menarche is the onset of menstrual periods, which occurs at an average age of 12 years old in the US.  Therefore, clearly the emphasis on early detection and screening for breast cancer is incomplete.  Instead, our focus should be on educating parents and young women about the steps that they can take to eliminate their controllable risk factors.

Lifestyle Factors Play a Role in Cancer

In the article highlighting this interview, Dr. Colditz demonstrates that 68% of breast cancer cases are attributable to controllable lifestyle factors which are weight (32%), breastfeeding (15%), physical activity (11%), alcohol consumption (5%), diet (3%) and tamoxifen (2%).  I suspect that diet plays a larger role than is suggested in this article, especially since the diet strongly correlates with weight.

So, given that 1 in 3 American children are overweight, and that few children are exercising for the recommended sixty minutes per day, we have a lot of room for improving our children’s risk factors.  Dr. Colditz is not the only one who is making these recommendations.  The Physicians Committee for Responsible Medicine (PCRM) has been long promoting the adoption of a healthy diet in childhood for cancer prevention.  In their booklet Nutrition for Kids, they state: “Cancers of the colon, breast, and prostate are influenced by diet, exercise, and healthy weight control.  Lifelong eating habits are established in childhood, and the longer the exposure to cancer-fighting foods and the avoidance of cancer-promoting foods, the greater the likelihood that cancer won’t strike during adulthood.”

According to the Research, Protective Factors Against Breast Cancer Include:

1)      Breastfeeding

2)      Physical activity

3)      Minimizing dairy consumption

4)      Healthy weight

5)      Eating a plant-based diet

6)      Minimizing alcohol consumption

Too few parents know this information.  Sure, mothers know that breastfeeding is good for their baby, but how many know that it can significantly reduce their breast cancer risk?  This kind of information might greatly increase the motivation to breastfeed.  And how many teenagers are told that among the dangers of alcohol drinking is an increased risk of breast cancer?

I applaud Dr. Colditz for sounding the alarm about this issue.  I hope we will make it a standard part of anticipatory guidance to emphasize these preventive strategies to parents at every well child visit.

Brookes, L., Colditz, G. Breast cancer prevention starts in childhood. www.medscape.com. December 8, 2014

Physicians Committee for Responsible Medicine, Nutrition for Kids: A Dietary Approach to Lifelong Health. 2011