Maintaining a healthy weight
Maintaining a healthy weight is important for everyone, but it is especially important for breast cancer survivors.
Body weight and breast cancer survival
Heavier breast cancer survivors tend to have lower overall survival compared to leaner survivors [44-46]. This means they are more likely to die from any cause, not necessarily related to their cancer (called overall mortality). And, growing evidence suggests heavier survivors are also more likely to die from their breast cancer (called breast cancer-specific mortality) [44,46-47].
Weight gain after breast cancer diagnosis may also increase the risk of overall and breast cancer-specific mortality in survivors [48-50].
Body weight and breast cancer recurrence
Some findings suggest being overweight and gaining weight after treatment may increase the risk of breast cancer recurrence [45,47,51]. This means heavier women and those who gain more weight may be more likely to have their breast cancer return compared to leaner women and those who gain little or no weight.
Body weight, hormones and breast cancer
Some studies have shown breast cancer survivors with higher body weight have higher blood hormone levels than leaner survivors [52-53]. Higher blood hormone levels increase the risk of developing breast cancer and may explain the increased risk of recurrence and death among postmenopausal survivors who are overweight .
Learn more about estrogen and the risk of developing breast cancer.
Learn more about insulin, prolactin and insulin-like growth factor 1 (IGF-1) and the risk of developing breast cancer.
Body weight and other health risks
Being overweight and gaining weight also increase the risk of other health problems, such as heart disease and diabetes. Regular exercise and eating a healthy diet are the best ways to maintain a healthy weight. For more information on weight control and exercise, visit the National Heart, Lung, and Blood Institute.
Learn about body weight, weight gain and the risk of developing breast cancer.
Eating a healthy diet
Diet and breast cancer survival
At this time, we do not fully understand how diet affects survival after breast cancer. Although increased body weight and weight gain appear to reduce survival, studies on dietary factors such as fat, fiber, fruits and vegetables have had mixed results [54-59].
For example, findings from the Women's Intervention Nutrition Study showed reducing dietary fat intake may improve disease-free survival (survival without a recurrence) . Women in this study who reduced their fat intake also lost weight, which may have played a role in their improved disease-free survival . Other studies have not shown a survival benefit from a diet low in fat after treatment [57-59].
Healthy diet for breast cancer survivors
Breast cancer survivors should follow the same healthy diet recommended for everyone . This diet, outlined below, promotes overall health and may help protect against different types of cancer and other diseases [60-61].
- 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.)
- Get at least 2 ½ cups of fruits and vegetables every day.
- Choose 100 percent whole grain foods (like 100 percent whole grain breads and cereals, brown rice, popcorn and quinoa).
- Limit red meat and processed meat (choose chicken, fish or beans instead).
- Cut down on "bad" fats (saturated and trans fats), and eat more "good" fats (polyunsaturated and monounsaturated fats, like olive and canola oil).
- Get enough vitamin D and calcium every day. For women ages 51 to 70, this means 600 IU of vitamin D and 1,200 mg of calcium. For men ages 51 to 70, this means 600 IU of vitamin D and 1,000 mg of calcium.
- Take a daily multivitamin with 400 mcg of folic acid (often called folate on nutrition labels).
- If you drink alcohol, limit to less than one drink of alcohol a day (for women, and fewer than two drinks a day for men). Those who drink alcohol should try to get enough folic acid, either through a multivitamin or foods like oranges, orange juice, leafy green vegetables and fortified breakfast cereals.
Adapted from the American Cancer Society’s Guidelines on Nutrition and Physical Activity for Cancer Survivors , Washington University School of Medicine's Siteman Cancer Center’s Your Disease Risk  and Institute of Medicine’s Dietary Reference Intakes for Calcium and Vitamin D .
Physical activity (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 . Some studies suggest it may also increase breast cancer survival and lower the risk of recurrence.
The American Cancer Society’s Guidelines on Nutrition and Physical Activity for Cancer Survivors recommend breast cancer survivors :
- 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 per week
Physical activity and breast cancer survival
Some studies have shown women who are more active after a breast cancer diagnosis have an increased chance of overall survival compared to less active women [37-42].
Researchers often use MET (metabolic equivalent) hours to assess the total amount of activity a person gets. The more energy an activity requires, the higher its MET score. For example, one MET hour is the energy used to sit quietly for one hour, but walking for an 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 an hour, score higher. Adding the MET scores of different activities gives a total number of MET hours.
A pooled analysis that combined data from over 13,000 breast cancer survivors found that survivors who got between 10 or more MET hours of activity a week (roughly three or more hours of walking) had a 30 percent lower risk of death (from any cause) compared to less active survivors . Survivors who were more active also had a lower risk of death from breast cancer .
Some findings suggest women do not need to do intense exercise to get a survival benefit. One study found activity equal to a 30-minute brisk walk several times a week improved survival . Women who got more activity appeared to get more benefit .
Combining regular exercise with a healthy diet may further increase survival in breast cancer survivors .
Physical activity and breast cancer recurrence
Regular exercise may also lower the risk of breast cancer recurrence. Findings from one large study showed breast cancer survivors who got between nine and 23 MET hours of activity a week (roughly three to nine hours of walking) had a 35 to 40 percent lower risk of recurrence compared to survivors who were less active .
Other benefits of physical activity for survivors
Physical activity offers other benefits for breast cancer survivors. It can [65-69]:
- Boost positive mood
- Improve physical condition and movement
- Improve body image
- Increase sexuality
- Decrease depression
- Decrease fatigue
- Maintain bone health
Together, these things can help improve the quality of life for breast cancer survivors.
Physical activity and lymphedema
Lymphedema (LIMF-eh-DEE-ma) is a condition where fluid collects in the arm (or other area such as the hand, fingers, chest or back) causing it to swell (edema). In the past, there was some concern that exercise might increase the risk of lymphedema in breast cancer survivors and worsen symptoms in those who developed the condition. However, arm exercises (such as weight-lifting) do not appear to increase the risk of lymphedema in survivors [70-72]. Moreover, studies now show weight-lifting (in a supervised research setting) can reduce symptoms in survivors with lymphedema, as well as improve body image, sexuality and physical strength [72-74]. Talk to your health care provider before starting an exercise program to manage lymphedema.
Learn more about lymphedema.
It's never too late to adopt a healthy lifestyle
Making healthy lifestyle choices has benefits at any age. Maintaining a healthy weight, eating a balanced diet, being more active and becoming more aware of your health can be physically and mentally rewarding at any point in life.