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

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 life.

A healthy lifestyle includes:

Some healthy behaviors are linked to a lower risk of breast cancer 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.

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 [160-164]:

  • 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 [165-167].

  • Breast cancer mortality
  • Overall mortality
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Komen Perspectives

Read Komen’s perspective on body weight and
breast cancer survival.*

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 [168-169]:

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

  • Diabetes
  • Heart disease
  • Stroke

Women who are overweight or obese may also have an increased risk of [168]:

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

Regular exercise and eating a healthy diet are the best ways to maintain a healthy weight [170].

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. 

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 [160-167]. 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) promotes overall health and may be linked to a lower risk of some cancers and other conditions such as heart disease, diabetes and osteoporosis.

  • Reach and maintain a healthy weight. People who’ve had breast cancer and 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 and candy.
  • 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.

Adapted from the American Cancer Society and the American Society of Clinical Oncology’s Breast Cancer Survivorship Care Guidelines [1].

A registered dietitian may use the term “nutrient density” when discussing diet. This is the balance of nutrients and calories in the foods and beverages you eat and drink. Nutrient dense foods have vitamins, minerals and other nutrients, with limited saturated fat, added sugars and salt.

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)

Carotenoids are natural orange-red food pigments found in fruits and vegetables such as melons, carrots and sweet potatoes. 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 by estimating carotenoids in a person’s diet.

Data on carotenoids and breast cancer survival are limited.

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 [171].

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 [172].

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 [173-174].

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 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 diet low in fat after a breast cancer diagnosis and women who ate a diet high in fat after diagnosis [172,175-177]

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 [178]. Researchers are studying whether the improved survival in the low-fat diet group may have been due to weight loss.

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

Soy

Soy foods

Studies suggest eating moderate amounts of soy foods is safe for breast cancer survivors [179-182].

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) [179-181]. 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 [180,183-184].

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 [180].

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 [180].

Soy supplements

Most studies looking at soy and breast cancer have focused on soy foods rather than soy supplements [179-184].

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 [185-186]. 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 [87-90].

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

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Komen Perspectives

Read our perspective on soy and breast cancer.*

Organic foods

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 [159].

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.

Some findings suggest women who drink alcohol after a breast cancer diagnosis may have an increased risk of [187]:

  • 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 breast cancer survivors who drink alcohol [188-192].

Drinking alcohol in moderation may be linked to a lower risk of heart disease, high blood pressure and overall mortality [193-194]. This may help explain some of the mixed findings on alcohol and mortality.

Drinking low or moderate amounts of alcohol

No one should drink a lot of alcohol.

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 these recommended limits has no health benefits and 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.

 

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Komen Perspectives

Read our perspective on alcohol and breast cancer.*

*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.

 

Many studies suggest being active may lower the risk of [195-204]:

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

How is physical activity measured?

MET (metabolic equivalent) hours are often used as a unit of measure for physical activity. One MET hour equals the energy used to sit quietly for one hour.

Different activities have different MET scores. Moderate activities, like mowing the lawn or slow dancing, range from 3 to 6 MET hours. Vigorous activities, like playing tennis or jogging, score higher than 6 MET hours. For example, walking is 3 MET hours and swimming is 7 MET hours.

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 [195].

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% lower overall mortality compared to less active survivors [195].

You may not need to do intense exercise to get a benefit. One study found activity equal to a 30-minute brisk walk several times a week, improved survival [197].

The American Cancer Society recommends breast cancer survivors [1]:

  • 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 [199]:

  • 11% lower risk of breast cancer mortality
  • 24% 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 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 [195,205].

For breast cancer survivors, physical activity is linked to [8-13,122-123,125,128,138-142-145,150,206-207]:

  • 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 [24,41-43]. (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 [44-47].

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

Learn more about lymphedema.

Growing evidence suggests smoking is linked to a lower chance of survival for women with breast cancer [208-210].

A pooled analysis of data from about 10,000 women treated for breast cancer found smoking was linked to an increased risk of [209]:

  • 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 [209].

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 [158]:

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 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 cancer and other cancers can drop to near that of someone who never smoked [211].

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.lung.org/quit-smoking/

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)

Updated 08/09/23

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