Diet, lifestyle and breast cancer recurrence

1. Can diet and lifestyle reduce the risk of recurrence?
2. Diet and breast cancer recurrence
3. Special ‘cancer diets'
4. Alcohol and breast cancer recurrence
5. Smoking and breast cancer recurrence
6. Physical activity and breast cancer recurrence

1. Can diet and lifestyle reduce the risk of recurrence?

You may have heard that diet and lifestyle can affect the risk of breast cancer coming back, also known as recurrence.

The World Cancer Research Fund recommends that women who have had breast cancer follow advice to reduce their risk of cancer coming back. This includes eating a healthy diet that is high in fibre and low in saturated fats, being physically active, maintaining a healthy weight and limiting alcohol (if consumed at all).

2. Diet and breast cancer recurrence

High-fibre foods

There is some evidence that fibre may reduce the risk of breast cancer recurrence, but more research is needed.

Experts think fibre has many health benefits including improving digestive health and helping to prevent heart disease and some cancers.

High-fibre foods tend to be lower in calories and can help you feel full up for longer. They include:

• Wholegrain foods such as brown rice, oats, wholewheat couscous and quinoa
• Pulses such as lentils and beans
• Starchy foods such as potatoes and sweet potatoes, preferably with their skins on
• Vegetables and fruits

Saturated fat

As with fibre, there is some evidence that saturated fat may affect the risk of recurrence, but again more research is needed.

It’s a good idea to limit the amount of fat you eat, particularly saturated fat, because it increases the risk of conditions such as heart disease.

Foods that are high in saturated fat include:

• Butter
• Fatty cuts of meat
• Processed meats such as sausages
• Full-fat dairy products, including whole milk, cream and hard cheese
• Chocolate, biscuits and cakes

Try to replace these with healthier unsaturated fats found in foods such as:

• Olive oil, rapeseed oil and their spreads
• Oily fish such as salmon and mackerel 
• Avocados
• Nuts and seeds

If you’re having foods that contain saturated fats, choose ones with lower saturated fats. For example, choose lower-fat dairy products such as skimmed milk, low-fat yoghurts, lower-fat cheeses like feta, and leaner meats such as chicken and turkey.

Soy and foods that contain phytoestrogens

Soy foods such as soy milk and tofu contain natural compounds called phytoestrogens. Foods such as chickpeas and linseeds also contain phytoestrogens.

Phytoestrogens have a chemical structure that is similar to the hormone oestrogen. As oestrogen can stimulate some breast cancers to grow, some people worry whether foods or supplements containing phytoestrogens might have the same effect as oestrogen and increase the risk of recurrence.

Current evidence suggests that a diet containing naturally occurring phytoestrogens is safe if you’ve had breast cancer and may be beneficial.

Phytoestrogens are also found in herbal remedies including:

• Black cohosh
• Red clover
• Sage

These are sometimes taken to relieve hot flushes and other menopausal symptoms. However, they are not recommended because the evidence on their effectiveness and safety is limited and conflicting.

Organic foods

Some people choose to eat organic foods as a way of reducing pesticides in their diet. However, no association has been found between eating an organic diet (before or after diagnosis) and the risk of breast cancer recurrence.

Superfoods

The term ‘superfood’ has been used to describe foods that are apparently beneficial for preventing or treating a range of health conditions.

So-called ‘superfoods’ include:

• Blueberries
• Raspberries
• Green tea
• Broccoli

There is no evidence that any single food can reduce the risk of breast cancer developing or coming back in someone who has been diagnosed. The EU has banned food companies from making health claims on their packaging unless they are supported by scientific evidence.

Find out more about diet and breast cancer.

3. Special ‘cancer diets’

Some people who have had breast cancer consider following a special diet. This may be because they believe it could reduce the risk of recurrence. These diets often encourage eating or avoiding certain types of food.

There’s no conclusive evidence that they reduce the risk of breast cancer recurrence.

Special diets can often be very restricting, expensive and can sometimes lead to a lack of nutrients. This may result in other conditions such as anaemia (too few red blood cells in the body), or bone conditions such as osteopenia or osteoporosis.

If you’re thinking about changing your diet or want to find out more about different diets, you may find it helpful to talk to your treatment team or a dietitian.

The Bristol Whole Life Approach to healthy eating

The Bristol Whole Life Approach to healthy eating is a set of dietary guidelines for people living with and beyond cancer. The guidelines mainly focus on eating foods that have not been altered. For example, they suggest:

• Eating brown rice instead of white rice
• Including a range of different colour vegetables and fruit in your diet
• Animal products permitted only in small amounts

The Bristol Whole Life Approach to healthy eating aims to help people eat healthily and cope better with the physical and emotional impact of cancer. However, there is no evidence that following these recommendations will reduce the risk of breast cancer recurrence. 

The recommendations were developed by Penny Brohn UK.

Dairy-free diet

Some people with breast cancer are concerned about eating dairy foods and believe that following a dairy-free diet will reduce their risk of recurrence.

In a dairy-free diet, dairy foods are avoided altogether and are replaced with non-dairy alternatives such as soy products, and almond and rice milks.

There’s no conclusive evidence that following a dairy-free diet will reduce the risk of breast cancer recurrence. As dairy foods are one of the main sources of calcium it’s still important to include non-dairy foods that contain the calcium the body needs. Find out what foods are high in calcium.

Macrobiotic diet

A macrobiotic diet is high in wholegrains and low in fat and protein. There are different types of macrobiotic diets and some are stricter than others. They may also include guidelines on how food is prepared, your lifestyle and environment.

This diet can be strict and is often low in calories, calcium, iron, B vitamins and other nutrients, so may not be suitable and possibly harmful. Speak to your dietitian or treatment team for advice.

Overnight fasting

Some research has suggested that overnight fasting of 13 or more hours may reduce the risk of recurrence but further research is needed to find out more.

If you’re thinking about fasting, always talk to your treatment team or GP first.

4. Alcohol and breast cancer recurrence

Studies have shown drinking alcohol increases the risk of getting breast cancer. It’s less clear if drinking alcohol affects the prognosis (outlook) of breast cancer.

NICE (National Institute for Health and Care Excellence) recommends people who’ve had breast cancer limit their alcohol intake to below 5 units a week.

You can find out how many units are in your drinks by using an online unit calculator. As a general guide:

• Half a pint of average-strength (4%) beer = 1 unit
• A 175ml glass of wine (12.5%) = 2 units
• A single 25ml measure of spirits (40%) = 1 unit

It’s worth bearing in mind that alcohol is also high in calories. 

5. Smoking and breast cancer recurrence

There is emerging evidence that smoking may affect the risk of breast cancer recurrence but further research is needed to find out more.

We know smoking causes a range of health conditions. If you want to stop smoking there are a range of programmes to help. Speak to your pharmacist, GP or practice nurse for advice.

6. Physical activity and breast cancer recurrence

Physical activity may reduce the risk of recurrence but more research is needed to find out more.

Regular physical activity can help improve your long-term health, and has been shown to reduce the risk of health conditions such as heart attacks, strokes and some cancers.