Yes, breastfeeding can reduce the risk of developing breast cancer. It is postulated that breastfeeding reduces the ovulatory cycle. This reduces a woman’s lifetime exposure to hormones that are linked to an increased risk of breast cancer.

A low-fat diet (food that derives 30% or less of the calories from fat) with plenty of fruits, vegetables and whole grains can help reduce the risk of developing breast cancer. A high-fat diet increases the risk because fat triggers estrogen production which can fuel tumour growth. Exercise boosts the immune system and helps keep the weight in check. With as little as three hours of exercise per week, or about 30 minutes a day, a woman can lower her risk of developing breast cancer by 10-20%.

Excessive alcohol intake is linked to an increased risk of breast, gastrointestinal, lung, head and neck cancers. Women who have more than one alcoholic drink per day have a higher risk of developing breast cancer than women who do not drink alcohol. The risk can be increased by 10-15%.

There is a slight increase risk of breast cancer for women who are current or recent users of oral contraceptive pills. This risk gradually decreases upon discontinuation, and within 2-5 years. The risk of developing breast cancer is similar to that of women who have never taken oral contraceptives.

During menopause, a woman’s body significantly reduces the production of estrogen. This decrease in estrogen may cause hot flushes, bone loss, vaginal dryness, and mood swings. To lessen the side effects, doctors may prescribe HRT. The combined use of HRT (i.e. estrogen and progesterone) has been shown to increase breast cancer risk, with higher risk associated with prolonged use. HRT is not recommended for breast cancer patients.

Most breast and ovarian cancers are sporadic. However, if there is a strong family history of multiple cancers, this suggests that there may be a genetic mutation that is passed from generation to generation. If a woman has inherited this mutation, she may have an increased risk of developing ovarian and breast cancer.

Studies have not found a link between antiperspirants and breast cancer.

Injury to the breast does not cause breast cancer. In some cases, the breast may become bruised after an injury, and scar tissue may form. However, if you are still concerned about a lump in your breast, consult with your doctor.

There is no evidence to suggest that wearing underwired bras (or any type of bras) will cause breast cancer.

Fibrocystic breast changes are likely caused by hormonal changes. They are common, benign (noncancerous) and do not increase the risk for breast cancer. Women with this condition may notice lumpiness and breast discomfort, which vary with the menstrual cycle.

Breast density is a term that describes the relative amount of different breast tissues seen on mammograms. Breast tissue is composed of glandular tissue (tissue that produces milk), connective tissue (supportive tissue) and adipose (fatty) tissue. Women with dense breasts have high amounts of glandular and connective tissue and a relatively low amount of fatty tissue. Women with dense breasts have a higher risk of developing breast cancer. Dense breasts also make it more challenging to detect abnormal breast changes on mammograms. Women with dense breasts may need to be followed up more closely.

Exercise recommendations include the following :

• Daily stretching exercises to help stop scar tissue from building up, which can limit your shoulder’s range of motion.
• Can start aerobic activities such as brisk walking as soon as you have medical clearance from your doctor.
• Complex decongestive therapy (CDT) is a four-fold conservative treatment which includes Manual lymphatic drainage (MLD), compression therapy (consisting of compression bandages, compression sleeves, or other types of compression garments), skin care, and lymph-reducing exercises (LREs).
• Manual lymphatic drainage, a type of hands-on therapy, is frequently used in the management of breast cancer related lymphoedema.
• Upper extremity exercises and diaphragmatic breathing can help to reduce the development of lymphedema.
• Research has shown that progressive resistance training can be safe and may assist in preventing lymphedema. Usually the exercise training is an individualised program and may need supervision during the initial post surgery period . Resistance exercises focus on large muscles groups and is performed 2 to 3 times a week.
• Resistance exercise or strength training improves functional capacity and augments muscular strength to offset the deleterious effects of cancer treatments.
• Commonly reported risk factors for lymphedema include obesity / overweight and routine exercises & healthy diet will help to maintain ideal body weight.
• General exercise guidelines and advice :
  • Avoid inactivity
  • Moderate intensity level aerobic exercises ( eg. Brisk walking / Stationary bike / slow jog)
  • At least 3 times a week for a minimum of 30 min per session
  • Resistance exercise at least 2 times a week of a minimum of 2 sets of 8 to 15 repetitions for each muscle group using weights or resistance. ( Eg. Arm curls , shoulder lifts )
  • Please seek professional advice if need further details.

Post operative exercises must be advised. Resumption of activities should be coordinated with the multi disciplinary team including the physicians and the therapist.

During post breast cancer treatment, women may experience any of the following impairments or problems:

• Decreased strength of the upper extremity
• Decreased shoulder mobility
• Scar tightness (breast and/or axilla)
• Upper extremity ache
• Lymphedema of the upper extremity
• Neuropathic pain
• Musculoskeletal pain (breast, axilla, and/or neck-shoulder)
• Chronic pain

Exercises and other interventions facilitate to counter measure the above impairments and aim to achieve better quality of life.