Breast cancer is responsible for the deaths of around 46,000 women in the U.S. each year. Most women are aware that early detection measures such as self breast exam and mammograms have led to more effective treatment of breast cancer. What is less well known, or practiced, are the lifestyle measures to reduce the risk of developing breast cancer. Some things you can't avoid when it comes to breast cancer risk, such as your age, genetic makeup and environmental exposures. But other breast cancer risk factors are well within your control. Granted, these measures are relatively few in number as compared to preventive measures for heart disease, and to some degree not as well studied, but should provide encouragement to women who want to reduce their risk as much as possible. Today's "Health Tip" will look at some of these modifiable risk factors. Employing preventive health measures can't guarantee that you won't develop breast cancer, but it's a step in the right direction.

results. Theoretically, there are dietary measures that can decrease free radical formation and reduce the risk of developing breast cancer. These include:

Diets rich in vegetables and fruits
Diets low in fats, and red and overcooked meats
Reasonable intake of anti-oxidants such as vitamins E and C

Alcohol  Use of alcohol is linked to a slightly increased risk of getting breast cancer. Women who have 1 drink a day have a very small increased risk. Those who have 2 to 5 drinks daily have about 1 1/2 times the risk of women who drink no alcohol. The American Cancer Society suggests limiting the amount you drink.

estrogen may increase the risk of breast cancer in these women. The big question is how much exercise is needed. One study found that as little as 1 hour and 15 minutes to 2 and a half hours per week of brisk walking reduced the risk by 18%. Walking 10 hours a week reduced the risk a little more. The American Cancer Society guidelines for nutrition and physical activity recommend that you engage in 45 to 60 minutes of intentional physical activity 5 or more days a week.

Smoking  A definite link between cigarette smoking and breast cancer has yet to be established. Lung cancer, which does have a direct link to cigarette smoking, is responsible for more cancer-related deaths in U.S. women each year than is breast cancer. That is more than ample reason to encourage women to quit smoking.

Not surprisingly, most of these lifestyle issues also play a role in determining your risk of developing coronary heart disease. As many "Health Tip" readers know already, coronary heart disease, not breast cancer is the leading cause of death in women. In fact, heart disease is responsible for more deaths among women than the next 6 leading causes of death combined--including all forms of cancer.

One question that we commonly receive relates to how hormone replacement therapy affects breast cancer risk. Results from the largest study to date on this topic, the Women's Health Initiative http://www.nhlbi.nih.gov/whi/, has shown that in post-menopausal women, long-term use of combined hormone therapy (estrogens together with progesterone) increases the risk of breast cancer as well as the risk of heart disease, blood clots, and strokes. Five years after stopping this combined therapy, the breast cancer risk appears to drop back to normal. Estrogen replacement alone, usually only used in women who have had a hysterectomy, does not seem to increase the risk of breast cancer as much, if at all.