Breast cancer remains a significant health concern in Singapore and Asia, affecting women across all age groups. While advances in detection and treatment have improved survival rates, understanding the role of lifestyle factors is crucial in prevention efforts. In this article we delve into the dynamics of breast cancer and how dietary and lifestyle choices can influence its occurrence.
In Singapore, breast cancer is the most common cancer among women with one in 13 women estimated to develop it in their lifetime. In the US, 1 in 8; in the UK, 1 in 7. While genetics are thought to be involved in about 5 to 10% of cases, environmental and lifestyle factors contribute significantly to its incidence. Studies show that maintaining a healthy weight, regular physical activity and a balanced diet can reduce the risk of breast cancer, even in those with a genetic predisposition. Conversely, factors like being overweight, excessive alcohol consumption, smoking, a high (saturated) fat and processed food diet are all linked to increased risk.
Lowering one’s BMI to less than 25 reduces breast cancer risk by 16.2%
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise or lifestyle, especially if you are under treatment. Links to supporting studies and resources are found at the end of page.
Singapore's culinary landscape offers a rich mix of cuisines, many of which can be beneficial in reducing the risk of breast cancer. Traditional Asian diets rich in vegetables, fruit, fish, soy and whole grains provide essential nutrients and antioxidants that protect against cancer. When we say ‘traditional’, this refers to simple kampung (village) cuisine rather than ‘modern’ rich, meat heavy festive or celebratory foods. Regular consumption of soy seems to provide protective benefits from its isoflavone content (naturally occurring chemical compounds) but be sure to eat soy foods rather than isoflavone supplements.
Conversely, the adoption of modern Western dietary patterns, characterised by high intake of processed foods, red meat and sugary beverages, elevates the risk of breast cancer. Ultra-processed foods often lead to weight gain and contain additives and preservatives that could disrupt hormones and gut health, cause inflammation and increase cancer risks. Limiting processed foods and opting for fresh, whole foods mitigates these risks.
Studies show that diets rich in cruciferous vegetables, fruit, green tea, soy products and tofu protect against cancer.
Regular physical activity is another crucial factor in breast cancer prevention. In Singapore sedentary lifestyles are prevalent due to long working hours and urbanisation. Engaging in activities such as climbing stairs instead of using the lift, brisk walking, jogging or yoga not only help in maintaining a healthy weight but also reduces the risk of breast cancer by regulating stress levels, boosting the immune system and keeping weight in check. How much to do? As much as you have time for. Building up to or achieving the ‘standard’ exercise recommendations is important. Find something that you enjoy, by yourself or with friends, and do it!
Stress and work-life balance have a significant role to play. While stress does not appear to be directly linked to breast cancer risk, stress affects healthy habits and lifestyle. Women often not only manage their careers but also take on the bulk of time-consuming and stress inducing responsibilities in family care. This can include their children, spouse and their elderly parents in this rapidly ageing society. It is important to understand that we first need to be well to provide care for others.
Breast cancer remains a pressing health issue in Singapore and Asia, but lifestyle modifications can play a crucial role in prevention. Don’t neglect conducting a monthly self-breast examination and go for your mammogram screening. Amidst our tall buildings and the pressures of daily living, Singapore provides opportunities for healthy eating, exercise and health. However, we need to prioritise guilt-free self-care and take the first, often most difficult, steps towards finding balance and living a healthier lifestyle.
Live Well,
Felicia
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Related Resources
Studies
van Die MD, Bone KM, Visvanathan K, Kyrø C, Aune D, Ee C, Paller CJ. Phytonutrients and outcomes following breast cancer: a systematic review and meta-analysis of observational studies. JNCI Cancer Spectr. 2024 Jan 4;8(1):pkad104. doi: 10.1093/jncics/pkad104. PMID: 38070485; PMCID: PMC10868383.
Hurtado MD, Tama E, D'Andre S, Shufelt CL. The relation between excess adiposity and breast cancer in women: Clinical implications and management. Crit Rev Oncol Hematol. 2024 Jan;193:104213. doi: 10.1016/j.critrevonc.2023.104213. Epub 2023 Nov 24. PMID: 38008197; PMCID: PMC10843740.
Gopinath A, Cheema AH, Chaludiya K, Khalid M, Nwosu M, Agyeman WY, Bisht A, Venugopal S. The Impact of Dietary Fat on Breast Cancer Incidence and Survival: A Systematic Review. Cureus. 2022 Oct 6;14(10):e30003. doi: 10.7759/cureus.30003. PMID: 36381753; PMCID: PMC9637429.
Lin L, Koh WL, Huang Q, Lee JK. Breast Cancer Information Behaviours and Needs among Singapore Women: A Qualitative Study. Asian Pac J Cancer Prev. 2021 Jun 1;22(6):1767-1774. doi: 10.31557/APJCP.2021.22.6.1767. PMID: 34181332; PMCID: PMC8418835.
Ho PJ, Lau HSH, Ho WK, Wong FY, Yang Q, Tan KW, Tan MH, Chay WY, Chia KS, Hartman M, Li J. Incidence of breast cancer attributable to breast density, modifiable and non-modifiable breast cancer risk factors in Singapore. Sci Rep. 2020 Jan 16;10(1):503. doi: 10.1038/s41598-019-57341-7. PMID: 31949192; PMCID: PMC6965174.
Wei Y, Lv J, Guo Y, Bian Z, Gao M, Du H, Yang L, Chen Y, Zhang X, Wang T, Chen J, Chen Z, Yu C, Huo D, Li L; China Kadoorie Biobank Collaborative Group. Soy intake and breast cancer risk: a prospective study of 300,000 Chinese women and a dose-response meta-analysis. Eur J Epidemiol. 2020 Jun;35(6):567-578. doi: 10.1007/s10654-019-00585-4. Epub 2019 Nov 21. PMID: 31754945; PMCID: PMC7320952.
Xiao Y, Xia J, Li L, Ke Y, Cheng J, Xie Y, Chu W, Cheung P, Kim JH, Colditz GA, Tamimi RM, Su X. Associations between dietary patterns and the risk of breast cancer: a systematic review and meta-analysis of observational studies. Breast Cancer Res. 2019 Jan 29;21(1):16. doi: 10.1186/s13058-019-1096-1. PMID: 30696460; PMCID: PMC6352362.
Fiolet T, Srour B, Sellem L, Kesse-Guyot E, Allès B, Méjean C, Deschasaux M, Fassier P, Latino-Martel P, Beslay M, Hercberg S, Lavalette C, Monteiro CA, Julia C, Touvier M. Consumption of ultra-processed foods and cancer risk: results from NutriNet-Santé prospective cohort. BMJ. 2018 Feb 14;360:k322. doi: 10.1136/bmj.k322. PMID: 29444771; PMCID: PMC5811844.
Messina M. Impact of Soy Foods on the Development of Breast Cancer and the Prognosis of Breast Cancer Patients. Forsch Komplementmed. 2016;23(2):75-80. doi: 10.1159/000444735. Epub 2016 Apr 12. PMID: 27161216.
Lahart IM, Metsios GS, Nevill AM, Carmichael AR. Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncol. 2015 May;54(5):635-54. doi: 10.3109/0284186X.2014.998275. Epub 2015 Mar 9. PMID: 25752971.
Wu YC, Zheng D, Sun JJ, Zou ZK, Ma ZL. Meta-analysis of studies on breast cancer risk and diet in Chinese women. Int J Clin Exp Med. 2015 Jan 15;8(1):73-85. PMID: 25784976; PMCID: PMC4358431.
Butler LM, Wu AH, Wang R, Koh WP, Yuan JM, Yu MC. A vegetable-fruit-soy dietary pattern protects against breast cancer among postmenopausal Singapore Chinese women. Am J Clin Nutr. 2010 Apr;91(4):1013-9. doi: 10.3945/ajcn.2009.28572. Epub 2010 Feb 24. PMID: 20181808; PMCID: PMC2844682.
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