Breast cancer is by far the most common cancer in women. With 55,000 cases diagnosed every year, an estimated one in eight women face the prospect of developing the disease at some point in their lives.
As consultant breast cancer surgeon at London's Royal Free Hospital, I know first-hand the impact of this illness on women and their families. But avoiding it isn't just about luck.
I have become increasingly convinced that diet and lifestyle play a part in the development of breast cancer. Making changes really can reduce your risk.
Numerous studies now show the risk of many different cancers is undoubtedly influenced by diet (particularly whether you eat enough fruit and vegetables), your weight, whether you exercise, smoke or drink alcohol.
This impact is made starkly clear when you consider that in the West, breast cancer is three times more prevalent than in Eastern Asia. But when populations migrate from areas with low breast cancer risk (such as Japan) to areas of high breast cancer risk (the U.S.) their risk of developing the disease soon rises to that of the host nation.
Numerous studies are continually analysing compounds in specific foods, but many doctors are confident the Mediterranean diet, packed with fresh fruit and vegetables, pulses, fish and olive oil, can reduce the risk of breast cancer, particularly in post-menopausal women.
Studies now show as many as 9 per cent of cancer cases could be prevented by dietary changes.
A major study led by my colleagues at the University of Westminster focuses on the effects of diet and lifestyle on the recurrence of breast cancer.
They are co-ordinating the largest dietary study to date of UK breast cancer patients, analysing the diets of more than 3,000 sufferers from 56 NHS hospitals.
Three years into this five-year study, there is strong evidence to suggest that breast cancer recurrence rates can be reduced - and survival rates improved - when patients adopt a healthy lifestyle.
Working with nutritionist Dr Claire Robertson and biochemist Dr Miriam Dwek, from the University of Westminster's Against Breast Cancer Unit, we have come up with a simple set of dietary recommendations that will improve your health - and might just save your life.
What to eat more of
Aim to eat at least five portions (400g/1 lb) of vegetables and fruit per day. Here's why:
• Vegetables and fruit are rich in antioxidants which prevent a process called oxidation (where oxygen molecules join with other chemicals to create gene damage in cells) which can lead to cancer development.
They are an excellent source of dietary fibre which, studies suggest, can reduce the risk of developing breast cancer.
• Plants such as soy contain phyto- estrogens, which mimic the oestrogen found in your body. These may modulate the body's own production of the hormone in a way that prevents cancer cell growth.
such as broccoli, Brussels sprouts, cauliflower, kale and cabbage are a particularly excellent source of plant nutrients which have been shown to prevent the formation of cancer cells and stop the spread of cancer.
Beans and pulses
are a great source of fibre, vegetable protein - which can help your body repair any damage imposed by cancer treatments - calcium, iron and B vitamins. Increase your consumption by adding canned pulses to soups, stews and salads or blitz them to make dips.
Dark leafy vegetables
such as spinach and kale and beetroot are loaded with a B vitamin which can strengthen your DNA and so reduce cancer risk.
Packed with healthy unsaturated fats, all seeds are an excellent source of omega-3s and omega-6s. They also provide soluble fibre, phytochemicals and plant sterols, which can protect against many diseases, including cancer.
Sesame seeds (either plain or toasted, as sesame oil and tahini paste) contain useful minerals and phytoestrogens that help regulate the body's oestrogen production and are known to hinder the production and spread of certain tumour cells. Sprinkle seeds over salads and add to muesli, muffins and home-made bread.
These bright green soy beans are a good source of vitamins, minerals, fibre and phytoestrogens, thought to inhibit the growth of cancer cells), and the only vegetable regarded as a complete protein food because they contain all nine essential amino acids. Find them in the freezer section. Defrost and add to salads (delicious with crumbled feta cheese and mint) or add to meat dishes to maximise the meal's nutritional value.
Beetroot is delicious eaten raw, finely shredded, roasted, or cooked and pickled. The purple colour comes from betacyanin, a compound shown in studies to have anti-carcinogenic properties. Leaves can be eaten like spinach and are packed with iron, calcium, and vitamins A, C and E.
This common herb is rich in phytochemicals and a good source of vital nutrients, including vitamins A, C and K and several B vitamins, as well as important minerals. It is thought that sage's phytochemical content may help prevent the formation of cancer and/or suppress its development.
A powerful source of the antioxidant lycopene, which has the potential to inhibit breast cancer by stopping cancer cell growth. Lycopene becomes more potent after cooking and processing, so try our recipes below.
What to eat less of
• Red meat. Saturated fat is associated with the risk of developing post- menopausal breast cancer and poorer survival after breast cancer diagnosis.
Eat less than 70-90g per day and try to avoid overcooking meat. Be careful not to char your food on a grill or barbecue as this can produce carcinogenic chemicals.
• Cakes, biscuits and pastries. Watch out for the 'hidden fats' in treats and avoid trans fatty acids (hydrogenated fat) which increase total cholesterol and lower the 'good' (HDL) cholesterol.
Refined sugar raises blood glucose levels and elevates insulin concentrations - a known risk factor for breast cancer development.
Some preservatives that are used in the production of processed meats (bacon, ham and hot dogs, for example) are thought (but not proven) to be carcinogenic.
Alcohol consumption has been linked to an increase in both the risk of developing breast cancer and the likelihood of breast cancer recurrence, even in light drinkers.
The risk increases with the volume of alcohol consumed - three or more alcoholic drinks per day can increase your risk of breast cancer by 40-50 per cent. Doctors aren't exactly sure why alcohol raises the risk of the disease but it could be that it taxes the liver, hindering its ability to remove oestrogen from the blood system.
This can lead to a rise in blood oestrogen levels, and as oestrogen can stimulate the growth of breast cells, this may raise the risk of breast cancer.
Recipes for salmon and oily fish
Oily fish such as salmon, sardines and mackerel - which are rich in omega-3 - help to decrease inflammation (and blood pressure), and provide a source of vitamin D to promote calcium uptake by the bones. Salmon may also contain natural chemopreventative agents that can inhibit or impede cancer.
Aim to eat oily fish once or twice a week:
Griddled with peaches and ginger:
Combine a 2 cm piece of fresh grated ginger with 2 tsp olive oil and rub over 4 fillets and 4 halved peaches then griddle for 6 mins (serves 4).
Cut 4 fillets into chunks and thread onto 8 skewers, then brush with a mix of 15g melted butter, 2 cm finely grated ginger and the juice of 1 lime. Grill for 6 mins (serves 4).
Flake 4 poached fillets and toss with 200g blanched peas, a handful of rocket, the zest and juice of a lemon, a handful of chopped parsley and 20g crumbled, light feta (serves 4).
Mix 2 tbsp sesame seeds with 2 tsp soy sauce and 1 tsp clear honey. Spread over 4 fillets and bake at 200c/gas 6 for 10-12 mins. Serve with steamed pak choi.
Mix 4 crushed garlic cloves, 1 tsp dried oregano, 2 tsp honey, 4 tsp balsamic vinegar and 4 tsp olive oil with 400g cherry tomatoes. Spread on baking tray. Grill for 6-8 mins (serves 4).
Spread 400g halved cherry tomatoes on baking tray. Sprinkle with 4 crushed garlic cloves, 4 tsp thyme leaves, 2 tbsp olive oil and black pepper. Roast at 140c for an hour (serves 4-6).
De-seed and chop 6 large tomatoes. Mix with a finely chopped red onion, 2 chopped red peppers, 1 chopped cucumber, 4 sliced Little Gem lettuces, a handful of chopped parsley. Dress with olive oil and red wine vinegar (serves 4-6).
Put 300g cherry tomatoes with 6 spring onions, 2 garlic cloves, 4 tsp olive oil, juice of 2 lemons, a pinch of paprika and 2 tbsp fresh herbs in a blender. Whizz until smooth.
About 5 per cent of breast cancer cases could be avoided by simply maintaining a healthy body weight. Several studies confirm exercise's link to reduced risk, possibly as it lowers oestrogen levels, modifying ways we store and process
what we eat.
- Daily Mail