Tips for Preventing a Recurrence of Breast Cancer

Heidi Mallis, Cancer Prevention and Treatment Fund

Women (and men) who are diagnosed with breast cancer usually focus on treatment to destroy the cancer, and many don’t consider what changes they can make to prevent the cancer from returning. They may wish they had taken better care of themselves, but think it is too late to prevent cancer. It isn’t. It’s not just the surgery, radiation, or chemo that can keep you safe after a cancer diagnosis; there is growing evidence that there are a lot of other things you can also do that will help keep cancer from coming back.

Dr. Christopher Li at the Fred Hutchinson Cancer Research Center in Seattle found that female breast cancer survivors who were obese, had a history of smoking, and drank more than seven alcoholic beverages per week, were at an increased risk of developing a second primary breast cancer (“primary cancer” refers to the place where the cancer starts).[1] For patients diagnosed with breast cancer, recurrence most commonly occurs in the opposite breast (referred to as contralateral breast cancer), not the same breast where the cancer was initially treated.[2] It is estimated that one in 25 breast cancer survivors will develop a second primary breast cancer at least six months after their initial diagnosis.[3]

Li and his colleagues found that women who were obese, had a history of smoking, and drank heavily were seven times more likely to develop contralateral breast cancer than women with a non-obese body mass index (BMI), who did not smoke, and consumed less than seven alcoholic beverages per week.[4]

If you are wondering if you or someone you love is obese, it is possible to calculate BMI using the following formula:

[Weight (lbs)/height (in)2] x 703
Say, for example, that you wanted to calculate the BMI for a person who is 5’9” and weighs 200 lbs.

Weight = 200 lbs, Height = 5’9” (69”),
Calculation = [200/(69)2] x 703 = 29.5

The resulting BMI of 29.5 could be plugged in to the standard BMI reference table to determine the weight status of a particular individual. The Centers for Disease Control and Prevention (CDC) provides the following BMI guidelines:

BMI Weight Status
Below 18.5
18.5 – 24.9
25.0 – 29.9
30.0 and Above

From this table, you can see that 29.5 would be considered “obese.”

The Bottom Line

Maintaining a healthy weight through diet and exercise can prevent breast cancer, and can also prevent breast cancer from returning. Breast cancer survivors have a much higher risks—two to six times greater risk—of developing a second breast cancer than women in the general population have of developing a first breast cancer. The study by Dr. Li and his colleagues shows very clearly that many women can reduce that risk by quitting smoking, maintaining a healthy weight or losing weight, and avoiding excessive consumption of alcoholic beverages.


  1. National Cancer Institute (2004). Metastatic cancer: Questions and answers. U.S. National Institutes of Health. September 1, 2004. (Accessed September 25, 2009).
  2. Wedam SB, Swain SM (2005). Contralateral breast cancer: Where does it all begin? Journal of Clinical Oncology, July 2005; 23(21): 4585-4587.
  3. Kurian AW, McClure LA, John EM, Horn-Ross PL, Ford JM, Clarke CA (2009). Second primary breast cancer occurrence according to hormone receptor status. Journal of the National Cancer Institute, August 5, 2009; 101(15):1058-1065.
  4. CI, Daling JR, Porter PL, Tang MT, Malone KE (2009). Relationship between potentially modifiable lifestyle factors and risk of second primary contralateral breast cancer among women diagnosed with estrogen receptor-positive invasive breast cancer. Journal of Clinical Oncology, September 8, 2009. (Accessed September 16, 2009).