The Daily Telegraph - Features

I’m a cancer surgeon – here’s what all women should know

The disease is linked to alcohol, exercise and weight, says breast cancer expert and survivor Liz O’Riordan

As a breast surgeon who was diagnosed with breast cancer at just 40 years old, I’m glad to see that The Lancet Breast Cancer Commission published earlier this month, highlighti­ng the link between breastfeed­ing, alcohol and breast cancer, is making waves. The more awareness we can raise of how lifestyle factors reduce our risk of breast cancer, the better.

The report, put together over three years by a team of global experts, oncologist­s, statistici­ans and researcher­s, predicted that by 2040, more than three million people will be diagnosed with breast cancer every year. More crucially it outlined how, in developed countries, 25 per cent of these cases could be prevented if we act now.

The biggest risk factors for getting breast cancer are out of our control: being female and getting older. What we can control is alcohol consumptio­n, breastfeed­ing, to an extent, exercise and how much we weigh. If we increase education and community awareness to help women and men make sensible lifestyle choices, over one in five global breast cancer deaths could be avoided. ALCOHOL I wouldn’t have listened to anyone who told me not to drink so much when I was in my 20s. Like many young adults, it was how I decompress­ed after a hard day on the wards. I drank to fit in. I drank to have fun. I drank to let my hair down. At that age, it’s easy to think that cancer is something that happens to other people. I can’t change the past but I can share the facts about alcohol and breast cancer so you can make an informed decision about how much you drink in the future. The report from The Lancet found that one in 10 breast cancer cases in the UK are linked to alcohol. That’s more than 4,000 cases a year. The more you drink, the greater your increase in risk. If you drink two units a day, your risk increases by 9 per cent. If you drink six units a day, your risk increases by 60 per cent. BREASTFEED­ING You may have spotted the widely quoted headline from The Lancet’s report saying that one in 20 breast cancer cases could be avoided by breastfeed­ing. I can reassure you that the impact of breastfeed­ing is not as large as the report, or the headlines make it seem. What you need to know is that for every 12 months a woman breastfeed­s a child, her lifetime risk of breast cancer drops by 4 per cent. You might think that sounds like a lot, but it’s not. If you don’t have a strong family history of breast cancer, your lifetime risk is 17 per cent. A 4 per cent drop of that 17 per cent gives you a 16.3 per cent chance of getting breast cancer in your lifetime. That’s a very small cut in risk and doesn’t take into account other factors such as alcohol and exercise. BEING ACTIVE Regardless of what you weigh, between 2 and 10 per cent of all breast cancers in the UK are linked to physical inactivity. Regular exercise can reduce your risk of getting the disease by up to 20 per cent. Although I’m a passionate promoter of the power of exercise to prevent breast cancer, I have a guilty secret. I avoided sport at school and rarely set foot in a gym as a doctor. It was only when I became a cycling widow that I learned to love riding a bike, and regular exercise has kept me sane throughout my three bouts of breast cancer. HEALTHY WEIGHT The final risk factor I need to talk about is how much you weigh. It’s hard to talk about and even harder to hear, but the facts are there. Around 8-13 per cent of breast cancer cases in the UK are linked to obesity, and one in four women in the UK are obese. The risk of breast cancer is higher for post-menopausal women. And because your risk of getting breast cancer goes up as you get older (in your 50s it’s one in 43; in your 60s it’s one in 29 women), the impact of being overweight kicks in. Being overweight increases your risk of breast cancer because fat cells increase inflammati­on, release extra growth factors and oestrogen into the bloodstrea­m which can all stimulate cancer growth. The more fat cells you have, the greater the risk.