There are many factors that are related to breast cancer. We cannot control many of these factors... but some of them we can. This leaflet serves to increase your awareness of breast cancer and to help you with those risk factors that we can do something about.

Risk Factors include:

• Age - the risk of developing breast cancer increases with age, especially above the age of 60 years.
• The age at which you have children - the risk increases as your age of having children increases. The risk is higher for those women who do not have children at all.
• Onset of menstruation - the risk is increased if menstruation started at a very young age, i.e. under 12 years.
• Family history - the risk is increased if family members, from either your mother's or father's side, had or have breast cancer or if your mother had breast cancer before menopause.
• Hormone Replacement Therapy - this increases oestrogen levels and may increase the risk of breast cancer if taken over extended periods of time, i.e. longer than 5 years. However, HRT has a protective effect against heart disease and osteoporosis. Taking HRT for a longer time needs to be a careful decision made between you and your Doctor.
• Smoking - this increases the risk of all types of cancers.
• Obesity -  increases the risk of breast cancer, and other diseases such as heart disease and diabetes. Eating healthy foods and being active will help to reduce and/or maintain body weight.
• High alcohol intake - drinking more than 2 alcoholic drinks per day increases the risk of breast cancer substantially.

What can you do?

• Check your breasts regularly
• Follow the healthy eating guidelines in this leaflet
• Be active

Breast examinations - you can do these yourself!

When? Once a month, preferably after your monthly period.

How? When you are in the shower, or lying down - raise one arm above your head and, with the other hand, gently feel your breast with the fingertips of a flattened hand. Repeat on the other side.

What are you looking for? Feel for a lump or thickening in the breast. If you do feel a lump, note that most lumps are not cancerous, but have it checked by your doctor. You should also check in the mirror for changes in the size, shape and look of your breasts, and if you have any discharge from the nipples.

Healthy eating guidelines:

Enjoy a variety of foods - to provide a variety of vitamins and minerals. These are important in preventing infections and illness.

Be active - This helps us to control our weight and makes us feel great! Being active keeps our bodies strong. You don't always have to go to a gym - walking, taking the stairs everyday, swimming, cycling and any fun sports will help you to stay active.

Starchy foods give us energy during the day and so you should include them with most meals.

Eat those that have more roughage to help keep your digestive system healthy.

Make starchy foods part of most meals:

• Brown rice and stampkoring
• Wholewheat or seed bread/rolls
•  Wholewheat pasta
• Potatoes with skin on and sweet potatoes
• Mealies and samp
• Porridge such as oats and Maltabella
• Cereals such as bran flakes and muesli

Eat plenty of vegetables and fruit everyday - They are an important part of daily eating as they provide us with many different vitamins and minerals which protect us against illness and disease, such as cancer.

Use sugar and food and drinks high in sugar sparingly.

Eat plenty of vegetables and fruit everyday
 

• ·Eat fruit with breakfast, e.g. a banana with cereal or a glass of fruit juice with your toast. Make fruit salad on the weekends.
• Snack on fruit between meals - apples, pears, grapes, naartjies or bananas are easy to eat at work. Dried fruit, e.g. raisins and dried peaches make tasty snacks.
• Include salad with lunch or on your roll, e.g. slices of tomato, lettuce and carrot sticks.
• Try to include 2 different coloured vegetables with dinner, e.g. green beans and carrots, spinach and butternut, peas and corn or broccoli and cauliflower.
• Eat dry beans, split-peas, lentils and soya regularly.
• These foods are very high in roughage and also contain protein, which keeps muscles strong.

Tips on including these foods are

• Add lentils or kidney beans to lean mince or stews.
• Have baked beans on toast for an easy breakfast or lunch.
• Try 3-bean salad with meals for a change.
• Fish, chicken, lean meat or eggs could be eaten daily.

Some tips

• Remove the fat from meat and skin from chicken.
• Grill chicken, fish and meat instead of frying
• Add flavour in the form of herbs, lemon juice, garlic, ginger or chillies
• Choose low fat or skim milk, yoghurt and cheese
• Boil or poach eggs rather than frying
• Include beans, lentils or soya with some meals instead of eating animal protein with all meals!

Have milk, maas or yoghurt every day

Dairy products provide protein for growth and calcium for bone development, muscle and nerve function, blood clotting and hormone release

Use fat sparingly; choose vegetable oils rather than hard fats

Some foods provide essential fatty acids which are good for us. These include tinned sardines, salmon and pilchards, nuts, avocados and seeds. Include avocados and seeds in salads, sandwiches or rolls. Use a little olive oil in salads or cook with a little olive, sunflower or canola oil. Other fats are not as healthy so eat them only in small amounts, e.g. margarine, butter, cream, mayonnaise, salad cream and salad dressings.

Use salt and food high in salt sparingly

Avoid cooking with salt. Some food contains a lot of salt, e.g. processed meats, packet crisps, packet soups and sauces. Try to use natural flavourings as mentioned previously (herbs, garlic, chillies, ginger, black pepper and lemon juice).

Drink lots of clean, safe water

Water out of the tap is safe. If you are unsure whether or not your water source is safe, boil it before drinking. Try to drink mostly water, but you can also include tea, fruit juice and low fat or skim milk. Water helps to move food through our bodies and keeps us hydrated.

If you drink alcohol, drink sensibly

Having more than 2 drinks per day increases your risk of breast cancer. Rather try to limit alcohol to one drink per day.

**If you need more advice, click on the ''Ask the Dietitian'' to pose a question to our Registered Dietitian