Heed the 4 E's

By Mary Ellen Strote

All of life is about managing risk, not about eliminating it," a famous banker once said. He's right. Once you pass puberty, you can get breast cancer and you have to deal with the risk. If you're young, that risk is low: Women aged 20-29 account for only 0.3 percent of cases, and rates don't rise sharply until age 50. But what you do in adolescence and early adulthood can affect your future risk, and what you do while pregnant may affect your daughter's risk when she's an adult.

In fact, your own odds of getting breast cancer may have been skewed before you were born, because some families carry a gene that makes them susceptible. Your mother's behaviors may also have had an influence: While baby girls who weighed more than 8.8 pounds at birth may be more prone to the disease in adulthood, those who were breastfed are 20-35 percent less likely to get pre-menopausal breast cancer. And though studies are conflicting, girls who eat a low-calorie diet with minimal animal fat during childhood and stay lean as young adults may also improve their chances.

Wherever those early influences placed you on the risk spectrum, there are ways to improve your odds of avoiding the disease. The time to start is now.

Too much estrogen: a modern dilemma
The number of menstrual periods you experience in your lifetime probably affects your breast-cancer risk. The culprit is estrogen. "We have evidence that breast-cancer risk is related to lifelong estrogen exposure," says Suzanne M. Snedeker, Ph.D., R.D., an assistant professor of environmental toxicology and health at Cornell University in Ithaca, N.Y. "The estrogen surges that accompany menstrual cycles stimulate breast-cell division, making the cells more prone to mutation. This may be why women who start to menstruate before age 12 or reach menopause after age 55 are at higher risk -- they are exposed to more cyclic estrogen."