Breast Cancer Risk and Fat

Hester Hill Schnipper, LICSW, OSW-C Program Manager Emeritus, Oncology Social Work

JANUARY 28, 2019

How do you maintain a healthy weight? 

I am somewhat reluctant to bring up this topic. Virtually all American women are already hyper-aware of weight and body fat, and there is no value to shaming ourselves or becoming obsessive about this. The basic fact is that, for many health reasons, it is important to maintain a healthy body weight. Note that this does not mean being model-skinny. It means being at a weight that is age-appropriate and reasonable.

Generally the Body Mass Index (BMI) is the tool that doctors used to evaluate whether you carry too many pounds, too few or just the right amount. The BMI is your weight in kilograms divided by the square of your height in meters. It can also be calculated by multiplying your weight in pounds by 703 and then dividing that number by your height in inches. Got it? This number is used by your doctor to screen for possible health problems that are related to being overweight. One of the limitations of BMI’s value is that it uses your total weight and can’t discriminate between fat and bones and muscle mass. If you want to read more about this, follow this link

Here is the disheartening news: A recent study suggests that even post-menopausal women who have a normal BMI but higher than normal body fat levels have an elevated risk of developing breast cancer. Note that this finding is about an initial diagnosis of breast cancer, not about the risk of a recurrence. However, common sense (wearing my non-doctor hat here) tells us that there could be a similar increased risk for those of us who have already had breast cancer, too.

What is this about? As you may know, estrogen camps out in fat cells. That is the basic fact behind all of the lifestyle suggestions related to maintaining a healthy body weight. Fat cells make estrogen, so more fat cells mean more estrogen in the body, and estrogen can make ER positive breast cancers develop or grow. Fat cells can also trigger long-term low-grade inflammation in the body and, yes, chronic inflammation has been linked to a higher risk of breast cancer recurrence.

What does this mean for you? I’m afraid it takes us back to the usual recommendations about a healthy diet and exercise. Fitting exercise into a busy life is tough and sticking with an exercise program is very challenging. There are many suggestions about how to do this, but they all boil down to self discipline and determination. On the plus side, we all know that exercise also helps us sleep better, boosts our mood and self esteem, and generally keeps us more healthy.

Lace up those sneakers.

What do you do to try to maintain a healthy weight? Share your story in the BIDMC Cancer Community.