You’ve finished your breast cancer treatment, and your doctor says all evidence of the disease is gone. You’re finally cancer-free.
But in the back of your mind is an ever-present warning from your doctor: There’s a high risk your cancer will come back, also called recurrence.
For hormone receptor-positive (HR-positive)/human epidermal growth factor receptor 2-negative (HER2-negative) breast cancer, which is fueled by hormones estrogen and progesterone, recurrence can happen years — or even decades — after initial treatment.
But there are choices you can make every day to lower the chance of your cancer from coming back.
Take Endocrine Therapy as Directed
“I would say that the most important thing to reduce risk of recurrence is taking endocrine therapy for the recommended duration,” says Laila Agrawal, MD, a medical oncologist specializing in breast health at Norton Healthcare in Louisville, Kentucky.
If you had HR-positive/HER2-negative breast cancer, this therapy likely included tamoxifen, which blocks estrogen activity in premenopausal women. If you developed breast cancer post-menopause, your doctor likely prescribed an aromatase inhibitor, which stops the body from making estrogen. Both treatments can cause side effects, which include headaches and hot flashes.
“We know that some women stop taking endocrine therapy early due to side effects,” Argawal says. “That’s why it is so important to address the side effects — including the often not talked about sexual symptoms. There are many ways to manage side effects to help people stay on their treatment. But the good news is, we don’t have to pick one thing. Medications and a healthy lifestyle go hand-in-hand.”
Lifestyle Choices That May Help Prevent Cancer Recurrence
In addition to taking your medications as directed, the following may help lower your risk of recurrence:
- Not smoking
- Maintaining a healthy weight
- Staying physically active
- Eating a healthy foods
But what does maintaining a healthy weight or eating healthy foods look like in everyday life? Here are practical ways to put these tips to practice.
General Advice: Maintain a Healthy Weight
Studies show that excess body fat can raise estrogen levels and increase your risk of recurrence. This is especially true after menopause.
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To stay consistent with your weight maintenance goals, try these tips:
- Track your daily steps, water intake, and sleep instead of your weight.
- Partner with a friend, relative, or coworker, and hold each other accountable.
General Advice: Stay Physically Active
The benefits of exercise are widely known, including reducing health risks. Staying physically active can lower the risk of your breast cancer coming back. That’s because exercise regulates hormones, eases inflammation and helps you maintain a healthy weight, all of which can help lower your risk of recurrence.
The American Cancer Society recommends 150-300 minutes of moderate-intensity exercise, or 75-150 minutes of vigorous intensity exercise each week. The Centers for Disease Control and the American College of Sports Medicine also recommend strength training at least two times a week.
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Here are a few ways to incorporate physical activity into your day and make it a habit:
- Schedule it on your calendar.
- Take a 10-minute walk after each meal.
- Use stairs instead of elevators when possible.
- Choose parking spots that are furthest from the building entrance.
The key to staying active is choosing activities you enjoy. This will help you stay consistent.
“Prioritizing an hour a day for a favorite activity or hobby, such as golf or gardening, can address the physical and psychosocial needs of a survivor,” says Heather Studwell, oncology survivorship coordinator at Yale New Haven Health’s Smilow Cancer Hospital. “The fundamental principle is to not be inactive.”
Agrawal agrees. “Even five minutes of exercise is a start. It’s not about perfection. It’s about building healthy and sustainable habits.”
General Advice: Eat Healthy Foods
Doctors aren’t sure whether specific foods can lower your risk of breast cancer recurrence. But eating good-for-you foods like fruits, vegetables, whole grains, legumes, and healthy fats can lower your risk of other conditions, such as diabetes and heart disease. It also helps you maintain a healthy weight.
Try to limit red meats, processed foods, excess sugar, and bad fats. One study found that women with early-stage breast cancer who reduced their fat intake had a 24% lower risk of breast cancer recurrence than women who didn’t cut their fat intake.
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Make healthier choices every day with these tips:
- Fill half your plate with veggies at each meal.
- Eat beans or chicken instead of red meat.
- Eat nuts or fruit instead of chips.
- Drink herbal tea instead of soda.
General Advice: Limit or Avoid Alcohol
While there’s no clear link between alcohol and breast cancer recurrence, alcohol can raise the level of estrogen in your body. Doctors recommend no more than one drink per day and no more than three drinks per week.
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Replace your nightly cocktail or glass of wine with a cup of caffeine-free herbal tea, such as chamomile.
General Advice: Manage Stress
“Stress doesn’t directly cause cancer, but it will add to them not having the right mindset to do the right things, such as eat right and maintain compliance with your medications,” says Jayanthi Srinivasiah, MD, a board-certified oncologist and hematologist at Northside Hospital Cancer Institute in Decatur, Georgia.
Chronic stress floods the body with cortisol. That’s the hormone that regulates our “fight or flight” response. This can lead to poor sleep and affect how well our immune system functions.
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Some ways you can manage and lower stress include:
- Use a guided meditation app to relax.
- Keep a daily journal.
- Listen to soothing music.
- Unplug from social media.
- Try yoga.
General Advice: Get Enough Sleep
Getting good, quality sleep is essential. Not only does it help you feel more rested and refreshed, but it also boosts your immune system, keeps your heart healthy, and helps you maintain a healthy weight. Aim for seven to eight hours of uninterrupted sleep each night.
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Try these tips to help you wind down and prepare for a good night’s sleep:
- Turn off all electronics at least one hour before bed.
- Avoid sugar, caffeine, and alcohol many hours before bed.
- Set the thermostat to low- to mid-60s.
- Block out all external light.
General Advice: Take Care of Your Mental Health
You made it through treatment and are cancer-free, but knowing that you’re at high risk for recurrence can take a toll on you mentally. While you’re working to eat right and maintain your weight, take care of your emotional health, too. Your overall health depends on it.
“Emotional well-being is also critical because then you can pay attention to your symptoms, you can be more compliant with your medications and be able to eat right — all of those are important,” Srinivasiah says.
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Srinivasiah says staying connected to a breast cancer survivors group through your hospital can offer much-needed emotional support. Other things you can do to care for your mental health each day include:
- Take one hour each day to do something you enjoy.
- Stay connected to friends and family.
- Rest when you need to.
- Research your condition and treatment options to stay informed.
- Talk to a licensed mental health professional.
Build a Lifestyle Routine
Once you begin making small changes to your daily habits, build them into your weekly schedule. This can help you stay consistent with your changes and track your progress toward your goals. Here’s an example of what a weekly lifestyle routine might look like:
Monday
- Morning: 30 minutes of brisk walk or light jog
- Midday: Plant-based lunch (for example, lentil salad, roasted veggies)
- Evening: Strength training (upper body) + 10 minutes of mindfulness practice
Tuesday
- Morning: 30 minutes of yoga or stretching
- Midday: Hydrate well + colorful veggie bowl for lunch with chickpeas
- Evening: Journaling or reading for relaxation
Wednesday
- Morning: 45 minutes of moderate aerobic activity (for example, cycling, swimming)
- Midday: Protein-rich plant meal (for example, chicken stir-fry)
- Evening: Connect with support group or loved ones
Thursday
- Morning: Strength training (lower body)
- Midday: Whole grain lunch + fruit smoothie
- Evening: Sleep hygiene routine (dim lights, no screens one hour before bed)
Friday
Extreme Detoxes and Supplements: Can They Prevent Cancer Recurrence?
There are types of claims to cure cancer. Common ones include detoxes, cleanses, natural supplements, and certain diets, such as the ketogenic diet or alkaline diet. But there’s little scientific evidence that they work. A plant-based diet that includes whole grains, legumes, and healthy fats is your best choice for preventing cancer recurrence.
Final Thoughts
The thought of breast cancer coming back can be scary, and whether it does depends on many things, some of which you can’t control. But you can make good choices that can lower your risk and greatly improve your health.
