While a diet emphasizing vegetables and fruit and de-emphasizing alcohol, red meat and omega-3 fats may reduce the likelihood of breast cancer or recurrence compared to the typical U.S. diet, simply following these rules will not maximize the chemopreventive potential of your diet. Tailoring your diet to your individual circumstances and breast cancer subtype will increase the diet's potential benefits. This web page is designed to enable you to customize your diet using the information in the Food for Breast Cancer web site. The overall goal is to bathe your normal cells with nutrients that promote healthy growth and cell division. Any new breast cancer cells that do arise are to find themselves in an environment that promotes their death and inhibits their proliferation and migration.

A word about enjoying your food, food variety, and supplements

Before outlining a strategy to develop a customized diet, we would like to say a few words about food and supplements. It is important to enjoy your food because what you eat and drink counts. The idea is to replace the elements of your current diet that promote breast cancer (see foods to avoid) with foods that prevent it (recommended foods) or are neutral. Adding beneficial foods to an unhealthy diet is not likely to make as much difference as an overhaul of your diet which substantially eliminates harmful foods. This can only happen if you enjoy what you eat. For example, if you do not like broccoli, do not eat it. But maybe you might enjoy broccoli sprouts, kale or watercress, which have many of the same chemopreventive characteristics.

Several studies have found that consuming a wide variety of foods is more beneficial in preventing breast cancer than consuming a limited selection. There are synergistic actions between foods, most of which might remain to be discovered. For example, the combination of mushrooms and green tea appears to be more chemopreventive than consuming either alone. Also, simultaneously consuming olive oil and orange vegetables increases the bioavailability of the beta-carotene in the vegetables.

Vitamins and supplements can make sense for deficiency states. For example, it appears to be difficult for most of us to get enough vitamin D through exposure to sunshine and in the diet. Adequate vitamin D is important for breast cancer chemoprevention. Supplementation with vitamin D has been found to be safe at dosages required to bring most women up to optimal levels. Similarly, taking high quality fish oil could benefit those who wish to increase their ratio of omega-3 to omega-6 fats, although note that taking fish oil is not recommended during chemotherapy.

However, it has been found that cancer can be promoted by large doses of some compounds that are chemopreventive when consumed in foods. Famous examples are vitamin A and vitamin C. Coenzyme Q10 (CoQ10) may be another example. This is one reason why we tend to de-emphasize supplements. Often there is a U-shaped curve in which both low and high levels of a given micronutrient promotes cancer and we simply do not have enough information to determine the dosage that aligns with the cancer-preventive sweet spot at the bottom of the curve. It is not that we do not understand the attraction of genistein, DIM, ellagic acid, resveratrol, etc. However, based on the available evidence, consuming micronutrients in pill form whose safety and effective dosage have not been established is as likely to be harmful as helpful. Nor do we believe that diet alone is able to effectively treat breast cancer (please see our articles on food as cancer cure and the raw food diet).

How to design your anti-cancer diet

Your diet should depend on whether you are at high risk for breast cancer (but not diagnosed with the disease), in active treatment, or a breast cancer survivor. Each of these situations is addressed below.

High risk, but not diagnosed with breast cancer

Women at high risk for breast cancer should use the recommended, avoid and alphabetical food lists to select their foods. The goal is to consume a wide variety of chemopreventive foods while limiting cancer-promoting foods such as processed meat. While many breast cancer risk factors (such as early puberty or being tall) cannot be influenced by diet in adulthood, some risk factors can be. The links below are to web pages that provide detailed information and food lists for some high-risk circumstances:

Dense breasts

Benign fibrocystic breast disease

BRCA1 or BRCA2 mutation carrier

Parent with breast cancer seeking to minimize risk of daughter or son

Undergoing surgery, chemotherapy or radiation for breast cancer

Women undergoing surgery, chemotherapy or radiation treatment for breast cancer should adopt a healthy but bland diet that de-emphasizes antioxidants (which could enable cancer cells to survive treatment). Specific foods have been found to increase the effectiveness of certain treatments and others have been shown to interfere with some treatments. Below are links to web pages that provide detailed information and food lists for specific treatments:

Breast cancer survivor

Women who are in remission for breast cancer should adopt a diet based on whether they are undergoing long-term anti-estrogen or Herceptin treatment, as well as their breast cancer type and subtype. The goal is to reduce recurrence risk.

Undergoing long-term anti-estrogen or Herceptin treatment

Breast cancer survivors undergoing long-term treatment with aromatase inhibitors, tamoxifen or Herceptin should design their diets according to their breast cancer subtypes (see below), taking into account the findings in the articles directly below concerning how specific foods interact with their treatments:

Ductal, lobular and other breast cancer types

Breast cancer is categorized into two main histological types, ductal and lobular, as well the far less common mucinous carcinoma, adenoid cystic carcinoma and mixed tumors (e.g. ductal plus lobular). Within the ductal category are inflammatory breast cancer, medullary carcinoma, tubular carcinoma, Piaget's disease of the nipple, and metaplastic carcinoma. Ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS) are noninvasive forms of breast cancer, which have not infiltrated healthy surrounding tissue but have the potential to do so. Breast cancer survivors should take into account both their histological type and hormone receptor subtype (see below) in designing their diets, as well as any long-term treatment they may be undergoing (see above):

Hormone receptor positive (ER+/PR+) breast cancer

Hormone receptor negative (ER-/PR-) and triple negative breast cancer

Mixed hormone receptor (ER+/PR- or ER-/PR+) breast cancer

HER2/neu overexpressing (HER2+) breast cancer

Women who have HER2-positive breast cancer should this into account, in addition to their histological type, any long-term treatment they may be undergoing, and their hormone receptor subtype: