In this article, we provide an example of how a breast cancer survivor can optimize her diet using the article How to optimize your breast cancer diet. Please note that we do not believe that any diet can cure breast cancer, but food choices may have a role in improving outcome.

My situation

I, Sarah Charles, am a survivor of premenopausal, lobular, hormone receptor positive (ER+/PR+), HER2 negative, bilateral, multifocal, familial breast cancer. My mother died of breast cancer. Initially, I was told that I had a small, stage I tumor in one breast and would need just a lumpectomy and radiation. After having a lumpectomy and subsequent partial mastectomy, both without obtaining clean margins, I underwent a bilateral mastectomy. I am not currently using an aromatase inhibitor or tamoxifen.

Breast cancer type

The first step is to examine the information concerning my histological type, lobular breast cancer, in the article What should lobular breast cancer patients and survivors eat?.

I start making two lists - one of foods to emphasize and one to avoid - based on the information provided in the article. I decide not to include any foods on my avoid list that I wouldn't normally eat anyway. Similarly, I'm not going to include any foods on the recommended list that I actively dislike.

I then decide to take quick look at the study summaries at the end of the article to see if there is any data that pertains to me in particular. I jot down bits of information from the studies to keep in mind when I finalize my list.

Breast cancer subtype

The next step is to examine the information concerning my breast cancer subtype, ER+/PR+, in the article What should hormone receptor positive breast cancer patients and survivors eat? I use this article to continue to expand my two lists of foods (emphasize and avoid), while writing down other relevant lifestyle information from the article and related studies to keep in mind when I finalize my food lists and think about possible changes in other aspects of my lifestyle:

• Consumption of at least five vegetables/fruits per day plus regular exercise has been found to be associated with lower risk of metastasis of ER+/PR+ breast cancer.
• Recent and lifetime aspirin use was found to be associated with reduced risk of breast cancer, with no differences by subtype. On the other hand, recent use of ibuprofen was significantly associated with increased risk of tumors that were hormone receptor positive (ER+/PR+).
• Higher intake of vitamin D (from both the sun and the diet) was found to be most consistently associated with a lower risk of ER+/PR+ breast cancer.
• Dietary alpha-carotene, beta-carotene, and lycopene were each found to be inversely associated with the risk of ER+/PR+ breast cancer.
• Only the combination of consuming five or more daily servings of vegetables/fruits plus accumulating at least 540 metabolic equivalent tasks-minutes per week (equivalent to walking 30 minutes, six days per week) was found to be associated with a significant survival advantage . . . the effect was stronger in women who had hormone receptor-positive (ER+/PR+) cancers.

Finalize food lists

The last step is to add foods to my two lists by looking at the recommended foods and foods to avoid tabs. These are more general lists of foods that have been reported to prevent or promote breast cancer, without necessarily taking into account breast cancer type or subtype. Again, I am only including foods that I like or am interested in trying in my foods to emphasize list and foods I might be tempted to consume in my foods to avoid list. This means that the lists below are customized for me.

The whole process described above took less than two hours. It's important to eat a wide variety of foods and to accommodate any dietary restrictions due to concurrent medical conditions and medications such as blood thinners. Work with a nutritionist if this is such a great change that you feel uncomfortable about obtaining the right balance of carbohydrates, protein and fats. For example, it might be difficult for already thin women not to lose to weight when eating this way. Strategies for keeping weight on include eating at least 500 calories per meal and eating some meals that consist mostly of a combination of starchy carbohydrates and fats (e.g., soba noodles (Japanese buckwheat noodles) with onions caramelized in olive oil).