Up to two-thirds of invasive breast cancers are classified as hormone receptor positive (ER+/PR+), which means they have both estrogen receptor positive and progesterone receptor positive tumor receptor status. Such tumors are also either HER2 overexpressing (HER2+) or do not overexpress HER2 (HER2-).
Compounds that oppose the production of estrogen in the body (i.e., aromatase inhibitors) or interfere with the binding of estrogen to estrogen receptors (tamoxifen) are among those used to treat this type of breast cancer. It turns out that diet can also influence outcomes for those with ER+/PR+ breast cancer.
Foods and spices that reduce the risk of ER+/PR+ breast cancer
The foods and spices listed below, or important components, have been found to reduce the risk of ER+/PR+ breast cancer:
- Apples
- Arctic char
- Artichokes
- Arugula
- Basil
- Beans, dry
- Bell peppers
- Bilberries
- Black cumin
- Black pepper
- Blackberries
- Blueberries
- Buckwheat
- Bok choy
- Boysenberries
- Broccoli
- Broccoli sprouts
- Brussels sprouts
- Butternut squash
- Cabbage
- Cantaloupe
- Carrots
- Cauliflower
- Celery
- Celery hearts
- Cherries, sweet or tart
- Chicken, organic
- Collard greens
- Cranberries
- Cucumbers
- Currants, black
- Flaxseed
- Flaxseed oil
- Garlic, fresh
- Ginger
- Grape juice, red or purple
- Grapes, red or black
- Green tea
- Greens
- Herring
- Honey, minimally processed
- Horseradish & wasabi
- Hot peppers
- Kale
- Kefir
- Lake trout
- Leeks
- Lettuce, romaine
- Ligonberries
- Mackerel
- Mushrooms, especially white button & related
- Mustard
- Mustard greens
- Olive oil, extra-virgin, and olives
- Onions, all types
- Oregano
- Parsley & cilantro
- Pomegranate juice
- Pomegranates
- Pumpkins
- Raspberries
- Rice, brown, black, or wild
- Saffron
- Salmon, wild
- Sardines
- Seaweed
- Strawberries
- Thyme
- Tomatoes
- Turkey, organic
- Turmeric
- Turnips
- Walnuts & walnut oil
- Watercress & garden cress
- Watermelon
- Zucchini
Foods to limit or avoid for ER+/PR+ breast cancer
The following foods or significant components have been linked specifically to increased risk of ER+/PR+ breast cancer or its recurrence:
- Alcohol
- Asparagus
- Liver
- Milk
- Highly salty foods
- Peanuts
- Pumpkin seeds
- Reishi mushroom tea (ok for ER+ inflammatory breast cancer (IBC))
Supplements for ER+/PR+ patients and survivors
There is no supplement or combination of supplements that has been proven to reduce the risk of ER+/PR+ breast cancer recurrence in women. When a beneficial micronutrient is administered at low doses by consuming food, it is likely to have subtle chemopreventive effects, whereas when the same micronutrient is administered at a high dose in a supplement, it is more likely to have pharmacological effects, with mostly unknown results. It is best to obtain beneficial compounds by consuming food, if possible. Supplements make sense if medically necessary or to make up for deficiencies that are difficult to correct through diet.
The following supplements generally have been found to be safe and beneficial for ER+/PR+ patients and survivors:
Please consult your oncology team for advice concerning your situation and dosages. It might make sense to be tested for deficiency in vitamin D and, if appropriate, plan for follow-up testing to determine whether your reading has reached a desirable level.
Supplements, vitamins & other to avoid for ER+/PR+ breast cancer
The supplements and other exposures below have been reported to promote ER+/PR+ breast cancer development or its recurrence. That is not to say that most other supplements are safe to take; there are no relevant scientific studies concerning the interactions between most supplements and ER+/PR+ breast cancer.
- Angelica sinensis (dong quai) supplements
- Apigenin supplements
- Astragalus or huang qi supplements
- Avlimil
- Copper supplements, incl. multivitamins
- Folic acid supplements
- Genistein, daidzein or equol supplements
- Green tea supplements
- Honey, propolis or royal jelly supplements
- HRT, combined (estrogen plus progestin), including bioidentical hormones
- Licorice root supplements
- Milk thistle supplements
- Quercetin supplements
- Red clover supplements
- Reishi mushroom supplements (ok for IBC)
- Sage supplements & sage essential oil
Sources of information provided in this webpage
The food lists above, which are updated continually as new research becomes available, have been developed based solely on the results of published academic studies. Clicking on any of the foods will take you to its webpage, which contains specific information concerning that food's relationship to breast cancer (including its overall ranking), as well as links to supporting studies.
Additional comments
In addition to paying particular attention to the foods, spices and supplements listed above, it makes sense for ER+/PR+ breast cancer patients and survivors to eat a wide variety of the foods from our recommended list and limit or avoid those on our avoid list. Please see our article on how to optimize your breast cancer diet for information on what to eat during all stages of treatment and recovery. Please also see our article on ER+/PR+ breast cancer prognosis. Below are links to 20 recent studies concerning ER+/PR+ breast cancer and diet.