Breast Cancer Prevention Starts in Childhood

Linda Brookes, MSc; Graham A. Colditz, MD, DrPH

Disclosures

December 08, 2014

Breast Cancer Prevention Starts Young -- Really Young

Medscape: In a recent posting on the AACR blog, you indicated that prevention should begin as early as age 2,[7] but what can parents do for children of that age group?

Dr Colditz: Diet and physical activity are the key factors. A child doesn't end up obese at age 10 by starting to gain weight at age 9. Breast-feeding, avoiding drinking gallons of milk (which is associated with increased growth velocity),[14]and keeping kids active—those are the key features in early childhood, and then moving to avoiding alcohol in late adolescence. Parents' modeling healthy behaviors for their children is also important.

Medscape: Presumably, children are amenable to their parents' suggestions up to a certain age, but in adolescence they become less so.

Dr Colditz: I agree, but prevention efforts really work. We have had substantial changes in adolescent cigarette smoking. In the United States, 35% of adolescents surveyed in 1999 had smoked within the previous month; in 2013, it was down to 16%.[16] Over the same period, any alcohol consumption within the previous month decreased from 50% to 34.9%,[17] We are never going to go to zero alcohol consumption, but we shouldn't throw out the baby with the bath water and say there's no point in even thinking about it. In countries like China, alcohol consumption is rising rapidly[18]—maybe in men at the moment, but women will catch up. It's like tobacco use; women smokers have caught up with men all over the world.

Figure 1. Prevention strategies for breast cancer should begin in childhood.[15]

Medscape: Is there evidence that children who are taught good habits by their parents or caregivers at an early age continue those habits into adolescence and adulthood?

Dr Colditz: In children younger than 8 or 9 years, parents have influence over what their kids eat. After that, peer pressure can take over and affect eating habits, just as peer pressure can influence adolescent girls toward smoking or drinking. Some good behaviors are easier to sustain if they have been reinforced at home. And there is need for continuing reinforcement at home, at school, and in the workplace. At college and beyond, another set of dynamics influences behavior. Diet, access to alcohol, and other pressures change as young women move into the workforce.

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