Last time we visited this topic, we discussed soy and its effect on breast cancer. Today, we’re diving into a much more complex topic of sugar and sugar substitutes. Just like with soy, there is an abundance of available information online which we will break down into what we really need to know. Let’s get started.

What exactly contains sugar?
In our diets, sugar is often consumed as a carbohydrate. Most people are aware that carbohydrates include foods such as breads, pasta, and rice, but it is important to realize that other vegetables such as corn, potatoes, butternut squash, and fruits such as bananas are also high in sugar and carbohydrates. Other sources of sugar in our diets are sweetened beverages, energy drinks, sodas, juice, desserts, and candy.
What is a sugar substitute?
Sugar substitutes are sweeteners that are used instead of regular table sugar (known as sucrose). These can be either natural (honey, maple syrup) or artificial. Artificial sweeteners, such as aspartame or sucralose, do not include calories and are thus sometimes appealing as additions to diet.
Sugar and Breast Cancer Risk
Generally, a person’s risk of breast cancer is higher if they are overweight. And generally, an increased sugar and carbohydrate intake is linked to higher weights and obesity. So, for a long time, cancer has been linked to sugar intake through patients’ weights. There is some new, early, small data that shows a link between diets that are high in sugar and an increased risk of breast cancer, even when controlling for patients’ weights. However, this data has only been shown by one small study and has not been reproduced in other research.
Sugar Substitute and Cancer Risk
There is very limited data into what the risk of breast cancer is with high sugar-substitute intake. Similar to sugar, there is new, small, non-reproduced data that shows that diets very high in sugar substitutes lead to a slightly higher risk of breast cancer. However, the data DOES NOT mean that sugar substitutes cause cancer. The Food and Drug Administration (FDA) states that “the use of aspartame as a general purpose sweetener… is safe” and the European Food Safety Authority (EFSA) has stated that “Studies do not suggest an increased risk associated with aspartame consumption for… leukaemia, brain tumours or a variety of cancers, including brain, lymphatic and haematopoietic (blood) cancers.”

Sugar and the Patient With Breast Cancer
Once diagnosed, many patients will ask me if they should start dieting, or start not eating sugary foods. It is important to know that having a piece of bread, or a glass of juice will not make your cancer spread. Patient’s do not need to take an “all-or-nothing” approach to eating once diagnosed with cancer. Generally, cancer patients should focus on eating a healthy, balanced diet with limited sugar in order to maintain weight and prevent weight gain.
What Should I Do from Here?
It’s a boring, but important statement. Eat a balanced diet. Avoid high sugar diets, high sugar foods, and do your best to keep your weight down.

Emily L. Siegel is a board certified general surgeon and fellowship-trained breast surgeon in Los Angeles, CA. After attending Williams College for her undergraduate studies, she went on to receive her MD from the USC Keck School of Medicine and subsequently trained in General Surgery at Cedars-Sinai Medical Center. After pursuing research interests in breast cancer, she finished her specialty training in Breast Oncology Surgery at H. Lee Moffitt Cancer Center in Tampa, Florida, a quaternary referral research hospital, and one of the nation’s top cancer centers. Her research interests include the surgical management of breast cancer and she is widely published in journals and medical textbooks.
Having grown up in Los Angeles, she is dedicated to providing care in the city and community in which she was raised. With interests in benign, malignant, and high risk breast disease, her practice encompasses all aspects of breast health.