Breast Cancer Prevention

Are you at increased risk for developing breast cancer? The National Cancer Institute has developed a risk assessment tool which will help to determine your risk for developing breast cancer during the next five years and over the course of a lifetime. The link for the breast cancer risk assessement tool is:

http://bcra.nci.nih.gov/brc/

Click on calculate risk for new patient and complete the questions. If you are at elevated risk for developing breast cancer three options are available to hopefully modify this risk:

1.

Increased survellience: This is important for women with a significantly positive premenopausal family history of breast cancer. Women should begin screening mammography a decade sooner than the age their family member was diagnosed. For example, if you other was age 35 at the time of diagnosis of her breast cancer, you should begin annual screening mammography at the age of 25.

2.
Bilateral prophylactic mastectomy: While bilateral prophylactic mastectomy will substantially reduce you risk for developing breast cancer, it does not completely eliminate the risk. Annual screening should continue.

3.
Chemoprevention: Women who are at increased risk for developing breast cancer can be placed on Tamoxifen. The breast cancer prevention trial (BCPT) began in 1992 and compared placebo (sugar pill) to Tamoxifen. The results of this trial indicate that the risk of developing breast cancer was reduced by 50%. Risk factors considered in the decision to place a woman on Tamoxifen include family history, age of the patient, the number of previous breast biopsies and the pathologic findings on these biopsies.

A second study comparing Tamoxifen to Raloxifene (Evista) is currently underway (STAR) and will enroll 22,000 postmenopausal women. The study is designed to compare the potential of Raloxifene to prevent breast cancer in comparison to Tamoxifen, which has proven ability to do so.

Most patients opt for increased survellience and or chemoprevention with Tamoxifen or Raloxifene to reduce their risk for developing breast cancer.

Quick Facts:

• 1:8 women develop breast cancer and the incidence is increasing.
• All women should consider themselves at risk for developing breast cancer.
• The whole breast must be treated in breast cancer, either by removing it, or by irradiation, as breast cancer can involve several areas of the breast 23-55% of the time.