Prevention of Breast Cancer
By age 40 the average American Woman has a 1.5% chance of developing breast cancer.
Some women have much higher risks, but all women will increase your chances of survival if you do get breast cancer if you begin screenings on time.
There are strategies to prevent ever getting breast cancer. You should not smoke, moderate alcohol consumption (in some studies that means no alcohol) lower the fat in your diet, increase exercise and normalize your weight.
Medicines can be used to prevent breast cancer in all women, but generally are used for those actually at higher than average risk. If you haven’t discussed with your gyno, it’s important to do so.
The prevention strategies that involve taking medications have their own side effects, they may cause hot flashes, vaginal dryness, or even change your risk for osteoporosis, depending on which medication and how long you are on it. If you are at risk for complications from prevention therapy, you may also want to consider non-medical treatment of vaginal dryness.
Tamoxifen is the medication most tested to prevent breast cancer, who should take it, for how long, and when to take it is the question for you and your gyno.
Traditionally gynos have relied on the Gail scale or something similar to calculate risk, but even that won’t tell us exactly at what age to begin therapy. For some women there is a very short sojourn between atypia and cancer, so if you wait until you have precancerous changes (like detected on a Halo breast pap smear or a biopsy) there may not be enough time to intervene and prevent the disease. Some mammogram reports add that calculation, so if you see those numbers, call your gyno to discuss.
Taking Tamoxifen to prevent cancer is called Chemoprevention: The thesis behind this chemoprevention is that this medication is the antiestrogen effects. And it is thought that estrogen is related to breast cancer cell growth. But in order for estrogen to affect this process the estrogen molecule has to bind to the breast cell to change it, and when tamoxifen is given the process, in essence, is interrupted.
Some of the effects of tamoxifen on the breast, paradoxically, can cause problems in the uterus. In the studies of this medication there were some polyps of the lining of the uterus, and there were some cases of blood clots and there was an increased risk of having a cataract. Patients can also consider raloxifene (Evista) as an alternative, especially if they need bone protection, as the mechanism of protection is similar: about 55% of the cases are prevented. In fact it is estimated that only about 10% of women that could benefit from these therapies are even getting the therapy.
Testosterone use in menopause has also been associated with lower risks of breast cancer.
For alternatives, set up a consultation with Women’s Health Practice. We are as close by as a telephone call!
