Women's Health Matters

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Prevention

Because we are still learning about the causes of breast cancer, we do not yet know the best ways to prevent it. The best defence is still early detection. Reducing your risk factors for breast cancer whenever possible may also help.

Although there is no certain way to prevent breast cancer, studies have suggested that regular exercise can reduce breast cancer risk. Researchers are also exploring the impact of diet on breast cancer, and the possibility of using chemoprevention – the use of drugs to decrease cancer risk – in some women who have a high risk of developing breast cancer

There are already some options available for women at high risk for breast cancer.

Genetic testing

Genetic testing can tell if a woman carries a mutation in her gene that increases her risk of breast cancer, but it cannot predict whether a woman will get the disease. Genetic testing is only appropriate for women with a family or personal history of breast cancer. Testing is usually preceeded by genetic counselling to help understand the implications of pursuing testing. Women who carry mutations in breast cancer genes will also have an increased risk of ovarian cancer.Women's College Hospital's Breast Centre has physicians who specialize in the care and screening of women who are known mutation carriers.

Chemoprevention

The drug tamoxifen has been used for many years as a treatment for some breast cancers. Recent studies show that women at high risk for breast cancer are less likely to develop the disease if they take tamoxifen.Tamoxifen does have risks as well as benefits. These factors must be weighed carefully in the case of each individual woman.

Raloxifene, a drug used to treat and prevent osteoporosis, has also been investigated as a possible preventive treatment for women at high risk of breast cancer. Raloxifene is the same type of drug as Tamoxifen (a selective estrogen receptor modulator), and also has risks as well as benefits that must be assessed on an individual basis. Some studies suggest that Tamoxifen and Raloxifene may be equally effective at reducing the risk of developing breast cancer.

Prophylactic mastectomy

Women at very high risk might consider a prophylactic (preventive) mastectomy. This is an operation in which both breasts are removed before there is any known breast cancer. Women who consider aprophylactic mastectomy usually have one or more of the following:

  • inherited mutated genes
  • a strong family history of breast cancer
  • a diagnosis of certain conditions such as lobular carcinoma in situ

There is still a possibility of developing breast cancer after aprophylactic mastectomy, because small amounts of breast tissue may still remain in areas such as the underarms. However, a prophylacticbilateral mastectomy is thought to reduce the risk by about 90 per cent.

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