Women's Health Matters

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Prevention

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

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

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 thatincreases her risk of breast cancer, but it cannot predict whether awoman will get the disease. Genetic testing is only appropriate forwomen with a family or personal history of breast cancer. Testing isusually preceeded by genetic counselling to help understand theimplications of pursuing testing. Women who carry mutations in breastcancer genes will also have an increased risk of ovarian cancer.Women's College Hospital's Breast Centre has physicians who specializein 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 somebreast cancers. Recent studies show that women at high risk for breastcancer are less likely to develop the disease if they take tamoxifen.Tamoxifen does have risks as well as benefits. These factors must beweighed carefully in the case of each individual woman.

Raloxifene,a drug used to treat and prevent osteoporosis, has also beeninvestigated as a possible preventive treatment for women at high riskof breast cancer. Raloxifene is the same type of drug as Tamoxifen (aselective estrogen receptor modulator), and also has risks as well asbenefits that must be assessed on an individual basis. Some studiessuggest that Tamoxifen and Raloxifene may be equally effective atreducing 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 removedbefore 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 maystill 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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