Breast Cancer Prevention in High-Risk
Women [return to the list
of articles]
"One out of 9 American women will get breast cancer."
Unfortunately, that is a true statement. Over the last 50 years,
the incidence has not significantly changed. There have been improvements
in early detection, but the fact remains one out of 9 women will
get breast cancer.
Until recently, there have not been any treatment options available
for women to prevent breast cancer. Some changes in lifestyle such
as diet modification and exercise may decrease one's risk, but not
significantly.
A study was done over the last few years in which women who were
at high risk to develop breast cancer were given tamoxifen (zenneca
pharmaceuticals), an estrogen blocker, to see if the rate of breast
cancer development could be lowered in these high risk women. The
study shows tamoxofen did significantly lower the rate of breast
cancer-prevent breast cancer in high risk women.
What puts women at high risk? This is the important question. Many
factors increase one's risk of breast cancer. Factors that play
a role are: family history, age, age of menarche (first menstrual
period), age at the first child's birth, race, and history of previous
breast biopsies.
Based on many factors, a statistical model was established called
the "gail model risk assessment tool" and if a woman has
a statistical risk of 1.7% or greater, tamoxifen should be prescribed
to help prevent breast cancer.
A reasonable question is "shouldn't all women take tamoxifen
to reduce their risk?" The answer is, "No". Although
this has helped those high risk women, there are risks and side
effects associated with taking tamoxifen. A very small increase
in dvt's (blood clots in the deep veins) and uterine cancer is seen
in women on tamoxifen and since tamoxifen does not prevent all breast
cancers, one must weigh the risks and benefits of the drug when
prescribing it.
If you are interested in learning more about your risk of breast
cancer and the prevention options available, you are welcome to
call our office for an appointment.
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