OurGYN

Author, Educator Dr. Michael Krychman Joins www.Ourgyn.com as site’s Co-Director

Over the course of a woman’s lifetime, approximately 1 in 8 women will be diagnosed with breast cancer. Most women are concerned about their personal risk for developing cancer and what they can do themselves to reduce their chances of getting the disease.

The following information was summarized from the National Institutes of Health:

Risk Factors for Developing Breast Cancer: Some risks factors are fixed and you are unable to change them. As you get older, your risk of developing breast cancer increases. The vast majority of metastatic and advanced breast cancer is in postmenopausal women who are over the age of 50. Men can and do get breast cancer, though in much less frequency and women are approximately 100 times more likely to develop breast cancer. It is important to know your family history and you may have a higher risk for breast cancer if you have a close relative who have had either breast, uterine, ovarian, or colon cancer. Approximately 30% of women who have breast cancer have a family history of the disease.

Cancer can be inherited and passed from parent to child. In some specific patient populations, some women may have genes that predispose them to developing breast cancer. The most common gene abnormalities are found in the BRCA1 and BRCA2 genes. But if you have inherited a defective gene, you will have an increased risk for breast cancer and in some cases ovarian cancer. Women who begin their menstrual cycles early (before the age 12) or go through menopause late (after age 55) may also have an increased risk for breast cancer.

Some other modifiable risk factors for breast cancer include: Women who consume more that one or two alcoholic beverages a day may have an increased risk for developing breast cancer. Women who have never had a child, or who delivered them after age 30 have an increased risk for breast cancer. Being pregnant maybe be protective and being pregnant at an early age may reduce your risk of breast cancer. In the 1940s and 1950s, diethylstilbestrol (DES) was prescribed to women to prevent miscarriage and these women may have an increased risk of developing breast cancer after age 40. Recent evidence from the Women’s health Initiative (WHI) study indicates that women who took estrogen and progestin may have an increased risk of breast cancer. This arm of the study was stopped prematurely due to this health concern. Interestingly, new data analysis demonstrated that those who were only taking estrogen actually had a lowered rate of breast cancer.

Obesity maybe linked to breast cancer although this remains controversial. Chest radiation therapy as child, adolescent or young for cancer therapy may increase your risk for developing breast cancer. Breast implants, cell phone use, using anti- perspirants, and wearing under wire bras do not increase breast cancer risk. Although extensively studied there remains no conclusive evidence of a direct link between breast cancer and environmental pesticides.

What can you do to Prevent Breast Cancer? Breast cancer is more easily treated and can be curable when discovered early. Some techniques that may help with early detection include: breast self-exams (BSE), clinical breast exams by a health care professional and screening mammography:

Many health care professionals advocate BSE on a regular basis usually once monthly during the week following the menstrual period. Newer screening protocols for mammography exist and baseline should occur by age 50 or earlier depending on your risk. Intervals between mammograms vary by different organizational guidelines from 1- 2 years and it’s important to discuss your personal screening plan with your health care professional. It is also important to report any breast changes in skin, color, changes in nipples or in the axillary region to your medical professional so a comprehensive evaluation can be completed. Mammography is often considered the most effective way of detecting early breast cancer. Some women, who are at a high risk for breast cancer, may need to have a breast MRI imaging study in association with their yearly mammogram.

Women may choose to take certain medications that may reduce their risk for developing breast cancer. Nolvadex (Tamoxifen ®) is approved for breast cancer prevention in women aged 35 and older who are at high risk. In a recent New England Journal of Medicine, Exenestane, (Aromasin ® ) is an aromatase inhibitor and considered an anti-estrogen compound that was recently studied as a chemo preventative agent for breast cancer. The study of over 4,500 post-menopausal women who were at high risk of developing breast cancer were randomly assigned to get either Aromasin or a placebo drug. In the three-year study, only 11 women on Aromasin ® developed breast cancer as compared to 32 who were on placebo. The relative risk reduction was approximately 65 percent. But because there were so many women involved and so few of them got breast cancer, the absolute risk went down from 1.4 percent of those on placebo to 0.5 percent of those on Aromasin. Many health care professionals doubt that women maybe unwilling to make that trade off, since Aromasin ® is not without serious distressing side effects including hot flashes, arthritis, vaginal dryness, joint pain, hair loss, fatigue and may have serious ramifications on bone health..

Some women who are at very high risk for breast cancer may even consider preventive (prophylactic) mastectomy, which is the surgical removal of the breasts. Possible candidates for this invasive and aggressive risk reducing procedure may include those who have a diagnosis of breast cancer, women with a strong family history of breast cancer, or those with genes or genetic mutations that increase their risk of breast cancer. (July, 2011.)

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