Prevention

Although there are many risk factors for breast cancer that you cannot change (such as family history), there are things that you can do to reduce your risk.

We know that “living well” is one of the best things you can do.  Yes, that means all the things your mother told you to do or not do.  Regular exercise and a low fat diet are not only best for your overall health, but are associated with a reduction in long term risk.  Smoking is generally bad for your health and does increase risk, as does excessive alcohol consumption.  Other life style changes such as use of mega vitamins or soy supplements are not known to reduce risk.  Long term use of combined estrogen-progesterone therapy clearly increases risk, but lower dose estrogen (including birth control bills) has no measurable effect in average risk patients.  There are some things that are often mentioned as increasing risk – such as wearing underwire bras or use of anti persperants – which do not seem to impact risk at all.

As with high blood pressure or high cholesterol, there are also medications which can substantially reduce your risk of breast cancer.  The best known and best studied of these is Tamoxifen, which for decades has been used to treat breast cancer.  This is proven to reduce risk by almost 50% in high risk women, and up to 86% in certain individuals.  Many other medications have also been shown to reduce risk of breast cancer such as Evista (Raloxifene) and a whole new group of drugs called “aromatase inhibitors.”  Whether these may be beneficial for you is something that can be determined only after a complete risk assessment.

MEDICATION TO REDUCE RISK

Very astute physicians noticed decades ago that patients taking Tamoxifen to treat breast cancer developed cancer in the opposite breast half as often as patients not on the medications.  At the same time, there was a growing body of  laboratory evidence to suggest that the same medication would prevent growth of breast cancer cells.  A clinical trial was then performed to evaluate the efficacy of Tamoxifen in preventing breast cancer, and showed the medication, given over 5 years, resulted in a 49% reduction in breast cancer risk. 

Subsequent trials have demonstrated the efficacy of other medications such as Evista, which is approved for prevention of osteoporoses, and other medications such as Arimidex or Femara which are currently used for breast cancer treatment in post menopausal patients.

For more information about using Tamoxifen to prevent breast cancer, click here to link to the National Cancer Institute web site.