Breast Cancer Prevention
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|Can Breast Cancer Be Prevented?
There is no scientifically ascertained way of preventing breast cancer. However the risks associated with lifestyle factors and environmental hazards do give hope that at least some of the risks of developing breast cancer can be reduced. Ultimately however studies reveal that the best means of preventing breast cancer from developing is early detection through mammogram screening, clinical breast examinations and breast self-examination. Even though controversy remains about the efficiency of these procedures, most health care professionals still recommend them as women's best chance for improving their breast cancer survival rate.
Prevention Versus Treatment Debate
In the last two decades breast cancer prevention has become as much a political issue as a scientific one. Many women’s groups became concerned that too much research dollars were being funneled into breast cancer treatments (to the advantage of large drug companies) rather than cure or prevention. In 1991 this lead to the founding of the National Breast Cancer Coalition (NBCC), a federation of over 2,000 interested groups. The federation lobbied Congress for increased spending on breast cancer research, and achieved a national budget increase from $90 million to $420 million. The long-term results from most of these studies are still far down the line. In the meantime, women can help themselves by trying to reduce their lifestyle risk factors.
Not sure what the signs are? Check: breast cancer symptoms.
Very few lifestyle breast cancer risk factors are set in stone. Women who have all the risk factors for example, may never develop breast cancer, whereas women who only have 2 of the key risk factors (aged over 55 and being a woman) may do so. That said, until research shows otherwise, it is worth taking the following precautions:
1. Eat a low fat diet, and buy organic produce where possible.
Prevention: Women With High Risks of Breast Cancer
Women with increased risk of breast cancer include those with:
1. A strong family history of breast cancer.
Women in this situation have various options including genetic testing, preventative drug therapy and ultimately preventative surgery. See cancer prevention for more information.
Women who have relatives with breast cancer may be recommended for BRCA genetic testing (which involves a simple blood test). The U.S. Preventive Services Task Force (USPSTF) only recommends genetic testing in very specific circumstances. Not only is there a significant financial cost involved but telling a woman that she a greater chance of developing breast cancer later in life may have unforeseen consequences on her employability, health insurance premiums and self-image. For this reason BRCA testing is only usually recommended to women who:
• Have 2 first degree relatives: mother, sister or daughter diagnosed with breast cancer, one of whom received a breast cancer diagnosis before 50.
Chemoprevention is the use of drugs to reduce the risk of cancer. This procedure is only ever considered with women who are at particularly high risk of developing breast cancer. It involves injections of substances which can stop hormone production by the ovaries or alternatively administering the drug tamoxifen to block the effect of the woman's own estrogen before cancer develops.
Tamoxifen is a hormone therapy of breast cancer. It has been approved by the FDA for women over the age of 35 who are at high risk of breast cancer. It has been used for years to prevent the recurrence of the disease and as a treatment for advanced breast cancer. However, as studies now show that it may also reduce a woman's chances of developing the disease it is prescribed on a restricted basis for prevention. Results from the Breast Cancer Prevention Trial (BCPT) show that women who took tamoxifen over 5 years were 42 percent less likely to develop breast cancer than those who took a placebo. Of course, nothing is straight forward. Tamoxifen has side effects, including increased risk of endometrial cancer (uterine) and blood clotting, so it needs to be considered carefully.
Raloxifene (brand name evista) is another hormone therapy drug, similar to tamoxifen, which helps to block the effect of estrogen on the breast tissue. It has been approved by the FDA for helping to reduce breast cancer in postmenopause women who have osteoporosis and who are at high risk of developing breast cancer. A study called the Study of Tamoxifen and Raloxifene (STAR) was begun in 1999 to compare the long-term effectiveness and safety of both drugs. The trial found that raloxifene worked nearly as well as tamoxifen. Raloxifene showed an advantage however in that it does not stimulate the uterus, and therefore does not increase the risk of uterine cancer. The National Cancer Institute of Canada is also currently studying the effects of yet another drug called Idoxifene, on both breast cancer and osteoporotic fractures.
Aromatase inhibitors are also being studied for their preventative uses. These drugs include exemestane, anastrozole and letrozole, which are already being used for preventing recurrences of breast cancer. They work by blocking the production of estrogen, but they can have side effects such as joint stiffness and bone loss which can lead to osteoporosis in women. They have not been approved yet by the FDA as a treatment for preventing breast cancer.
Other Studies: Non-steroidal anti-inflammatory drugs (NSAIDs) such as aspirin treatment appears to have some affect on lowering risk of breast cancer. Bisphosphonates, drugs normally used as an osteoporosis treatment are also being studied as a treatment for cancer which has spread to the bone. At this point however, neither drug is FDA approved for reducing breast cancer risk at this time. However do be sure to check out books on breast cancer for a list of books on prevention.
Women who are at extremely high risk of breast cancer are sometimes offered prophylactic mastectomies. That is, a mastectomy that removes seemingly healthy breasts in anticipation that breast cancer will develop in the future. Many women with a strong history of breast cancer in the family feel so overwhelmed with worry that they take this drastic step in their 20s or 30s, although no malignancy has been detected. Although the surgery remains controversial recent evidence suggests that removing both breasts can reduce the incidence of breast cancer by about 90 percent. It certainly may be a better alternative than living with the permanent fear of the disease and the appearance can be restored with breast reconstruction surgery. However, the discovery of the BRCA mutated genes has reduced the need for this surgery. If the genes are not present in a genetic test, the surgery is rarely performed. Second opinions are very important before proceeding with this surgery. Recent studies also suggest that women with a BRCA mutation can reduce their risk of breast cancer by 50 percent with a prophylactic oophorectomy procedure (removal of their ovaries). This is because the ovaries are the main source of estrogen production in the body.
|Related Articles on Breast Cancer Prevention
For more details on prevention and progress of the disease, see the following:
• Recommended health screenings - For each life stage.
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