Breast cancer primary prevention: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Breast cancer}} | {{Breast cancer}} | ||
{{CMG}}, | {{CMG}}, {{AE}} {{MGS}} | ||
== Prevention == | == Prevention == | ||
Avoiding risk factors and increasing protective factors may help prevent cancer. | |||
*The following are risk factors for breast cancer: | |||
:*Older age | |||
:*A personal history of breast cancer or benign (noncancer) breast disease | |||
:*A family history of breast cancer | |||
:*Inherited gene changes | |||
:*Dense breasts | |||
:*Exposure of breast tissue to estrogen made in the body | |||
:*Taking hormone therapy for symptoms of menopause | |||
:*Radiation therapy to the breast or chest | |||
:*Obesity | |||
:*Drinking alcohol | |||
:*Being white | |||
*The following are protective factors for breast cancer: | |||
:*Less exposure of breast tissue to estrogen made by the body | |||
:*Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators | |||
:*Estrogen-only hormone therapy after hysterectomy | |||
:*Selective estrogen receptor modulators: In the MORE trial, the [[relative risk reduction]] for [[raloxifene]] was 76%.<ref name="pmid10376571">{{cite journal |author=Cummings SR, Eckert S, Krueger KA, ''et al'' |title=The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation |journal=JAMA |volume=281 |issue=23 |pages=2189-97 |year=1999 |pmid=10376571 |doi=}}</ref> The P-1 preventative study demonstrated that [[tamoxifen]] can prevent breast cancer in high-risk individuals. The [[relative risk reduction]] was up to 50% of new breast cancers, though the cancers prevented were more likely estrogen-receptor positive (this is analogous to the effect of [[finasteride]] on the prevention of [[prostate cancer]], in which only low-grade [[prostate cancer]]s were prevented).<ref name="pmid16288118">{{cite journal |author=Fisher B, Costantino JP, Wickerham DL, ''et al'' |title=Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study |journal=J. Natl. Cancer Inst. |volume=97 |issue=22 |pages=1652-62 |year=2005 |pmid=16288118 |doi=10.1093/jnci/dji372}}</ref><ref name="pmid9747868">{{cite journal |author=Fisher B, Costantino JP, Wickerham DL, ''et al'' |title=Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study |journal=J. Natl. Cancer Inst. |volume=90 |issue=18 |pages=1371-88 |year=1998 |pmid=9747868 |doi=}}</ref> | |||
:*Aromatase inhibitors and inactivators | |||
:*Risk-reducing mastectomy: Bilateral prophylactic [[Mastectomy|mastectomies]] have been shown to prevent breast cancer in high-risk individuals, such as patients with [[BRCA1]] or [[BRCA2]] gene mutations. <ref name=Kauff_2002>{{cite journal |author=Kauff N, Satagopan J, Robson M, Scheuer L, Hensley M, Hudis C, Ellis N, Boyd J, Borgen P, Barakat R, Norton L, Castiel M, Nafa K, Offit K |title=Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation |journal=N Engl J Med |volume=346 |issue=21 |pages=1609-15 |year=2002 |url=http://content.nejm.org/cgi/content/abstract/NEJMoa020119v1 |pmid=12023992}}</ref> | |||
:*Ovarian ablation: Prophylactic [[oophorectomy]] (removal of ovaries), in high-risk individuals, when child-bearing is complete, reduces the risk of developing breast cancer by 60%, as well as reducing the risk of developing ovarian cancer by 96%.<ref name=Kauff_2002>{{cite journal |author=Kauff N, Satagopan J, Robson M, Scheuer L, Hensley M, Hudis C, Ellis N, Boyd J, Borgen P, Barakat R, Norton L, Castiel M, Nafa K, Offit K |title=Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation |journal=N Engl J Med |volume=346 |issue=21 |pages=1609-15 |year=2002 |url=http://content.nejm.org/cgi/content/abstract/NEJMoa020119v1 |pmid=12023992}}</ref> | |||
:*Getting enough exercise | |||
==References== | ==References== | ||
Revision as of 03:50, 16 January 2016
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1], Associate Editor(s)-in-Chief: Mirdula Sharma, MBBS [2]
Prevention
Avoiding risk factors and increasing protective factors may help prevent cancer.
- The following are risk factors for breast cancer:
- Older age
- A personal history of breast cancer or benign (noncancer) breast disease
- A family history of breast cancer
- Inherited gene changes
- Dense breasts
- Exposure of breast tissue to estrogen made in the body
- Taking hormone therapy for symptoms of menopause
- Radiation therapy to the breast or chest
- Obesity
- Drinking alcohol
- Being white
- The following are protective factors for breast cancer:
- Less exposure of breast tissue to estrogen made by the body
- Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators
- Estrogen-only hormone therapy after hysterectomy
- Selective estrogen receptor modulators: In the MORE trial, the relative risk reduction for raloxifene was 76%.[1] The P-1 preventative study demonstrated that tamoxifen can prevent breast cancer in high-risk individuals. The relative risk reduction was up to 50% of new breast cancers, though the cancers prevented were more likely estrogen-receptor positive (this is analogous to the effect of finasteride on the prevention of prostate cancer, in which only low-grade prostate cancers were prevented).[2][3]
- Aromatase inhibitors and inactivators
- Risk-reducing mastectomy: Bilateral prophylactic mastectomies have been shown to prevent breast cancer in high-risk individuals, such as patients with BRCA1 or BRCA2 gene mutations. [4]
- Ovarian ablation: Prophylactic oophorectomy (removal of ovaries), in high-risk individuals, when child-bearing is complete, reduces the risk of developing breast cancer by 60%, as well as reducing the risk of developing ovarian cancer by 96%.[4]
- Getting enough exercise
References
- ↑ Cummings SR, Eckert S, Krueger KA; et al. (1999). "The effect of raloxifene on risk of breast cancer in postmenopausal women: results from the MORE randomized trial. Multiple Outcomes of Raloxifene Evaluation". JAMA. 281 (23): 2189–97. PMID 10376571.
- ↑ Fisher B, Costantino JP, Wickerham DL; et al. (2005). "Tamoxifen for the prevention of breast cancer: current status of the National Surgical Adjuvant Breast and Bowel Project P-1 study". J. Natl. Cancer Inst. 97 (22): 1652–62. doi:10.1093/jnci/dji372. PMID 16288118.
- ↑ Fisher B, Costantino JP, Wickerham DL; et al. (1998). "Tamoxifen for prevention of breast cancer: report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study". J. Natl. Cancer Inst. 90 (18): 1371–88. PMID 9747868.
- ↑ 4.0 4.1 Kauff N, Satagopan J, Robson M, Scheuer L, Hensley M, Hudis C, Ellis N, Boyd J, Borgen P, Barakat R, Norton L, Castiel M, Nafa K, Offit K (2002). "Risk-reducing salpingo-oophorectomy in women with a BRCA1 or BRCA2 mutation". N Engl J Med. 346 (21): 1609–15. PMID 12023992.