Breast Cancer (cont.)
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Breast Cancer Prevention
The most important risk factors for the development of breast cancer are gender, age, and genetics. Because women can do nothing about these risks, regular screening is recommended in order to allow early detection and thus prevent death from breast cancer.
Regular screening includes breast self-examination, clinical breast examination, and mammography.
Breast self-examination (BSE) is cheap and easy. Routine monthly examination may be helpful. Previously considered critical, more recent studies suggest that self-breast exam may be less valuable than previously thought, especially for women who are having routine clinical breast examination and/or mammography.
Clinical breast examination: The American Cancer Society recommends a breast examination by a trained health-care provider once every three years starting at 20 years of age and then yearly after age 40 years.
The National Cancer Institute recommends women 40 and older should get mammograms every one to two years while the American Cancer Society recommends that women 40 and older have yearly mammograms. For women at high risk for the development of breast cancer, mammogram screening may start earlier, generally 10 years prior to the age at which the youngest close relative developed breast cancer.
Obesity after menopause and excessive alcohol intake may increase the risk of breast cancer slightly. Physically active women may have a lower risk. All women are encouraged to maintain normal body weight, especially after menopause, to limit excess alcohol intake, and to get regular exercise. Hormone replacement should be limited in duration if it is medically required.
In women who are genetically at high risk for the development of breast cancer, estrogen-blocking drugs (Tamoxifen) have shown to decrease the incident of breast cancer. Side effects should be carefully discussed with your health-care provider prior to embarking on therapy. A second drug, raloxifene (Evista), which is now being used for the treatment of osteoporosis, also blocks the effects of estrogen and appears to prevent breast cancer. Initial studies showed that both tamoxifen and raloxifene were able to reduce the risk of invasive breast cancer, but raloxifene did not have this protective effect against noninvasive cancer. Studies are ongoing to further characterize the effectiveness and indications for use of raloxifene as a breast cancer preventive drug.
Occasionally, a woman at very high risk for development of breast cancer will decide to have a preventive or prophylactic mastectomy to avoid developing breast cancer. Additionally, removal of the ovaries has shown to reduce the risk of developing breast cancer in women who have the BRCA1 mutation and who have their ovaries surgically removed before they reach age 40.
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