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Breast Cancer (cont.)

Breast Cancer Follow-up

People who have been diagnosed with breast cancer need careful follow-up care for life. Initial follow-up care after completion of treatment is usually every three to six months for the first two to three years.

  • This follow-up protocol is based on the individual circumstances and treatments received.

Are There Ways to Prevent Breast Cancer?

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.

Clinical breast examination: The American Cancer Society historically recommended 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. More recent recommendations have called this recommendation into question, since there is no evidence to show any benefit of self-breast examination or examination by a physician. Currently, these practices are not recommended, but it is recommended that women be familiar with the look and feel of their breasts and report any changes to a health-care provider. .

Controversy has also arisen regarding when to begin mammograms for breast cancer screening. Screening truly refers to studies done in people with average risk and no symptoms in order to look for hidden cancers. The American Cancer Society recommends the following screening practice for women at average risk:

  • Women ages 40 to 44 should have the choice to start annual mammograms if they wish to do so. The risks of screening as well as the potential benefits should be considered.
  • Women age 45 to 54 should get mammograms every year.
  • Women age 55 and older should switch to mammograms every two years or have the choice to continue yearly screening.

Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.

For women at high risk for the development of breast cancer, mammogram testing may start earlier, generally 10 years prior to the age at which the youngest close relative developed breast cancer. Genetic testing should be considered.

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 or BRCA2 mutations and who have their ovaries surgically removed before they reach age 40.

Medically Reviewed by a Doctor on 11/20/2017

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