Breast cancer primary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:  Mirdula Sharma, MBBS [2] Soroush Seifirad, M.D.[3]

## Overview[edit | edit source]

Avoiding risk factors and increasing protective factors may help prevent cancer.

## Prevention[edit | edit source]

There are a number of known risk factors and protective factors for developing breast cancer.[1]

* The following are known risk factors of developing 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%.[2] 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).[3][4]
* 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. [5]
* 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%.[5]
* Getting enough exercise

## References[edit | edit source]

1. ↑ Breast Cancer. National Cancer Institute (2015) http://www.cancer.gov/types/breast/patient/breast-prevention-pdq#section/_12 Accessed on January 15, 2016
2. ↑ 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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
3. ↑ 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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
4. ↑ 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.CS1 maint: Explicit use of et al. (link) CS1 maint: Multiple names: authors list (link)
5. ↑ 5.0 5.1 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.CS1 maint: Multiple names: authors list (link)

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