Breast cancer primary prevention: Difference between revisions

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{{Breast cancer}}
{{Breast cancer}}
{{CMG}} {{AE}} {{MGS}}
{{CMG}} {{AE}} {{MGS}} {{Soroush}}
==Overview==
==Overview==
Avoiding risk factors and increasing protective factors may help prevent cancer.
Avoiding risk factors and increasing protective factors may help prevent cancer.
== Prevention ==
== Prevention ==
Avoiding risk factors and increasing protective factors may help prevent cancer.<ref name = Prev> Breast Cancer. National Cancer Institute (2015) http://www.cancer.gov/types/breast/patient/breast-prevention-pdq#section/_12 Accessed on January 15, 2016 </ref>
There are a number of known [[Risk factor|risk factors]] and protective factors for developing breast cancer.<ref name="Prev">Breast Cancer. National Cancer Institute (2015) http://www.cancer.gov/types/breast/patient/breast-prevention-pdq#section/_12 Accessed on January 15, 2016 </ref>
*The following are risk factors for breast cancer:
*The following are known [[Risk factor|risk factors]] of developing breast cancer:
:*Older age
:*Older [[Ageing|age]]
:*A personal history of breast cancer or benign (noncancer) breast disease
:*A personal history of breast cancer or [[benign]] (noncancer) breast disease
:*A family history of breast cancer
:*A [[family history]] of breast cancer
:*Inherited gene changes
:*Inherited gene changes
:*Dense breasts
:*Dense breasts
:*Exposure of breast tissue to estrogen made in the body
:*Exposure of breast tissue to [[estrogen]] made in the body
:*Taking hormone therapy for symptoms of menopause
:*Taking hormone therapy for symptoms of [[menopause]]
:*Radiation therapy to the breast or chest
:*Radiation therapy to the breast or chest
:*Obesity
:*[[Obesity]]
:*Drinking alcohol
:*Drinking [[Alcohol, Drug Abuse, and Mental Health Services Block Grant|alcohol]]
:*Being white
:*Being white
*The following are protective factors for breast cancer:
*The following are protective factors for breast cancer:
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:*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>
:*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
:*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>  
:*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>  
:*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
:*Getting enough exercise


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[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Gynecology]]
[[Category:Surgery]]

Latest revision as of 22:38, 23 April 2019

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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

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

Prevention

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

  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.
  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.
  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.
  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.

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