Copyright © 2011 Rosemary Delgado MD, Inc.
Understanding your risk level is the first step toward taking control of your breast health. Armed with this knowledge, you and your doctor can make the best choices about what is right for you. We have no control over some risk factors, like family history or the age at which we start our periods or enter menopause. But certain lifestyle choices can make a difference and there are drugs proven to prevent breast cancer in high risk women. Some women at very high risk may also choose surgical intervention. All high risk women should be watched more carefully for signs and symptoms so that if breast cancer does develop, it is found at an early, more treatable stage.
Lifestyle
Here are some of the lifestyle choices that may promote breast health:7
Increased intake of:
Polyunsaturated fats
Soy (in premenopausal women only)
Vitamin D
Antioxidants (in premenopausal women only)
Green Tea
Caffeinated Coffee
Decreased alcohol consumption
Regular exercise
Maintaining normal weight
Avoiding obesity if postmenopausal
Having a child before age 30
Breast-feeding
Preventive Drugs
Two different drugs have been proven to dramatically reduce breast cancer incidence in high risk women when they are taken before cancer develops. Tamoxifen prevented half of breast cancers in high risk women, and prevented 86% of breast cancers in women with atypical cells in their breast ducts8 (which may be found with the HALO Well Breast Test.) Raloxifene also prevented about half of cancers in high risk women but was only tested in postmenopausal women.9 Both of these drugs have the potential to cause side effects so their benefits should be considered carefully against their risks.
Surgical Prevention
Surgery is typically considered only for very high risk women, such as those with known genetic mutations that predispose them to breast cancer.
Increased Surveillance
A breast specialist can consider each woman’s specific situation and develop a customized surveillance plan that is best for her. Doctors usually recommend that women at high risk for breast cancer be checked more frequently, perhaps every six months, or with additional imaging methods. Mammography, MRI and ultrasound are all used for breast imaging and each one is particularly good for certain types of abnormalities.
Mammography is good for finding solid masses or fluid filled cysts, but it isn’t very good for telling the difference between the two.
Ultrasound is very good for differentiating between solid masses and fluid filled cysts, but isn’t as good for finding small abnormalities.
MRI is good for finding very small abnormalities but some of these small abnormalities turn out to be normal breast changes or false alarms.7
Other newer imaging technologies may also be recommended, such as Breast Thermography (see www.breastthermography.org for more information) or Breast Specific Gamma Imaging (BSGI – see www.dilon.com for more information).
Most high risk surveillance plans will include breast exams by a doctor and a HALO Well Breast Test every six months.
References:
7 Morris JA, Gordon OK. 2010. Positive Results. Prometheus Books, New York, New York. Page 122.
8 Fisher B, Costantino JP, et.al. Tamoxifen for Prevention of Breast Cancer: Report of the National Surgical Adjuvant Breast and Bowel Project P-1 Study. JNCI 1998;90(18):1371-1388.
9 Vogel VC, Costantino JP, et.al. Effects of Tamoxifen vs Raloxifene on the Risk of Developing Invasive Breast Cancer and Other Disease Outcomes. JAMA 2006;295(23): 2727-2926.
