Breast Cancer Prevention

Lowering Risk in High-Risk Women

If you come from a family in which three or more related members have had breast or ovarian cancer, you may be at high risk of developing the disease. In addition to the risk-reduction strategies that are appropriate for all women, you may want to consider the following:

• Tamoxifen
  Tamoxifen has been found to lower the risk of breast cancer by more than 40 percent in high-risk women. However, some women have uncomfortable side effects when they take tamoxifen. Also, taking tamoxifen increases the risk of developing a blood clot in your leg or lung, cancer of the uterus, and cataracts. A woman who has had a prophylactic mastectomy or oophorectomy probably does not need to take tamoxifen. Talk to your doctor about the risks and benefits of tamoxifen.

• Prophylactic mastectomy
  The most effective method for preventing breast cancer in high-risk women is prophylactic mastectomy, surgery to remove one or both breasts before there are any signs of disease. This surgery lowers their risk of dying from breast cancer by almost 90 percent. The mastectomy is usually followed by reconstructive surgery. Although it may seem extreme, most women who choose prophylactic mastectomy say they are satisfied with their decision.

• Prophylactic oophorectomy
  Women who have harmful changes in one of their BRCA1 or BRCA2 genes are at higher risk of developing breast and ovarian cancer than are other women. For this reason, some experts recommend that these women consider having both ovaries removed once they have completed their families. A prophylactic oophorectomy also reduces the risk of breast cancer in these women.

There are risks associated with this procedure, and a woman considering prophylactic oophorectomy should have a frank conversation with her doctor about the benefits and risks of the surgery.

For more information, contact the Breast and Ovarian Cancer Prevention Program at SCCA or the UWMC Cancer Genetics Clinic.

Adapted from: Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast Cancer, by Anne McTiernan, M.D., Ph.D.; Julie Gralow, M.D.; and Lisa Talbot, M.P.H. Used with permission.

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