Protective factors to reduce breast cancer risk
Reproductive history leading to less estrogen exposure
A woman's reproductive history can affect the amount of time breast tissue is exposed to estrogen. Early onset of menstruation, late onset of menopause, and older age at the onset of pregnancy have been associated with increased estrogen exposure and breast cancer risk. The following reproductive factors decrease the amount of time a woman's breast tissue is exposed to estrogen and may help prevent breast cancer:
Early pregnancy: estrogen levels are lower during pregnancy. Women who have a full-term pregnancy before age 20 have a lower risk of breast cancer than women who have never had children or who give birth to their first child after age 35.
Breastfeeding: Estrogen levels may remain lower while a woman is breastfeeding. Women who breastfeed have a lower risk of breast cancer than women who have had children but have not breastfed.
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Estrogen-alone hormone therapy after hysterectomy
Estrogen-only hormone therapy may be given to women who have had a hysterectomy. In these women, this type of therapy performed after menopause may decrease the risk of breast cancer. There is an increased risk of stroke and cardiovascular disease in postmenopausal women taking estrogen after hysterectomy.
Selective estrogen receptor modulators.
Tamoxifen and raloxifene belong to a family of drugs called selective estrogen receptor modulators (SERMs). SERMs act like estrogen in some tissues of the body, but block the effect of estrogen in other tissues.
Tamoxifen treatment
Decreases the risk of estrogen receptor-positive (ER-positive) breast cancer and ductal carcinoma in situ in high-risk premenopausal and postmenopausal women. Tamoxifen is also used to treat metastatic breast cancer and prevent cancer recurrence after surgery to remove breast tumors.
Treatment with raloxifene
It also reduces the risk of breast cancer in postmenopausal women. With any of these drugs, the risk reduction lasts for several years or more after stopping treatment. Lower rates of bone fractures have been observed in patients taking raloxifene.
Taking tamoxifen
Taking tamoxifen increases the risk of hot flashes, endometrial cancer, stroke, cataracts and blood clots (especially in the lungs and legs). The risk of these problems is significantly increased in women over the age of 50 compared to younger women. Women younger than 50 who are at high risk for breast cancer may benefit more from tamoxifen treatment.
The risk of endometrial cancer lasts 5 years after stopping tamoxifen, but the risk of cataracts or blood clots does not last long. Talk to your doctor about the risks and benefits of taking this medicine.
Taking raloxifene
Taking raloxifene increases the risk of blood clots in the lungs and legs, but does not seem to increase the risk of endometrial cancer. In postmenopausal women with osteoporosis (decreased bone density), raloxifene reduces the risk of breast cancer.
It is not known whether raloxifene would have the same effect in women who do not have osteoporosis. Talk to your doctor about the risks and benefits of taking this medicine.
Aromatase Inhibitors and Inactivators
Aromatase inhibitors (anastrozole, letrozole) and inactivators (exemestane) decrease the risk of recurrence and breast cancer in women with a history of breast cancer. Aromatase inhibitors also decrease the risk of breast cancer in women with the following conditions:
Postmenopausal women with a personal history of breast cancer.
Women with no personal history of breast cancer older than 60 years, with a history of ductal carcinoma in situ with mastectomy or at high risk of cancer, according to the Gail modeled assessment, a tool used to estimate the risk of developing breast cancer. this type of cancer.
In women at high risk for breast cancer, taking aromatase inhibitors decreases the amount of estrogen produced by the body. Before menopause, estrogen is produced by the ovaries and other tissues in a woman's body, including the brain, fat tissue and skin.
After menopause, the ovaries stop producing estrogen, but the other tissues continue to do so. Aromatase inhibitors block the action of this enzyme, which is used to produce all the estrogen in the body.
Possible side effects of taking aromatase inhibitors include muscle and joint pain, osteoporosis, hot flashes and feeling tired.
Prophylactic or Risk-Reducing Mastectomy
Some women who have an increased risk of breast cancer may choose to have a prophylactic or risk-reducing mastectomy (removal of one or both breasts when there are no signs of cancer). After surgery, the risk of breast cancer becomes much lower in these women and most feel less concerned.
Some women diagnosed with breast cancer may decide to have the healthy breast removed at the same time the breast with cancer is removed. This procedure is called contralateral prophylactic mastectomy. However, it is very important to have a cancer risk assessment and counseling on the different ways to prevent breast cancer before making any decisions about surgery.
Ovarian ablation
The ovaries produce most of the estrogen that the body produces. Treatments that stop or decrease the amount of estrogen produced by the ovaries include surgery to remove the ovaries, radiation therapy, or taking certain medications. This is called ovarian ablation.
Premenopausal women who have a high risk of breast cancer due to certain changes in the BRCA1 and BRCA2 genes may choose to undergo a risk-reducing oophorectomy (removal of both ovaries when there are no signs of cancer). This decreases the amount of estrogen produced by the body and reduces the risk of breast cancer.
Risk-reducing oophorectomy also reduces the risk of breast cancer in premenopausal women at average risk and in women at high risk for thoracic radiation.
However, it is very important to consult your physician for a cancer risk assessment and counseling before making this decision. The sudden drop in estrogen levels can cause menopausal symptoms to begin. These include hot flashes, difficulty sleeping, anxiety and depression. Long-term effects include decreased sex drive, vaginal dryness and decreased bone density.
A healthy lifestyle
Studies have shown that lifestyle changes can reduce the risk of breast cancer even in high-risk women. Exercise every day, don't smoke, don't consume excessive alcohol, and adopt a healthy diet based on fruits and vegetables.
It's up to you! Don't miss your breast screening!