High Risk / Risk Reduction Options for High-Risk Women
High-Risk Breast Cancer Screening Programs A number of medical centers have established high-risk breast cancer screening programs to help identify and monitor women at high risk for developing breast cancer. Women often need to be referred to one of these centers by their primary care physician or ob/gyn.
Magnetic Resonance Imaging (MRI) Screening Studies have found magnetic resonance imaging (MRI) screening is better than mammography screening in detecting tumors in women who are at high risk for breast cancer. If you are at high risk for breast cancer, you may want to consider adding MRI screening to your annual mammography screening. Learn more.
BRCA Genetic Testing If you have many women in your family who have developed breast cancer, you may want to consider genetic testing. It is recommended that all women speak with a genetic counselor before deciding whether to be tested.
If your test result is negative it means you have an average or only slightly higher than average risk of developing breast cancer. A positive test result means you carry a genetic mutation for breast cancer, and that you are at greater risk of getting the disease. It does not mean you definitely will get it. Because some particular mutations are associated with higher risks than others, it is essential to have a qualified genetic counselor interpret the results. Additional information that can help you decide whether to be tested for a BRCA mutation can be found on the National Cancer Institute's information sheet "It's Your Choice."
Women who are found to carry a BRCA mutation have several options:
Regular monitoring by a breast care specialist with frequent breast exams and annual mammograms.
Prophylactic mastectomy (removal of both breasts) and/or prophylactic oophorectomy (removal of the ovaries).
Taking the drug tamoxifen for five years to reduce breast cancer risk.
Chemoprevention Tamoxifen and raloxifene are hormonal treatments used to prevent breast cancer. (Tamoxifen is also used used to treat hormone-sensitive breast cancer.) Hormonal therapies slow or stop cancer's growth by changing the hormonal milieu. The Breast Cancer Prevention Trial found that tamoxifen reduced the risk of developing breast cancer in high-risk women. As a result, tamoxifen was approved for use as breast cancer prevention in October 1998. The following year the NCI started the STAR Trial to assess whether raloxifene could also decrease a woman's breast cancer risk. That study led to raloxifene's approval for use as breast cancer prevention in high-risk women in September 2007. Tamoxifen can be taken by both premenopausal and postmenopausal women. In contrast, raloxifene can only be used by postmenopausal. (It hasn't yet been tested in premenopausal women.) Both drugs come in pill form and are taken daily, for five years.
Should you take tamoxifen or raloxifene if you carry a BRCA1 or BRCA2 mutation or have a family history of the disease? Learn more.
Should you take tamoxifen or raloxifene if you have atypical hyperplasia?Learn more.
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FORCE (Facing Our Risk of Cancer Empowered) This nonprofit organization for high-risk women provides information on its website on how to find good health care and a list of special clinics for high-risk women. MORE >
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The thyroid, located in the neck, is a gland that makes and stores hormones. To date, at least four published studied have looked at the risk of developing breast cancer after begin treated for thyroid cancer. MORE >
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