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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 is a hormonal treatment used to treat 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. Tamoxifen, which is currently the only drug approved
for breast cancer risk reduction, can be taken by both premenopausal
and postmenopausal women. The drug is taken orally, daily, for five
years.
Should you take tamoxifen if you carry a BRCA1 or BRCA2 mutation or have a family history of the disease? Learn more.
Should you take tamoxifen if you have atypical hyperplasia? Learn more.
The ExCel Research Study
If you are postmenopausal and are at high risk for breast cancer (but
have not had breast cancer), you may be eligible to enter the ExCel research study.
This trial is the first in the United States to evaluate whether a type
of hormone therapy called an aromatase inhibitor is effective in
reducing breast cancer risk. Learn more about using exemestane (brand name Aromasin) for breast cancer prevention here.
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