Reducing Cancer Risk

Women who carry the genetic mutations for breast cancer and ovarian cancer have several options to help prevent the diseases. Some of the options are fairly easy to implement but do not lower the risk by much. Others greatly reduce risk but are difficult to maintain or are life-changing.

Surveillance: in this watch-and-wait approach, women undergo a clinical breast exam and mammogram or MRI at least once a year, and they conduct breast self-exams. The idea is to catch a tumour early. This option worries some women because the gene mutations tend to cause faster-growing cancers that might emerge between exams. But doctors report that technical advances in imaging the breast are transforming surveillance into a better option.

Lifestyle Changes: Women can choose to limit their intake of fat and alcohol, which tend to raise oestrogen levels. Exercise, in contrast, is thought to reduce circulating oestrogen. Breast-feeding also appears to lower the risk.

Chemoprevention: Medications might lower the risk for several years. Side-effects, however, can cause women to stop taking the medications, and scientists are not sure how helpful the medications are in women with BRCA gene mutation, especially those with BRCAI. Raloxifene or evista was approved recently to reduce the risk of breast cancer in high risk post-menopausal women with osteoporosis. It is thought to work as well as tamoxifen with fewer side-effects. However, raloxifene has not been studied specifically for prevention in women with a BRCA mutation. Aromatase inhibitors, ised to treat breast cancer in post-menopausal women, also might help.

Prophylactic Surgery: Dramatic though such surgeries are, neither approach is 100 percent effective. It is disfiguring, and many patients then opt for reconstruction. The methods are improving, but not all surgeons specialize in the latest techniques.