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Many risk factors cannot be controlled. Some experts in the field of diet and cancer agree that changes in diet and lifestyle may reduce the incidence of cancer generally.
Efforts have focused on early detection since breast cancer is more easily treated and often curable if it is found early. Breast self-examination (BSE), clinical breast examination (CBE) by a medical professional, and screening mammography are the three tools of early detection. Women who carry the BRCA mutations have several effective options for screening and prevention.
Most recommend breast self-examinations (BSE) once a month -- the week following your menstrual period if you are age 20 or older.
Regular clinical breast examinations (CBE) by a health professional are recommended for women between ages 20 and 39, at least every 3 years. After age 40, women should have a CBE by a health professional every year.
Mammography is the most effective way of detecting breast cancer early. The American Cancer Society recommends mammogram screening every year for all women age 40 and older.
The National Cancer Institute (NCI) recommends mammogram screening every 1-2 years for women age 40 and older. For those with risk factors, including a close family member with the disease, annual mammograms should begin 10 years earlier than the age at which the relative was diagnosed.
Questions have been raised about the benefit of screening mammography. Some respected medical organizations such as PDQ, part of the NCI, no longer recommend screening mammography. This is a topic fraught with controversy, and a woman needs to have an informed and balanced discussion with her doctor, along with doing additional reading and researching on her own, to determine if mammography is right for her.
Two drugs are being studied currently that have been shown to reduce the risk of breast cancer: tamoxifen (Nolvadex ®) and raloxifene (Evista ®). Both are anti-estrogens in breast tissue.
Tamoxifen is already widely used to prevent recurrence in women who have been treated for breast cancer. Many other newer hormonal agents, such as aromatase inhibitors and others, are being used after Tamoxifen is stopped, or even in place of Tamoxifen. For some women at very high risk of breast cancer, preventive use of these drugs may be appropriate. This should be discussed with a qualified physician.
Preventive Mastectomy, which is the surgical removal of one or both breasts, is an option to prevent breast cancer for women who are at very high risk for breast cancer.
Possible candidates for this procedure are women who have already had one breast removed due to cancer, women with a strong family history of breast cancer and those who have a mutation in genes p53, BRCA1, or have gene BRCA2.
For additional information on breast cancer, see the website of the American Cancer Society.
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