Breast cancer is the most common type of cancer in women. One in eight women is at risk of developing breast cancer in their lifetime. For this reason, it is very important to recognize breast cancer and use early diagnosis methods, and to initiate treatments to prevent the development of breast cancer in high-risk women. This section will focus on preventive treatment modalities in high-risk women.
Risk factors for the development of breast cancer:
1. Gender, age, race/ethnicity
2. Age at menarche (age of first menstruation), birth and number, first menstrual period full-term pregnancy age, menopause age, lactation, infertility, miscarriage.
3. Family history, known or suspected genetic disorders (BRCA1/2, p53, PTEN or other gene mutations associated with breast cancer risk)
4. Thoracic (chest) before age 30 radiotherapy to the area, hormone replacement therapy, alcohol use.
5. Other factors (Personal breast cancer history, number of breast biopsies, atypical hyperplasia or lobular carcinoma in situ, dense breast structure, body mass index
Risk-reducing treatments in high-risk patients
Some risk-reducing methods have been defined and applied for women who are in the high-risk group for breast cancer.The general purpose of risk-reducing treatments is i) cancer prevention, ii) survival advantage, and iii) increase in quality of life.
Approaches defined for this purpose: 1. Change in lifestyle 2. Close monitoring (Screening) 3. Prevention with drugs (Chemoprevention) 4. Surgery
a. Risk-reducing mastectomy (removal of the breast) b. Risk-reducing opherectomy (removal of the ovary)
There is evidence that certain lifestyle characteristics (such as obesity, excess alcohol intake, and certain types of hormone replacement therapy) are risk factors or markers for increased risk for breast cancer. However, the relationship between lifestyle changes and a reduced risk of breast cancer has not been conclusively demonstrated.
Treatments with risk-reducing drugs (chemoprevention)
Medicines that reduce the risk of breast cancer are only recommended for women aged 35 years and older. First of all, a woman’s risk of developing breast cancer is calculated by means of a specially prepared computer program or forms on websites created for “Breast Cancer Development Risk”. If the risk of developing breast cancer is found to be high, the individual is informed about the treatments to prevent the development of breast cancer, and it is enlightened about which of these treatments will be more appropriate and what the negative side effects of the methods may be.
Two important drugs that reduce the risk of developing breast cancer are Tamoxifen and Raloxifene. Both drugs have been shown in scientific studies to significantly reduce the risk of developing breast cancer. Both drugs are recommended in important treatment guidelines to prevent the development of breast cancer. In the breast diseases consensus meeting held in our country in 2010, it was suggested that these drugs be used for therapeutic purposes in preventing breast cancer.
In particular, the risk assessment of individuals whose first degree relatives (mother, sister) have breast cancer should be made, and precautions should be taken for preventive treatments for breast cancer in high-risk individuals over 35 years of age.
