Are you at increased risk for developing breast cancer? The
National Cancer Institute has developed a risk assessment tool which will
help to determine your risk for developing breast cancer during the next
five years and over the course of a lifetime. The link for the breast cancer
risk assessement tool is:
Click on calculate risk for new patient and complete the
questions. If you are at elevated risk for developing breast cancer three
options are available to hopefully modify this risk:
Increased survellience: This is important
for women with a significantly positive premenopausal family history
of breast cancer. Women should begin screening mammography a decade
sooner than the age their family member was diagnosed. For example,
if you other was age 35 at the time of diagnosis of her breast cancer,
you should begin annual screening mammography at the age of 25.
Bilateral prophylactic mastectomy: While bilateral prophylactic
mastectomy will substantially reduce you risk for developing breast
cancer, it does not completely eliminate the risk. Annual screening
Chemoprevention: Women who are at increased risk for developing
breast cancer can be placed on Tamoxifen. The breast cancer prevention
trial (BCPT) began in 1992 and compared placebo (sugar pill) to Tamoxifen.
The results of this trial indicate that the risk of developing breast
cancer was reduced by 50%. Risk factors considered in the decision
to place a woman on Tamoxifen include family history, age of the patient,
the number of previous breast biopsies and the pathologic findings
on these biopsies.
A second study comparing Tamoxifen to Raloxifene (Evista)
is currently underway (STAR) and will enroll 22,000 postmenopausal women.
The study is designed to compare the potential of Raloxifene to prevent
breast cancer in comparison to Tamoxifen, which has proven ability to
Most patients opt for increased survellience and or chemoprevention
with Tamoxifen or Raloxifene to reduce their risk for developing breast
1:8 women develop breast cancer and the incidence is increasing.
All women should consider themselves at risk for developing breast cancer.
The whole breast must be treated in breast cancer, either by removing
it, or by irradiation, as breast cancer can involve several areas of the
breast 23-55% of the time.