Posted: October 10, 2019

How to prevent breast cancer?  Starting about twenty years ago investigators have been trying to develop strategies to help women prevent breast cancer.  Recently the American Society of Clinical Oncology has updated its guidelines to help primary care physicians give women the best available advice.  Their reommendations can be found here.  If you cannot view the entire article Dr. Stark can email it to you.  Just fill out the form to the right of this page.  Basically the article emphasizes that there are strategies in place that can reduct a woman’s risk of getting breast cancer by up to 50%.  The first thing that needs to be done is to assess risk.  The average woman’s risk may not be high enough to justify the expense and potential side effects from taking a drug for five to ten years.  That said, women at higher risk can benefit from drug treatment.  That treatment will depend on their menstrural status.  Pre- and post-menopausal women will take different drugs. Pre-menopausal women will take tamoxifen; post-menopausal women have a choice of drugs, most prominently an aromatase inhibitor such as Anastrozole.

Who are those women at higher risk?  The article cites the following groups:

1. A history of lobular carcinoma in situ or atypical ductal hyperplasia on a prior breast biopsy

2. A family history of breast cancer without the BRCA genetic mutation.

3 A likelihood of getting breast cancer of at least 5% in the next 10 years as defined by one of several available algorithms.

Dr. Stark weighs in: The shame of the current situation is that in fhe face of effective treatment so few women choose to avail themselves of this opportunity.  The risk of cancer outweighs the risks and expense of the treatment.

Update 2020: nothing much new here: that the percentage of women availing themselves of the option of breast cancer prevention drugs has not increased since this post was created in 2013.  The lack of championing by primary care physicians is largely the issue.