Breast cancer primary prevention

Avoiding risk factors and increasing protective factors may help prevent cancer.

There are a number of known risk factors and protective factors for developing breast cancer.^[1]

• The following are known risk factors of developing breast cancer:

• Older age
• A personal history of breast cancer or benign (noncancer) breast disease
• A family history of breast cancer
• Inherited gene changes
• Dense breasts
• Exposure of breast tissue to estrogen made in the body
• Taking hormone therapy for symptoms of menopause
• Radiation therapy to the breast or chest
• Obesity
• Drinking alcohol
• Being white

• The following are protective factors for breast cancer:

• Less exposure of breast tissue to estrogen made by the body
• Taking estrogen-only hormone therapy after hysterectomy, selective estrogen receptor modulators, or aromatase inhibitors and inactivators
• Estrogen-only hormone therapy after hysterectomy
• Selective estrogen receptor modulators: In the MORE trial, the relative risk reduction for raloxifene was 76%.^[2] The P-1 preventative study demonstrated that tamoxifen can prevent breast cancer in high-risk individuals. The relative risk reduction was up to 50% of new breast cancers, though the cancers prevented were more likely estrogen-receptor positive (this is analogous to the effect of finasteride on the prevention of prostate cancer, in which only low-grade prostate cancers were prevented).^[3][4]
• Aromatase inhibitors and inactivators
• Risk-reducing mastectomy: Bilateral prophylactic mastectomies have been shown to prevent breast cancer in high-risk individuals, such as patients with BRCA1 or BRCA2 gene mutations. ^[5]
• Ovarian ablation: Prophylactic oophorectomy (removal of ovaries), in high-risk individuals, when child-bearing is complete, reduces the risk of developing breast cancer by 60%, as well as reducing the risk of developing ovarian cancer by 96%.^[5]
• Getting enough exercise

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