I’m at Risk for Developing Breast Cancer: Now What?

Your doctor has told you that you fall into a high-risk category for developing breast cancer. Now you're wondering: What action can I take?

Gretchen Todd CNP, a nurse practitioner in TriHealth's High-Risk Breast Program, explains a few measures your doctor may suggest for preventing breast cancer down the road.

Preventive Measure #1: Lifestyle Modifications

In some cases, protecting yourself from developing breast cancer can be as simple as lifestyle modifications, like losing weight, eating a better diet or exercising.

Preventive Measure #2: Medication

Your doctor may also recommend taking a medication, like Tamoxifen, to lower your risk. “Studies vary widely on the effectiveness, depending on what study you read. It could range anywhere from 30 to 50 percent risk reduction, so it’s pretty significant,” Gretchen explains.

On the other hand, she warns that you need to be aware of the potential side effects before taking this medication. “The issues with Tamoxifen … it gives you menopausal-type symptoms. It gives you hot flashes, irritability, difficulty sleeping, aches and pains – and it could take up to a year for those symptoms to go away.”

A long-term side effect that concerns doctors is how taking Tamoxifen can negatively affect bone health, putting you at risk for developing brittle bones and osteoporosis down the road.

Preventive Measure #3: Surgery

Surgery is an option for anyone who falls into a high-risk category, but it's an invasive option, so it depends on how aggressively you want to reduce your risk. Surgery usually reduces your risk of developing breast cancer by about 80 or 90 percent of your original risk score.

There are two main types of surgeries used for breast cancer prevention:

• Double mastectomy – The removal of both breasts
• Ovary removal – This is a viable option for women who test positive for the BRCA1 or BRCA2 gene mutations, which are known to increase the risk of breast and ovarian cancer.

“Most breast cancers are fueled by estrogen, and by having your ovaries removed, it completely cuts off that estrogen production,” Gretchen points out. While ovary removal isn’t as effective as a double mastectomy, it usually reduces the risk of developing breast cancer by 50 to 60 percent, she explains.

Which Option is Best for Me?

Because each measure carries its own set of risks and benefits, Gretchen says it’s important to remember: There’s no blanket answer for everyone. “It’s a personal decision that a woman has to discuss with her healthcare provider and family, to figure out what works best for her during that point in time,” she explains.

She also reminds patients that they can always change their mind. While you may not consider the idea of having both breasts removed at age 35, your perspective may change five years later. “You might think, ‘I don’t care about these anymore. Get them out of here because they’re just adding stress to my life."