Chemoprevention & Risk Reduction Surgery

Chemoprevention Options: Tamoxifen and Raloxifene

ChemopreventionUsing drugs and their chemical reactions to stop cancer growth. is the use of a medication to reduce the risk of developing cancer in cancer free individuals who are at high risk for developing cancer. Two medications, TamoxifenA drug used to treat certain types of breast cancer in women and men. and RaloxifeneA drug used to reduce the risk of breast cancer in postmenopausal women who are at a high risk of developing the disease., have been approved for breast cancer chemoprevention.

Tamoxifen and Raloxifene are part of a group of drugs that block the effects of estrogenA type of hormone made by the body that helps develop and maintain female sex characteristics and the growth of bones. on breast tissueA group of cells that are the same and work together to make up parts of the body.. These drugs are Selective Estrogen Receptor Modulators (SERMs)Block the action of estrogen in the breast and tissues by occupying estrogen receptors inside cells..

Tamoxifen and Raloxifene may stop the growth of breast cancers that need estrogen to grow. These cancers are called estrogen or progesteroneFemale hormone that protects the growth of the baby in the mother during pregnancy, and also prepares the body for the attachment of the fertilized egg to the lining of the uterus. receptor positive breast cancers.

A very large breast cancer prevention trial studied high risk women who took Tamoxifen for five years versus women who took a placeboAn inactive substance or treatment that looks the same as, and is given the same way as, an active drug or treatment being tested. The effects of the active drug or treatment are compared to the effects of the placebo.. The trial showed that in women at higher risk for breast cancer, Tamoxifen reduces the risk of getting breast cancer in the next five years by 44%. Women taking Tamoxifen had a lower chance of developing breast cancer than women taking the placebo pill.

Tamoxifen does have side effects, which a patient should think about when deciding on whether to use chemoprevention. In previous studies, Tamoxifen increased the risk for:

Raloxifene reduces the risk of breast cancer just as well as Tamoxifen, but has slightly fewer side effects. Raloxifene is also less likely to cause these side effects than Tamoxifen.

Raloxifene may increase these risks slightly less than Tamoxifen:

Talk to your doctor or pharmacist for more information on the costs of these medications, how patients take them, and whether or not they are covered by your insurance. These chemoprevention options are helpful for some, but not appropriate for all individuals.

Risk Reduction Surgery Options

With the help of cancer genetics professionals and other specialists, some individuals decide that undergoing surgery is the best way to manage their risk for developing cancer. There are many advantages, risks, and disadvantages involved with this type of cancer risk reduction that can be explored with the help of trained professionals such as geneticistsA doctor who is an expert in genes and genetics., oncologistsA doctor that has extra training in caring for people with cancer., surgeons, plastic surgeonsA surgeon who specializes in reducing scarring or disfigurement that may occur as a result of accidents, birth defects, or treatment for diseases. and psychologists. Two types of surgeries that are currently available are:

Prophylactic mastectomy is the surgical removal of breast tissue to prevent breast cancer. BilateralAffecting both the left and right sides of body. prophylactic mastectomy is the surgical removal of both breasts. The word "prophylactic" refers to the preventative nature of the surgery because it involves the removal of otherwise healthy breast tissue. Bilateral prophylactic mastectomy reduces the risk of breast cancer by approximately 90%. Because breast tissue extends over the chest wallThe system of structures outside the lungs that move as a part of breathing, including the rib cage, diaphragm, and abdomen. up to the collarbone, over into the armpit and down to the abdominal wallThe boundary of the abdominal organs. The stomach, bladder, kidneys, intestines, spleen, liver, appendix, gallbladder, pancreas, and adrenal glands are all located within the abdominal wall; also includes your uterus and ovaries if you are female., it is not possible to be sure that 100% of the breast tissue has been removed during surgery. As a result, there is still a small risk of developing breast cancer after this surgery.

Prophaylactic salpingo-oophorectomy is the surgical removal of the ovaries and fallopian tubes to prevent ovarian cancerA kind of cancer that develops in the cells of a woman's ovary.. The word "prophylactic" refers to the preventative nature of the surgery because it involves the removal of otherwise healthy ovarian tissue. This is an option available to women who are at high risk for developing ovarian cancer. Bilateral salpingo-oophorectomySurgery to remove both ovaries and both fallopian tubes. is the surgical removal of both ovaries and fallopian tubes. Bilateral salpingo-oophorectomy reduces the risk of ovarian cancer by approximately 90-95%. There is still a risk following surgery of developing a cancer in the inner lining of the abdomen called the peritoneumThe case that holds the abdominal organs and keeps them separated from other muscles., though this risk is quite small compared to the risk of ovarian cancer.

These risk reduction surgery options are helpful for some, but not appropriate for all individuals.