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reducing your risk of breast cancer
A Special Q&A With Dr. Poras K. Patel of Southern Oncology Specialists
ACCO R DIN G TO T H E A ME R I CA N CA N C E R S O C I E TY,
about 281,550 new cases of invasive breast cancer will be diagnosed in women in the United States for 2021. And while breast cancer remains the most common cancer in women, there are more than 3.8 million breast cancer survivors in the United States. What are my risk factors? Alcohol consumption: 2-3 drinks per day increases breast cancer risk by 20 percent. Lack of physical activity: Regular physical activity reduces breast cancer risk, especially in postmenopausal women. Overweight/Obesity: Having more fat tissue after menopause can raise estrogen levels, which increases risk of breast cancer. Nulliparous: History of multiple pregnancies and/or becoming pregnant at an early age reduces breast cancer risk. Not breastfeeding: Breastfeeding may slightly lower breast cancer risk, especially if it is continued for a year or more. Birth control: Some birth control methods use hormones, which may increase breast cancer risk. Hormone therapy: Use of hormonal therapy with estrogen after menopause increases risk of breast cancer. LKN EXPERT
What are unmodifiable risk factors? Genetics (5-10 percent of breast cancer cases are hereditary). Mutations in BRCA1 and BRCA2 genes are the most common cause of hereditary breast cancer. Personal or family history of breast cancer. Race/ethnicity (White women have slightly higher risk than African American women; however, in women under age 45, breast cancer is more common in African American women). Having dense breast tissue. Abnormal breast tissue. Early menstruation and late menopause. Radiation exposure to chest before age 30.
Poras K. Patel, MD, is board-certified in hematology/oncology and received his residency and fellowship training at The Brooklyn Hospital Center. He was honored as chief resident and chief fellow during his training and has published several medical articles and journals. Dr. Patel is a physician with Southern Oncology Specialists. Visit them at one of their four area locations (Charlotte, Huntersville, Denver, Mooresville) or via www.southernoncology.com.
What should I consider in cancer risk assessment? Women above age 35 should have their risk for breast cancer estimated according to the modified Gail model—which is a computerbased model that uses several factors, including age, race, age at menarche, age at first live birth or nulliparity, number of first-degree relatives with breast cancer, number of previous breast biopsies, and histology of the breast biopsies to produce estimates of future breast cancer risk. Women at high risk for breast cancer may benefit from riskreducing intervention. Options for risk reduction should be discussed in a shared decision-making environment. Risk-reducing mastectomy is generally considered in women with a pathogenic genetic mutation conferring a high-risk for breast cancer, compelling family history, or possibly with prior thoracic radiation therapy before age 30. Some women may benefit from bilateral oophorectomy (removal of both ovaries). There are four approved riskreducing agents - tamoxifen, raloxifene, anastrozole, and exemestane. Tamoxifen can be utilized in premenopausal and postmenopausal women, whereas the other three agents can only be used in postmenopausal women. Tamoxifen and raloxifene are contraindicated in women with history of blood clot, and none of the agents are approved in pregnancy. Uterine malignancy was reported in a very small number of patients taking tamoxifen. w WRITER DR. PORAS K. PATEL