Breast cancer risk reduction

Therese B. Bevers, Deborah K. Armstrong, Banu Arun, Robert W. Carlson, Kenneth H Cowan, Mary B. Daly, Irvin Fleming, Judy E. Garber, Mary Gemignani, William J. Gradishar, Helen Krontiras, Swati Kulkarni, Christine Laronga, Loretta Loftus, Deborah J. MacDonald, Martin C. Mahoney, Sofia D. Merajver, Ingrid Meszoely, Lisa Newman, Elizabeth PritchardVictoria Seewaldt, Rena V. Sellin, Charles L. Shapiro, John H. Ward

Research output: Contribution to journalReview article

22 Scopus citations

Abstract

Breast cancer risk assessment provides a means of identifying healthy women at increased risk for future development of this disease. However, many of the risk factors for breast cancer are not modifiable. The demonstration that use of tamoxifen or raloxifene for 5 years substantially decreases the future risk of breast cancer provides an opportunity for a risk reduction intervention. However, the risks and benefits associated with tamoxifen or raloxifene use should be evaluated and discussed with each woman as part of a shared decision-making process. Women taking a risk reduction agent must be closely monitored for potential side effects associated with use of these agents. In special circumstances, such as in carriers of a BRCA1/2 mutation, in whom the risk of breast cancer is very high, a bilateral mastectomy or bilateral salpingo-oophorectomy may be considered for breast cancer risk reduction. Women considering either surgery should undergo multidisciplinary consultations before surgery to become well informed about all treatment alternatives, the risks and benefits of risk reduction surgery, and, in the case of bilateral mastectomy, the various reconstruction options available. The panel strongly encourages women and health care providers to participate in clinical trials to test new strategies to decrease the risk of breast cancer. Only through the accumulated experience gained from prospective and well-designed clinical trials will additional advances in the reduction of breast cancer risk be realized.

Original languageEnglish (US)
Pages (from-to)1112-1146
Number of pages35
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume8
Issue number10
DOIs
Publication statusPublished - Oct 1 2010

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Keywords

  • BCRA1
  • BCRA2
  • Breast cancer
  • Breast carcinoma
  • Chemoprevention
  • LCIS
  • NCCN clinical practice guidelines
  • NCCN guidelines
  • Prophylactic mastectomy
  • Raloxifene
  • Risk assessment
  • Risk reduction
  • Tamoxifen

ASJC Scopus subject areas

  • Oncology

Cite this

Bevers, T. B., Armstrong, D. K., Arun, B., Carlson, R. W., Cowan, K. H., Daly, M. B., ... Ward, J. H. (2010). Breast cancer risk reduction. JNCCN Journal of the National Comprehensive Cancer Network, 8(10), 1112-1146. https://doi.org/10.6004/jnccn.2010.0083