Dense breasts are not the only factor increasing the risk for a breast cancer diagnosis. Family history matters, especially in a first degree relative who was diagnosed at a young age. Younger onset menstruation and older age at first pregnancy also boost the threat for breast cancer.
So what can at-risk women do?
At the Robert H Lurie Comprehensive Cancer Center, doctors, following years of research, have an idea. A medication once used only to treat breast cancer, is showing great promise for preventing it in high risk women.
Dr. Seema Khan is a professor of surgery at Lurie Comprehensive Cancer Center.
“It became clear that it was a very well tolerated drug for cancer treatment and there was potential for using it for prevention in women who are at increased risk but don’t yet have breast cancer,” Khan said. “There were trials done and those trials showed that tamoxifen does in fact reduce the chances of developing breast cancer by almost a half for women who are at increased risk. And there was a lot of excitement about this discovery because the idea was shown we could reduce the burden of breast cancer development among women who are at increased risk.”
But many women didn’t want to take tamoxifen in the doses required for cancer treatment.
So Lurie investigators, building on a Swedish study, have launched a clinical trial using tamoxifen in small doses.
“They found even low dose tamoxifen reduces breast density as well as higher doses,” Khan said. “So we had two areas of research coming together: low doses may work for prevention and also cut breast density. So we are in fact starting a trial at Northwestern that’s going to be open at 10 sites throughout the country. It’s funded by the national cancer institute. … The idea is we want to use a measurement of breast density reduction with tamoxifen as an indicator tamoxifen is doing what it needs to do to prevent breast cancer. Women who participate in our trial who are at increased risk for breast cancer, pre-menopausal women will be offered 5 mg of tamoxifen to start with and then we will check their breast density.”
Tamoxifen works by disrupting estrogen.
Lifestyle modifications, while not as effective, do help.
- Avoid post-menopausal hormone use.
- Limit alcohol use to 2-3 drinks or less per week.
- Engage in physical activity to retain bone density.
- Most importantly maintain a healthy body weight, especially after menopause. Shedding just 10 extra pounds reduces circulating estrogen and subsequently breast cancer risk.