Are There Reasons Not To Take One Of These Drugs To Help Reduce Breast Cancer Risk
All drugs have risks and side effects that must be discussed when making the decision about chemoprevention.
Most experts agree that tamoxifen and raloxifene should not be used to reduce breast cancer risk in women who:
- Have a higher risk of serious blood clots*
- Are pregnant or planning to become pregnant
- Are breastfeeding
- Are taking estrogen
- Are taking an aromatase inhibitor
- Are younger than 35 years old
*Women who have a higher risk of serious blood clots include those who have ever had serious blood clots . Many doctors also feel that if youve had a stroke or heart attack, or if you smoke, are obese, or have high blood pressure or diabetes, you also have a higher risk of serious blood clots. Women with any of these conditions should ask their doctors if the benefits of taking one of these drugs would outweigh the risks.
A woman who has been diagnosed with any type of uterine cancer or atypical hyperplasia of the uterus should not take tamoxifen to help lower breast cancer risk.
Raloxifene has not been tested in pre-menopausal women, so it should only be used if you have gone through menopause.
Aromatase inhibitors are not useful for pre-menopausal women, so they should only be used if you have gone through menopause. These drugs can cause bone thinning , so theyre not likely to be a good option in women who already have thin or weakened bones.
Talk with your doctor about your total health picture to make the best possible choice for you.
Be Mindful Of Your Environment Including Household Chemicals
It’s long been suspected that environmental exposures, including the chemicals we are exposed to in everything from household cleaners to cosmetics, may play a role both in breast cancer risk and recurrence. While it’s difficult to study , we are learning that practicing caution is wise.
A 2017 review looked at the evidence to date connecting breast cancer and the environment. Some compounds, such as PCBs , may raise the risk of recurrence. Others may alter the regulation of genes involved in cell growth, apoptosis , and much more. Endocrine disrupting chemicals can mimic the function of hormones in our bodies, and it’s well known that the hormone estrogen should be avoided to reduce breast cancer recurrence, at least for people with hormone positive tumors.
There is a great amount of information out there of varying degrees of concern, but the important thing to note is that it’s relatively easy to avoid concerning chemicals . Most household cleaners can easily be replaced with baking soda, lemon juice, and vinegar .
The environmental working group has a website where you can search on thousands of personal care products . And adding a few houseplants to your home can help to absorb many indoor air carcinogens with indoor air thought to be more of a concern that outdoor air pollution.
Answer: Risks Of Breast Cancer With Lift
All surgical procedures carry some degree of risk. Any breastoperation can result in changes in sensation. This happens less with lifts thanreductions but is still possible Occasionally, minor complications occur and donot affect the surgical outcome. Major complications associated with thisprocedure are rare. The suitability of the breast lift procedure and specificrisks may be determined during your consultation. Although these risks and some risks of scarring exist, there is no real increased risk of breast cysts or cancer from the breast lift alone. Best of luck to you!
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Does Breast Reduction Surgery Affect Sensation In The Breast
Sensation loss is a real concern, Manahan admits. Its hard to guarantee breast and nipple sensation will be the same after breast reduction. As surgeons, we do everything we can.
There is not one major nerve that we can see and preserve when we operate. The nerves that supply sensation are more like seedlings or sprouts in a pot, and sometimes removing excess tissue from the interior of the breast results in areas of numbness. If loss of sensation is a serious concern for the prospective patient, thats an important factor to consider.
Testing Only When Necessary
In recent years, medical organizations have asked their members to identify tests and procedures commonly used in their field whose necessity should be questioned and discussed.
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The American Society of Plastic Surgeons is one of those groups. It stated in 2014 that women undergoing elective breast surgeryshould not have additional screening beyond existing guidelines unless there was a concern based on their medical history or a physical finding.
But it can be hard to help doctors stop doing something they have done for years.
The recent JAMA Surgery study showed 30 percent of women ages 30 to 39 had mammograms before breast reduction surgery, a rate five times higher than that of other women their age.
About 4 percent of women ages 29 and younger received mammograms as they considered breast reduction compared with 0.2 percent of the population of millennial women.
The young women in this study probably wouldnt have had the screenings otherwise.
The reason: None of them had a reported breast cancer risk.
When performing the analysis, researchers had excluded women whose medical records indicated a personal or family history of breast cancer, genetic predisposition or prior benign breast disease although theres a chance the risk existed but wasnt noted in their records.
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Is There Scarring After Reduction Mammoplasty
This procedure involves a sizable incision and thus will create scarring. Your incision scars will be pink for a few weeks, and then they will begin to lighten. They will always be there, but their appearance will continue to improve with time.
The best advice for managing or attempting to minimize the appearance of your scars is to leave the steri-strips in place until Dr. Silverman removes them at your follow-up. Also, wearing your surgical bra and then your support bra at all times during the first 4-6 weeks is critical. This eliminates any pressure on the incisions, which keeps the scars as narrow as possible. It also helps eliminate some of the redness.
Keep your scars out of the sun. Healing skin is extra sensitive, plus sun exposure makes scars darken. A product called bioCorneum+ SPF 30 is a good topical silicone treatment that doubles as a sunscreen. It creates an invisible protective layer over the scar. This keeps it clean, supported, and shielded from UV rays.
Dr. Silverman can recommend topical scar-minimizing treatments that keep the area moisturized and help to minimize the appearance of the scars. SkinMedica makes one such product called Scar Recovery Gel with Centelline.
Lightly massaging your scars can help them heal more smoothly. But you cannot do this too early and put stress on your incisions. Ask Dr. Silverman when massage could be appropriate, along with the proper technique.
What Are The Potential Harms Of Risk
As with any other major surgery, bilateral prophylactic mastectomy and bilateral prophylactic salpingo-oophorectomy have potential complications or harms, such as bleeding or infection . Also, both surgeries are irreversible.
Bilateral prophylactic mastectomy can also affect a womanâs psychological well-being due to a change in body image and the loss of normal breast functions. Although most women who choose to have this surgery are satisfied with their decision, they can still experience anxiety and concerns about body image . The most common psychological side effects include difficulties with body appearance, with feelings of femininity, and with sexual relationships . Women who undergo total mastectomies lose nipple sensation, which may hinder sexual arousal.
Bilateral prophylactic salpingo-oophorectomy causes a sudden drop in estrogen production, which will induce early menopause in a premenopausal woman . Surgical menopause can cause an abrupt onset of menopausal symptoms, including hot flashes, insomnia, anxiety, and depression, and some of these symptoms can be severe. The long-term effects of surgical menopause include decreased sex drive, vaginal dryness, and decreased bone density.
Women who have severe menopausal symptoms after undergoing bilateral prophylactic salpingo-oophorectomy may consider using short-term menopausal hormone therapy after surgery to alleviate these symptoms.
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Your Sex Life After Risk
Having breast surgery may affect your sex life and your body image.
Breast reconstruction forms new breast shapes but the sensations will not be the same as before. If you have a partner, there will usually be a period of adjustment for you both. Talking to each other and sharing your feelings and fears can help you overcome most difficulties with time.
Getting Information And Support
A team of specialists will answer your questions and give you the information you need. You may need lots of time to decide or you may already have decided.
This usually takes a few months. This may sound like a long time. But it is important to take time to make sure you make an informed decision. These healthcare professionals will support you while you make your decision:
- Clinical geneticist or genetics counsellor
They explain your risk of getting breast cancer over the next 5 to 10 years and over your lifetime. They will also talk to you about ways you can reduce or manage your risk of breast cancer.
- Breast surgeon
They will explain what risk reducing surgery involves
- Reconstructive surgeon
They will talk about your options for breast reconstruction with you.
- Breast care nurse
A breast care nurse will give you information and support.
- Psychologist
A psychologist can help you explore your feelings and expectations about risk-reducing breast surgery.
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What Can I Do To Reduce My Risk Of Breast Cancer
You can make healthy choices to help lower your breast cancer risk. CDCs Dr. Temeika Fairley explains in this video.
Many factors over the course of a lifetime can influence your breast cancer risk. You cant change some factors, such as getting older or your family history, but you can help lower your risk of breast cancer by taking care of your health in the following ways
- Exercise regularly.
- Dont drink alcohol, or limit alcoholic drinks.
- If you are taking, or have been told to take, hormone replacement therapyexternal icon or oral contraceptivesexternal icon , ask your doctor about the risks and find out if it is right for you.
- Breastfeed your children, if possible.
- If you have a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, talk to your doctor about other ways to lower your risk.
Staying healthy throughout your life will lower your risk of developing cancer, and improve your chances of surviving cancer if it occurs.
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Which Women Might Consider Having Surgery To Reduce Their Risk Of Breast Cancer
Women who inherit a deleterious mutation in the BRCA1 gene or the BRCA2 gene or mutations in certain other genes that greatly increase the risk of developing breast cancer may consider having bilateral prophylactic mastectomy and/or bilateral prophylactic salpingo-oophorectomy to reduce this risk.
In two studies, the estimated risks of developing breast cancer by age 70 years were 55 to 65 percent for women who carry a deleterious mutation in the BRCA1 gene and 45 to 47 percent for women who carry a deleterious mutation in the BRCA2 gene . Estimates of the lifetime risk of breast cancer for women with Cowden syndrome, which is caused by certain mutations in the PTEN gene, range from 25 to 50 percent or higher , and for women with Li-Fraumeni syndrome, which is caused by certain mutations in the TP53 gene, from 49 to 60 percent .
Other women who are at very high risk of breast cancer may also consider bilateral prophylactic mastectomy, including:
- those with a strong family history of breast cancer
- those with lobular carcinoma in situ plus a family history of breast cancer
- those who have had radiation therapy to the chest before the age of 30 yearsâfor example, if they were treated with radiation therapy for Hodgkin lymphoma
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What Kinds Of Surgery Can Reduce The Risk Of Breast Cancer
Two kinds of surgery can be performed to reduce the risk of breast cancer in a woman who has never been diagnosed with breast cancer but is known to be at very high risk of the disease.
A woman can be at very high risk of developing breast cancer if she has a strong family history of breast and/or ovarian cancer, a deleterious mutation in the BRCA1 gene or the BRCA2 gene, or a high-penetrancemutation in one of several other genes associated with breast cancer risk, such as TP53 or PTEN.
The most common risk-reducing surgery is bilateral prophylactic mastectomy . Bilateral prophylactic mastectomy may involve complete removal of both breasts, including the nipples , or it may involve removal of as much breast tissue as possible while leaving the nipples intact . Subcutaneous mastectomies preserve the nipple and allow for more natural-looking breasts if a woman chooses to have breast reconstruction surgery afterward. However, total mastectomy provides the greatest breast cancer risk reduction because more breast tissue is removed in this procedure than in a subcutaneous mastectomy .
Even with total mastectomy, not all breast tissue that may be at risk of becoming cancerous in the future can be removed. The chest wall, which is not typically removed during a mastectomy, may contain some breast tissue, and breast tissue can sometimes be found in the armpit, above the collarbone, and as far down as the abdomenâand it is impossible for a surgeon to remove all of this tissue.
Do You Recommend Having A Breast Reduction Before Having Kids Or After
Generally, we recommend having breast reduction surgery after having children, not before. That said, there is room for options. During your consultation with Dr. Silverman, you can discuss how future pregnancy and breastfeeding may affect the outcome of your procedure. There is no reason not to explore your options for breast contouring even if you plan to have children in the future. In most cases, women who have breast reduction surgery can breastfeed later if they would like. This must be a prominent topic discussed during the consultation so the maximum amount of glandular tissue can be preserved during the breast reduction procedure. That said, it is important to understand that there is a slight risk of disruption to the milk glands that could make breastfeeding difficult. Additionally, there are concerns related to the cosmetic effects that pregnancy and breastfeeding can have on the breasts, even after reduction surgery.
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Can A Breast Reduction Reduce The Risk Of Cancer
Breast reduction surgery is a medical and cosmetic procedure performed by a breast reduction surgeon. This type of surgeon is specifically trained to perform procedures involving the reduction and augmentation of the breasts. If you have a strong family history of breast cancer you may have the disease-causing mutation in your genes and you may be wondering if there are preventative measures you can take. Studies have been done that show that there is evidence that breast reduction surgery can reduce the risk of cancer, but there are some caveats that well explore below.
Can breast reduction reduce the risk of cancer?
Breast reduction surgery cannot cure cancer, but it can reduce the risk. Because breast reduction surgery involves the excision of excess tissues, skin and fat from the chest, it can remove cancerous cells if they are already there or if the person undergoing the surgery already possesses the disease-causing mutation but does not show signs of breast cancer. There is one specific procedure that can be done to reduce the risk of breast cancer: bilateral prophylactic mastectomy.
What is bilateral prophylactic mastectomy?
A breast cancer surgeon must perform this surgery. You cannot visit any surgical professional. They must be specifically trained to handle the contours, muscles and tissues of the breasts.
What to look for in a breast reduction surgeon
Breast Reduction Surgery What Happens During Surgery
All surgery, including breast reduction surgery, must be performed within licensed and accredited facilities. A registered anaesthetist must be present to treat you for any adverse reaction you may have to the anaesthetic. You can check if your anaesthetist is registered by searching on the AHPRA website.
Breast reduction surgery is usually performed under general anaesthetic. In some cases, when the reduction is only small, the medical practitioner may opt for local anaesthetic with sedation.Generally speaking, breast reduction surgery involves:
- The medical practitioner makes an incision around the nipple. The incision is continued in a straight vertical line to the breast crease. Sometimes, a further cut is made in the crease beneath the breast.
- In most cases, the nipple remains attached to its blood and nerve supply at all times. Sometimes, however, an extremely heavy breast may need a free nipple graft. The nipple is removed and reattached at a higher point on the breast.
- Excess skin, fat and glandular tissue is removed. Sometimes, the medical practitioner will use liposuction to help remove excess fat.
- The medical practitioner puts stitches deep inside the breast tissue to add support.
- Skin incisions are brought together and closed.
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