Proactive steps to take when family history?


Question from Rosie: With a history of breast cancer in the family, what are some proactive steps I can take for my daughters and myself to ensure our lives are not ruled by this constant threat yet remain vigilant?
Answers - Patricia A. Ganz, M.D. First of all, most women with a family history overestimate their risk of getting breast cancer. For example, if your mother had breast cancer after the postmenopausal years—after 65 years of age—your risk might only be 15 to 18 percent, compared to a woman without a family history whose risk might be 10 or 11 percent. So your risk might be higher, but not 100 percent higher.

The value of knowing your family history is that you can take steps to reduce your risk of breast cancer, just like if you knew diabetes was in your family. If you know you are at risk for diabetes, for instance, you'd try to watch your weight and diet. If you are worried about heart disease, take steps to lower blood pressure. For breast cancer, have regular exams by a health professional every six months, so if an abnormality is detected, it can be evaluated further.

Similarly, mammography can be used to detect breast cancer earlier, and this is generally started in the early 40s and continued annually, thereafter. If your family member had breast cancer at a young age, less than 40, you may want to consider mammography earlier than your other family members. In addition to an early screening, we now have the medication tamoxifen, an anti-estrogen, which clinical trials find reduces the risk of breast cancer about 50 percent in women with a high risk of getting breast cancer.

The risk factors that we consider when calculating whether someone is at high risk for breast cancer include the number of close family members that have had it—mother, sister, or daughter, whether the women have had a breast biopsy and abnormal tissue on the biopsy, whether she menstruated at a young age and whether she had children. Also, there is another study going on in the US and Canada called the STAR trial, which is studying tamoxifen versus raloxifene to see if they are equivalent or better in postmenopausal women at high risk for breast cancer.
Marisa Weiss, M.D. Lifestyle changes may also help reduce your risk. Each one alone may have a minimal benefit, but when added together, they may be significantly more helpful. These include weight control, trying to stay as close to your body weight as possible, regular exercise, try to shoot for 3 to 4 hours a week, trying to minimize the amount of alcohol that you drink. Also, smoking cessation is important for your overall health, and may also be helpful in reducing breast cancer risk a little bit. There are studies that show that regular support groups and an active spiritual life are likely to improve your overall health and may reduce your risk for experiencing illness.

On Wednesday, October 17, 2001, our Ask-the-Expert Online Conference was called Quality of LifePatricia A. Ganz, M.D.,Marisa Weiss, M.D., answered your questions about how breast cancer can affect physical, emotional, social, and sexual aspects of your life.

The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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