If you've been diagnosed with breast cancer, you're 3 to 4 times more likely to develop a new cancer in the other breast or a different part of the same breast. This risk is different from the risk of the original cancer coming back (called risk of recurrence).
Steps you can take
If you've been diagnosed with breast cancer, you might already be taking medicine to reduce your risk of developing a new breast cancer. Beyond that important step, there are a number of lifestyle choices you can make to help keep your risk as low as it can be:
- maintaining a healthy weight
- exercising regularly
- limiting alcohol
- eating nutritious food
- never smoking (or quitting if you do smoke)
These are just a few steps you can take. Review the links on the left side of this page for more options.
Along with these lifestyle choices, there other options that may be able to reduce both your risk of recurrence and your risk of developing a new cancer.
Hormonal therapy medicines, such as an aromatase inhibitor or a SERM (selective estrogen receptor modulators) can help reduce the risk of:
- hormone-receptor-positive breast cancer coming back
- a new hormone-receptor-positive breast cancer developing
Hormonal therapy medicines work in two ways:
- by lowering the amount of estrogen in the body
- by blocking the action of estrogen on breast cancer cells
Hormonal therapy medicines do not reduce the risk of hormone-receptor-negative breast cancer.
For more information, visit the Breastcancer.org Hormonal Therapy section.
Avoid products that contain estrogen or progesterone. If you've been diagnosed with breast cancer, you shouldn't use HRT (hormone replacement therapy) to treat menopausal symptoms or birth control methods that contain the hormones estrogen and/or progesterone. These hormones can cause hormone-receptor-positive breast cancers to develop and grow.
While only a few small studies have looked at HRT use in women with a personal history of breast cancer, very large research studies have shown that using HRT increases breast cancer risk among women in general. So doctors recommend that women with a personal history of breast cancer avoid HRT. Not being able to use HRT can present a challenge, because menopausal side effects can dramatically reduce quality of life for some women. If you're having severe hot flashes or other menopausal side effects and have a personal history of breast cancer, talk to your doctor about non-hormonal options for treating these side effects, such as acupuncture or meditation.
Similarly, it's generally thought that birth control pills are considered unsafe for premenopausal women with a personal history of breast cancer. They cause higher levels of hormones than your body makes (that's how they overpower your menstrual cycle). Because of this issue, most doctors recommend using barrier methods of birth control: condoms or a diaphragm, or a non-hormonal I.U.D. such as ParaGard.
More frequent screening: If you've been diagnosed with breast cancer, you and your doctor will develop a screening plan tailored to your unique situation. In addition to the recommended screening guidelines for women at average risk, a screening plan for a woman with a history of breast cancer may include:
- a monthly breast self-exam
- a yearly breast exam by your doctor
- a digital mammogram every year starting at age 40
- an MRI scan every year
You may have these tests more often than a woman at average risk. So you might have one screening test -- a mammogram, say -- and then have a different test -- an MRI -- 6 months later. Before or after each screening test, your doctor may perform a breast exam.
A breast ultrasound is another powerful tool that can help detect breast cancer in women with a history of breast cancer gene. This test does not take the place of digital mammography and MRI scanning.
Talk to your doctor about developing a specialized program for early detection that addresses your breast cancer risk, meets your individual needs, and gives you peace of mind.
Protective surgery: Removing the other healthy breast and ovaries -- called prophylactic surgery ("prophylactic" means "protective") -- are very aggressive, irreversible risk-reduction options that some women choose. The benefits of prophylactic surgery after being diagnosed with breast cancer depend on your age, your overall health, and the stage and type of breast cancer you had.
If you don't have an abnormal BRCA1 or BRCA2 gene (Most inherited cases of breast cancer are associated with one of two abnormal breast cancer genes: BRCA1 -- BReast CAncer gene one -- and BRCA2 -- BReast CAncer gene two) or a strong family history of breast cancer, and you were diagnosed with early-stage breast cancer, you have a low risk of the original cancer coming back. Prophylactic surgery may or may not benefit you.
If you've been diagnosed with breast cancer and do have an abnormal BRCA1 or BRCA2 gene or strong family history of breast cancer, you have a higher risk of developing a new, unrelated cancer. In this case, prophylactic surgery may be of value to you.
If you've been diagnosed with advanced-stage breast cancer, the risk of the cancer coming back in the same breast may be greater than the risk of developing a new, unrelated breast cancer. In this case, prophylactic surgery may offer limited benefits.
It's important to remember that no procedure -- even surgery -- totally eliminates the risk of cancer. Even when a breast or ovary has been removed, cancer can still develop in the area where it used to be. Close follow-up is necessary, even after prophylactic surgery.
Prophylactic surgery decisions require a great deal of thought, patience, and discussion with your doctors, genetic counselors, and family -- plus a tremendous amount of courage. Take the time you need to consider these options and make decisions that feel comfortable to you.
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