Approximately one out of every eight American women will be diagnosed with breast cancer at some time during her life, according to the National Cancer Institute. Several factors can contribute to an increased risk of breast cancer, including a personal or family history, age, obesity, smoking and alcohol consumption. For those with a particularly high risk of developing the potentially deadly disease, doctors may recommend a number of prevention options, from healthy lifestyle changes and more frequent screenings to surgical treatment. Breast surgeon Dr. Kristi Funk joins The Doctors to discuss another, less well-known, tool in the cancer prevention arsenal: risk-reducing medication.
According to Dr. Funk, estrogen antagonist medications, such as tamoxifen and raloxifene, have been in use for more than 30 years and have been shown to drop the risk of breast cancer by half or more. The treatment isn’t for everyone, however. Dr. Funk explains that cancer specialists and geneticists can assess a patient’s likelihood of developing the disease within five years, 10 years and 20 years. If a patient has a 20 percent lifetime risk or a calculated risk that is more than 1.7 percent in the next five years, she would be a good candidate for these medications.
Side effects of these drugs can include menopause, hot flashes, night sweats, vaginal dryness, decreased libido, insomnia and mood swings. More serious risks of use include uterine cancer, blood clots, stroke and cataracts, though Dr. Funk emphasizes that these risks are infrequent.
Due to these potential effects, Dr. Funk says recommendations should be individualized for each patient with an elevated risk for cancer. A younger woman who plans to conceive children, for instance, likely would require a different prevention option than an older woman already approaching menopause. She adds that many general practitioners and family medicine physicians may be unaware of all the options available to women with elevated risks, so patients should consult with a specialist.
“This is an example about talking to your doctor, asking them, ‘Are you the right person to have this discussion with me?’” OB-GYN Dr. Jennifer Ashton says.