NYU Langone’s Perlmutter Cancer Center offers a screening and prevention program for women who are at a particularly high risk of developing breast cancer. In addition to regular screening, doctors can recommend several preventive treatments that help reduce this risk.
Preventive Hormone Therapies
Certain hormone therapies can be used preventively if doctors determine you are at high risk of developing breast cancer tumors that have certain hormone receptors. These types of cancers are known as estrogen receptor-positive and progesterone receptor-positive.
Selective Estrogen Receptor Modulators
Selective estrogen receptor modulators block the potentially harmful effects of the hormone estrogen in the breast but allow it to continue to have a positive impact on your bones.
Doctors may prescribe selective estrogen receptor modulators to lower a woman’s risk of developing breast cancer. The medication tamoxifen is used in both premenopausal and postmenopausal women. While it decreases the risk of breast cancer, it can increase the risk of uterine cancer, more commonly in postmenopausal women.
Raloxifene, another selective estrogen receptor modulator, is only prescribed in postmenopausal women.
You may need to take tamoxifen or raloxifene for up to five years to reap the preventive benefits.
Aromatase inhibitors block the enzyme aromatase, preventing a woman’s body from producing estrogen. These hormone therapies, which include anastrozole and exemestane, prevent breast cancer in postmenopausal women by blocking the small amount of estrogen that their bodies still make.
Another aromatase inhibitor, letrozole, may be prescribed in a clinical trial setting. Our doctors can help you decide whether a clinical trial is right for you.
Doctors can help women decide whether to have surgery to reduce their risk of developing breast cancer. This option is most often recommended for women with genetic mutations, such as BRCA1 and BRCA2, although some women with a strong family history of breast cancer may also consider it.
A bilateral mastectomy involves removing both breasts. This procedure can greatly reduce the risk of breast cancer in women with BRCA1 and BRCA2 mutations.
Women may have the option of a mastectomy that spares the nipples and areola, the ring of pigmented tissue around the nipple. Several options for reconstruction are available at the time of the surgery to help a woman preserve the natural appearance of her breasts, including our breast in a day surgery, during which surgeons perform a nipple-sparing mastectomy and implant reconstruction on the same day.
The hospital stay for a double mastectomy ranges from one to several days, depending on whether you have reconstruction and the type of reconstruction procedure. During this time, doctors monitor your condition and ensure you are healing properly.
Removal of the Ovaries and Fallopian Tubes
Women with BRCA mutations who have completed their childbearing may be candidates for surgery to remove the ovaries and fallopian tubes. This procedure is called a bilateral prophylactic salpingo-oophorectomy. Ovaries produce estrogen, which can increase the risk of breast cancer. Removing them can slow or prevent the growth of cancer.
While removing the ovaries and fallopian tubes may reduce the risk of developing breast cancer, the procedure also causes the body to enter menopause if you have not already done so at the time of surgery. Your doctor can help you prepare for and manage menopausal symptoms, such as hot flashes and decreased sex drive, with medications and other treatments.
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