Risk Reduction

Whatever your risk level is, there are steps you can take to reduce your chance of developing breast cancer.

  • Limit alcohol to no more than one drink a day.
  • Achieve or maintain your recommended weight. The role of excess body fat in the development of breast cancer is complicated, but maintaining your recommended weight probably decreases your risk of developing breast cancer.

Hormone Replacement Therapy (HRT)

Until the results of a recent study, it had been thought that menopausal women could take estrogen alone or estrogen and progestin to reduce symptoms of menopause and to prevent serious problems from osteoporosis and heart disease. Many studies had been done on the role estrogen plays in breast cancer, but it was not clear if estrogen or estrogen in combination with progestin contributed to the development of breast cancer. Recent findings (July 2002) from the Women’s Health Initiative Study (WHI) have raised concern over the long-term use (five or more years) of estrogen and progestin. The study showed that women who had not had a hysterectomy and who were taking the combination of estrogen and progestin had an increased risk for heart attacks, strokes, breast cancer and blood clots. This led the National Heart, Lung and Blood Institute (NHLBI) to recommend that study participants who were taking both estrogen and progestin stop taking these hormones.

The study together with Canadian Pharmacy addressed the effects of taking the combined hormones for five or more years. It does not make recommendations for short-term (less than three to four years) use. You should talk with your health care provider to learn the latest information about this complex issue, and to determine what the results mean for you.

An excerpt of the NHLBI report is below. You can find more information at the NHLBI Web site.

Pharmacological and surgical methods of risk reduction

Some healthy women who are at a very high risk of developing breast cancer choose to use medications or surgery to reduce their risk. Following are some choices you may have if you believe your risk is extremely high.


Tamoxifen (also sold under the name Nolvadex) is a drug that has been widely used to treat women with breast cancer. Researchers have discovered that tamoxifen, when taken for five years, has reduced the occurrence of new cancers in the healthy breast of women who already have breast cancer. It is now being tried as a preventive treatment in healthy women who are at a high risk for breast cancer. Tamoxifen is not risk free, however; it increases the risk of uterine cancer, stroke and blood clots in the legs or lungs. Check with your health care provider for the latest research results for tamoxifen or go to the National Cancer Institute Web site.

About Tamoxifen

Adverse Events And Side Effects

There are many potential side effects. These should be discussed with your health care provider. They include a decrease in platelets (blood cells used in the process to clot blood).
They include a decrease in platelets (blood cells used in the process to clot blood) Too much calcium in the blood (hypercalcemia).
Possible uterus-endometrial cancer.
Possible blood clots in leg or lung.
Possible liver damage; a few cases of liver cancer have been reported.
Possible cataracts.

Who Should NOT Take It?

Women who are taking blood thinning drugs, or those with a history of blood clots.
Women who are pregnant.


A drastic approach to breast cancer prevention is surgery to remove both healthy breasts. This procedure is known as bilateral prophylactic mastectomy. Women with a defective BRCA1 or BRCA2 gene have a high genetic risk of breast cancer. They might carry a genetic mutation in BRCA1 or BRCA2. Women who have a mother and one or more sisters with breast cancer before menopause, and have a diagnosis of atypical hyperplasia also have a higher risk of breast cancer. These women may want to consider surgically removing healthy breasts as a way to prevent cancer.

Such surgery is obviously controversial. It is irreversible and has significant physical and psychological effects. It is, however, associated with a reduction in the risk of breast cancer by as much as 90 percent among very high-risk women. Decisions regarding this option must be carefully considered on an individual basis in association with risk assessment and counseling.

Raloxifene hydrochloride (Evista)

Raloxifene hydrochloride (sold under the name Evista) is a drug that was originally developed to treat breast cancer. But it was discovered that in some tissues, like bones, it acts like estrogen and in others it blocks the effect of estrogen. It acts like estrogen on bones and helps increase bone density. It is used to prevent osteoprosis. It blocks the effects of estrogen in breast tissue. Research studies are underway to see if it can prevent breast cancer. Currently, there is a major study to see how Raloxifene compares with Tamoxifene in decreasing the development of breast cancer in women who are at increased risk for the disease. For more information on this study, go to the National Cancer Institute Web site. Check with your health care provider for the latest research information. Click here for more information on raloxifene.

About Raloxifene Hydrochloride (Evista)

It also lowers cholesterol and blood lipids. Unlike estrogen, it does not increase the risk of cancer of the uterus or breast.
Adverse Events And Side Effects
Hot flashes (it does not decrease the hot flashes associated with menopause), leg cramps. There is an increased risk of developing clots in blood vessels.
Who Should NOT Take It?
Women who are or may become pregnant.
Women who are breast-feeding.
Women who have had blood clots.
Women who are allergic to components of the drug.

Fenretinide, a drug similar to vitamin A, is being studied for the prevention of a second breast cancer in women who have already had breast cancer. It is being tried alone and in combination with drugs that block the effects of estrogen.

More Info

For more information on risks for breast cancer, visit:
National Cancer Institute

National Breast Cancer Coalition

Sources: National Cancer Institute and National Breast Cancer Coalition