There are many options for high-risk women including:
High-Risk Breast Cancer Screening Programs
A number of medical centers have established high-risk breast cancer screening programs to help identify and monitor women at high risk for developing breast cancer. Women often need to be referred to one of these centers by their primary care physician or ob/gyn.
Magnetic Resonance Imaging (MRI) Screening
Studies have found magnetic resonance imaging (MRI) screening is better than mammography screening in detecting tumors in women who are at high risk for breast cancer. If you are at high risk for breast cancer, you may want to consider adding MRI screening to your annual mammography screening.
BRCA Genetic Testing
If you have many women or men in your family who have developed breast cancer, you may want to consider genetic testing. It is recommended that all women speak with a genetic counselor before deciding whether to be tested.
If your test result is negative it means you have an average or only slightly higher than average risk of developing breast cancer. A positive test result means you carry a genetic mutation for breast cancer, and you are at greater risk of getting the disease. It does not mean you definitely will get it. Because some particular mutations are associated with higher risks than others, it is essential to have a qualified genetic counselor interpret the results.
Women who are found to carry a BRCA mutation have several options:
- Regular monitoring by a breast specialist. At the current time, MRI with mammography and ultrasound starting when you're around 25 or 30 seems to be the best approach to surveillance. But you must make sure you are getting the best breast MRI available, in a high-risk or genetic clinic. Images are only as good as the person taking and then reading the pictures.
- Prophylactic mastectomy (removal of both breasts) and/or prophylactic oophorectomy (removal of the ovaries).
- Chemoprevention (like tamoxifen or raloxifene).
Tamoxifen and raloxifene are hormonal treatments used to prevent breast cancer. (Tamoxifen is also used to treat hormone-sensitive breast cancer.) Hormonal therapies slow or stop cancer's growth by changing the hormonal environment. Tamoxifen can be taken by both premenopausal and postmenopausal women. In contrast, raloxifene can only be used by postmenopausal. (It hasn't yet been tested in premenopausal women.) Both drugs come in pill form and are taken daily, for five years.