PRE­VEN­TION IN PILL FORM

Reader's Digest (Canada) - - Health -

Did you know that sev­eral med­i­ca­tions to treat breast can­cer have been shown to stave off the dis­ease in healthy women? “Of all the big can­cers, there’s only one that can be pre­vented with med­i­ca­tions, and that’s breast can­cer,” says Dr. Ju­lian Kim at CancerCare Man­i­toba. Tamox­ifen and ralox­ifene, which block es­tro­gen re­cep­tors in breast cells, pro­vide up to a 50 per cent re­duc­tion in rel­a­tive risk. Ex­emes­tane and anas­tro­zole lower resid­ual lev­els of es­tro­gen in post­menopausal women, re­sult­ing in an up to 65 per cent rel­a­tive risk re­duc­tion.

This mat­ters if your risk hap­pens to be higher than av­er­age. In 2015, an in­ter­na­tional study of over 67,000 women re­sulted in a new breast can­cer risk cal­cu­la­tor. Called the poly­genic risk score (PRS), it takes into ac­count what’s in your genes—not whether you carry a BRCA gene mu­ta­tion, which ac­counts for less than 10 per cent of breast can­cer cases, but whether a par­tic­u­lar set of spell­ing mis­takes in your genome is as­so­ci­ated with greater or lower odds of de­vel­op­ing breast can­cer.

Cur­rently, Kim is lead­ing a breast can­cer pre­ven­tion trial in which women will be as­sessed re­gard­ing their de­ci­sion to use or to forgo pre­ven­ta­tive med­i­ca­tions, then shown dif­fer­ent ways of low­er­ing their risk. For some women, in­creas­ing ex­er­cise and mak­ing health­ier diet choices may be suf­fi­cient. But those with a higher PRS may also choose to take med­i­ca­tion. For them, side ef­fects, such as hot flashes, may be well worth it.

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