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Preventive (prophylactic) mastectomy: Surgery to reduce breast cancer risk

Are there other options for reducing the risk of breast cancer?

If you're at high risk of breast cancer and you decide against prophylactic mastectomy, you have other options for early detection and risk reduction.

Medications

Estrogens are hormones produced in your body that can promote breast cancer development and growth. Medications that block the effects of estrogen or reduce estrogen production in your body can reduce your risk of breast cancer. The options include:

  • Tamoxifen for premenopausal or postmenopausal women
  • Raloxifene (Evista), for postmenopausal women
  • Exemestane (Aromasin), for postmenopausal women
  • Anastrozole (Arimidex), for postmenopausal women

Although these medications can reduce the risk of invasive breast cancer by about 50 percent, they carry a risk of side effects. Discuss the risks and benefits of these medications with your doctor, and together you can decide whether medication is right for you.

Other options

Other options for early detection and risk reduction include:

  • Breast cancer screening. Your doctor may suggest mammogram and MRI every year. Screening should also involve an annual clinical breast exam by your doctor and breast-awareness education to familiarize you with the normal consistency of your breast tissue.
  • Surgery to remove the ovaries (prophylactic oophorectomy). This procedure can reduce the risk of both breast and ovarian cancers. In women at high risk of breast cancer, prophylactic oophorectomy may reduce that risk by up to 50 percent if the procedure is done before age 50, when women are premenopausal.
  • Healthy lifestyle. Maintaining a healthy weight, exercising most days of the week, limiting alcohol use and avoiding hormone therapy during menopause may reduce the risk of breast cancer.

    Eating a healthy diet might decrease your risk of some types of cancer, as well as diabetes, heart disease and stroke.

    For example, women who eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts might have a reduced risk of breast cancer. The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet choose healthy fats, such as olive oil, over butter and eat fish instead of red meat.