MEDizzy - A 59-year-old woman comes to your clinic wanting to know if

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Breast Cancer

A 59-year-old woman comes to your clinic wanting to know if there is anything she can do to decrease her risk of breast cancer. Two of her four sisters developed breast cancer while they were in their 50s. She experienced menarche at 12 years of age and menopause at 55 years of age. She had one child at 34 years of age. She underwent two breast biopsies for suspicious masses, which revealed normal breast tissue. Since she was 50 years of age, she has undergone yearly screening mammography, the results of which have been normal. Her breast examination reveals no masses, and there is no axillary lymphadenopathy. Which of the following statements is false?

ExplanationRisk factors for the development of breast cancer include age, early menarche, late menopause, older age at first live birth or nulliparity, number of breast biopsies, number of first-degree relatives with breast cancer, and biopsies showing atypical hyperplasia. Women at high risk who received a 5-year course of tamoxifen were found to have 50% fewer diagnoses of breast cancer compared with women at comparable risk who did not receive tamoxifen. This therapy is associated with an increased risk of endometrial cancer and pulmonary embolism. Evidence from case series indicate that bilateral prophylactic mastectomy is associated with a greater than 90% reduction in the incidence of breast cancer. Prophylactic surgery has not been compared with aggressive screening in combination with appropriate management of breast cancer and should be considered only for high- risk patients. Lifestyle modifications, such as adherence to a low-fat diet, weight loss for obese patients, and smoking cessation, have not been shown in prospective clinical trials to reduce breast cancer risk but are associated with decreased breast cancer risk in epidemiologic studies and are therefore recommended by some advisory groups