Eliminating some of the risks
Hormone replacement therapy is sometimes given to women to help them overcome the unpleasant symptoms associated with the onset of menopause. Usually, a combination of the female hormones estrogen and progestin are given, to counteract the body’s sudden inability to produce these hormones naturally. But this is one example where the cure may be worse than the “disease” – levels of lifetime exposure to these hormones, which can act as fuel for cancer cells, plays a significant role in the development of many breast cancers. Studies have now shown that when a post-menopausal woman has been receiving hormone therapy for five years, her chances of being diagnosed with breast cancer doubles. This makes hormone therapy a significant risk factor for breast cancer but fortunately, this is a risk factor that women can eliminate rather easily. Within one year of stopping combined hormone therapy, risk levels return to normal and when estrogen alone is taken for the alleviation of menopausal symptoms, elevated risk for breast cancer has not been observed.
Obesity in post-menopausal women increases risk for breast cancer because fat cells are a source of estrogen, and after the ovaries no longer produce it fat becomes the body’s main supplier of this potential cancer cell fuel. Women with a BMI of over 30, who are officially obese, have a 1.5 times greater chance of coming down with breast cancer than women who have BMIs below 25 and are classified as being of normal weight. Since diet and inactive lifestyle are the primary enablers of obesity, most women can do something about this risk factor by starting exercise programs and eating healthier foods in smaller quantities. And of course, obesity is strongly implicated in heart disease, which kills many more women than breast cancer, so there are other reasons for losing weight besides its connection to reduced breast cancer risk.
Preventative chemotherapy
For women over 50 who are classified high risk for reasons other than just age, preventative chemotherapy could offer promise. The idea is that if drugs used in breast cancer chemotherapy are taken even before there is a diagnosis, they will be able to knock out cancers retroactively before screening mammograms even have the chance to find them. And indeed, for both pre- and post-menopausal women, breast cancer rates for women who have undergone preventative chemotherapy have been shown to decrease by almost 50%. Because the side effects of chemotherapy can be unpleasant and even debilitating, this kind of therapy should probably only be used by women who know they are facing significantly elevated risk.
The popular chemotherapy drug tamoxifen has been the standard choice for preventative chemotherapy. However, studies have shown it increases the risk of blood clots and uterine cancers to unacceptable levels in post-menopausal women. Fortunately, a drug called raloxifene, which was previously used to treat osteoporosis, works just as well as tamoxifen as a cancer-fighter, and for preventative chemotherapy it has become the drug of choice for post-menopausal women.
Viewing the risks realistically
While age remains the most reliable predictor of breast cancer diagnosis, the likelihood of a woman over 50 developing this disease is still influenced to a large degree by the presence of other risk factors. Women of all ages – but especially those over the age of 50 – need to consult with medical professionals to determine just exactly what their chances of coming down with breast cancer are. Once this has been determined, they can then decide what actions if any they would like to take to help themselves feel safer and more protected from this disease.
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