Studies Support Menopausal Breast Cancer Risk Screening

Breast density improves estimations of risk; chemoprevention may benefit those at greater risk

18 mar 2009 -- Evidence supports screening postmenopausal women for risk of breast cancer and the consideration of chemoprevention for women at high risk, as well as the use of lifestyle changes for cancer prevention, according to research published in the March 18 issue of the Journal of the National Cancer Institute.

Steven R. Cummings, M.D., of the California Pacific Medical Center Research Institute in San Francisco, and colleagues reviewed prospective studies on methods of estimating women's risk of breast cancer, as well as interventions to reduce the risk.

The investigators found that risk models that rely on demographic factors and medical history had modest discriminatory accuracy for estimating risk. Breast density had a strong association with breast cancer, and incorporating density into models added to their discriminatory accuracy. In general, studies associated exercise, weight loss, a low-fat diet and lowered alcohol consumption with a smaller risk of breast cancer, the researchers report. Tamoxifen and raloxifene were also found to lower the risk of invasive breast cancer, they note.

"In conclusion, evidence from these reviews supports systematic assessment of postmenopausal women for breast cancer risk with risk factors and assessment of breast density. Chemoprevention should be considered for those at high risk; however, cost benefit analyses are needed to provide specific recommendations about who should be offered chemoprevention. Several lifestyle changes can be recommended to postmenopausal women, regardless of their estimated risk category," the authors write.

Several study co-authors disclosed financial relationships with Eli Lilly, AstraZeneca, Pfizer and Novartis, and several have a patent on a device used in breast densitometry.

Abstract
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