Endocrine factors are critically important in the development of breast cancer. A woman’s menstrual and reproductive history plays a significant role in influencing the incidence of breast cancer. Women experiencing early menarche and late menopause at are a reduced risk of developing breast cancer.
The incidence of breast cancer in patients older than 60 or younger patients with high breast cancer risk (e.g. patients carrying the breast cancer gene diagnosed through genetic screening) can be decreased by approximately 50% with the administration of tamoxifen or raloxifene (anti-estrogen medications). Randomized clinical trials comparing tamoxifen to a placebo in patients considered at high risk for breast cancer have confirmed such findings.
For those patients with a very high risk of developing breast cancer, bilateral prophylactic mastectomies have been studied. Several studies have suggested that such preventative treatment can reduce the incidence of breast cancer up to 90% in high-risk patients, including those with familial beast cancer syndromes.
A woman who undergoes surgical removal of an ovary (oophorectomy) before 40 also has a 50% less chance of developing breast cancer. However, oophorectomy is related to substantial complications for young female patients, and prophylactic oophorectomy for high-risk subjects has not been well studied.
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