Things To Consider When Deciding Between A Preventative Mastectomy Or Tamoxifen Therapy

7 November 2016
 Categories: Health & Medical , Blog

Some women have a very high risk of developing breast cancer within their lifetime. For example, a woman with a mutation in the BRCA1 gene has a 55 to 65 percent chance of developing breast cancer by the time she turns 70 and one with a mutation in the BRCA2 gene has a 45 to 47 percent risk. This is much greater than the 12 percent risk of the average American woman developing this disease. Having certain medical conditions, such as Cowden syndrome or Li-Fraumeni syndrome, also greatly increases the risk of breast cancer. Such a high risk often leads women to consider taking some preventative measures, which could include a preventative double mastectomy or a hormone therapy, such as tamoxifen, that reduces estrogen levels in the body.

Potential Benefits of Preventative Mastectomies

A preventative mastectomy can reduce the risk of a person with BRCA1 or BRCA2 gene mutations developing breast cancer significantly, with some studies showing reductions of up to 95 percent. In women with a strong family history including two or more close female relatives with breast cancer, the potential reduction in risk can be as high as 90 percent. The risk can't be totally removed because not all breast tissue can be removed during a mastectomy. Those who have a full mastectomy rather than one that spares the nipple will have a greater reduction in risk because more tissue is removed. This vast reduction in breast cancer risk can give women with a high risk peace of mind so they can go about their lives without constantly worrying.

Potential Benefits of Tamoxifen

Tamoxifen acts by preventing estrogen from binding with cell receptors, preventing the potential effects of estrogen on the breast tissue cells, while acting similarly to estrogen when it comes to bone or the uterine tissue. This is important because approximately 70 percent of all breast cancers are estrogen receptor-positive. Using tamoxifen can potentially decrease the risk of high-risk individuals developing breast cancer by about 50 percent, according to the National Cancer Institute. The benefits can be even greater for some women, as about half of high-risk women experience a decrease in risk of up to 70 percent. Choosing tamoxifen over a preventative mastectomy means that surgery often isn't necessary and a woman can keep her breasts unless she later develops cancer and needs a mastectomy as part of the treatment process.

Potential Drawbacks of Preventative Mastectomy

Removing the breasts means losing the functionality of the breast. Breastfeeding will no longer be possible and some women experience more difficulty with sexual stimulation. Body image issues may also be an issue, but reconstruction surgery can help with this problem.

Potential Drawbacks of Tamoxifen Therapy

Symptoms typically associated with menopause, such as mood swings, hot flashes, nausea and vaginal dryness are most commonly described as tamoxifen side effects. While it sounds counterintuitive, taking hormone replacement therapy for a short time can help with the symptoms without greatly reducing the benefits of taking tamoxifen to reduce breast cancer risk. Tamoxifen may also increase the risk of endometrial cancer, stroke, cataracts and blood clots. Women who are premenopausal may experience some bone loss as well.

If you have recently discovered that you have breast cancer, these are also options for removal of the cancerous material. Go to sites like for more information.