BRCA cancer prevention

Prophylactic bilateral mastectomy is a surgery that removes both healthy breasts. This is known to reduce the risk for breast cancer by 90%. All women who have prophylactic bilateral mastectomy have the option of breast reconstruction.

This surgery option is not provided for male BRCA carriers.

Prophylactic bilateral salpingo oophorectomy is a surgery that removes both fallopian tubes and ovaries. If this is done before menopause, it can prevent breast cancer by up to 50%. Current recommendations are that BRCA carriers remove their ovaries between the ages of 35 and 40 or after they have finished having children.

The use of drugs to reduce risk of cancer is called chemoprevention. The most well studied and commonly used drug to reduce the risk of breast cancer is tamoxifen. Tamoxifen may be an option for women who have never had breast cancer, or women who have already had an estrogen sensitive breast cancer. Tamoxifen has its own side effects and women interested in learning more about Tamoxifen should consult their oncologist or family doctor.

Willow

• What type of cancer screening is advised for women at high risk?
• What kinds of surgery can reduce the risk of breast cancer for women at high risk?
• How do I decide about having surgery or not?
• Do provincial healthcare programs cover these surgeries?
• Are there any drugs available that can reduce the risk of breast cancer for women at high risk?

National Cancer Institute

• Risk factors that may increase risk of breast cancer
• Protective factors that may decrease the risk of breast cancer
• The following have been proven not to be risk factors for breast cancer or their effects on breast cancer risk are unknown

Breastcancer.org

• What is prophylactic mastectomy?
• Is prophylactic mastectomy right for you?
• Prophylactic mastectomy plus reconstruction
• Prophylactic mastectomy: What to expect
• Prophylactic mastectomy risks

Mayo Clinic

• What is oophorectomy?
• Who can consider prophylactic oophorectomy?
• How much can oophorectomy reduce the risk of cancer?
• What are the risks of oophorectomy?
• Do women have to take post-menopausal hormone therapy after oophorectomy?
• Are there alternatives to oophorectomy for preventing ovarian cancer?
• Doesn’t mastectomy offer a greater reduction in breast cancer risk?
• Why might a woman opt for oophorectomy over mastectomy?
• What questions should you ask your doctor?

Women with a BRCA mutation have the option of removing both fallopian tubes and ovaries before a diagnosis of cancer (prophylactic bilateral salpingo oophorectomy). This is known to reduce the risk for ovarian cancer by over 90%.

If oral contraceptives (birth control pills) are taken for over 5 years they are known to reduce the risk of ovarian cancer by up to 40% in women with a BRCA1 or BRCA2 gene mutation. However, women who use oral contraceptives have a slightly higher risk for breast cancer than woman who do not.

Mayo Clinic

• What is oophorectomy?
• Who can consider prophylactic oophorectomy?
• How much can oophorectomy reduce the risk of cancer?
• What are the risks of oophorectomy?
• Do women have to take post-menopausal hormone therapy after oophorectomy?
• Are there alternatives to oophorectomy for preventing ovarian cancer?
• Doesn’t mastectomy offer a greater reduction in breast cancer risk?
• Why might a woman opt for oophorectomy over mastectomy?
• What questions should you ask your doctor?

Canadian Cancer Society

• Reducing your risk for ovarian cancer
• Find out if you're at high risk
• Prophylactic salpingo-oophorectomy
• Oral contraceptives
• Pregnancy
• Gynecological surgery

There are currently no specific recommended forms of prostate cancer prevention for men with a BRCA mutation. Eating well and enjoying a healthy active lifestyle remains the best form of prevention for prostate cancer. Removing the prostate (prophylactic prostatectomy) is not recommended. Men with a BRCA gene mutation, particularly BRCA2, may be advised to have more aggressive treatment for lower grade prostate cancers compared to men in the general population.

For information and advice on diet and nutrition, ask your genetic counsellor or Sunnybrook oncologist for a referral to our Sunnybrook dietitians.

Mayo Clinic

• Prostate cancer prevention: Ways to reduce your risk
• Choose a healthy diet
• Maintain a healthy weight
• Exercise most days of the week
• Talk to your doctor about your risk

American Cancer Society

• Can prostate cancer be prevented?
• Body weight, physical activity, and diet
• Vitamins, minerals, and other supplements
• 5-alpha reductase inhibitors

Sun exposure, particularly ultraviolet (UV) rays are the biggest risk factor for melanoma. The best form of prevention of melanoma is avoiding UV exposure. The American Cancer Society trademarked the phrase Slip! Slop! Slap!®… and Wrap to help remember the key steps of protecting from UV rays: slip on a shirt, slop on sunscreen, slap on a hat and wrap on sunglasses to protect the eyes and sensitive skin around them.

American Cancer Society

• Can skin cancer be prevented?
• Limiting ultraviolet (UV) exposure
• Seek shade
• Protect your skin with clothing
• Wear a hat
• Use sunscreen
• Wear sunglasses
• Avoid tanning beds and sunlamps
• Protect children from the sun
• A word about exposure and vitamin D

Melanoma Cancer Network of Canada

• How to Prevent Melanoma
• Be Sun Safe Outdoors
• Avoid Indoor Tanning Equipment

There are no known forms of pancreatic cancer prevention aside from enjoying a healthy active lifestyle. With today’s knowledge, avoiding pancreatic risk factors is the best way to manage pancreatic cancer risk.

Manageable risk factors for pancreatic cancer include:

• Smoking tobacco – risk increases based on the number of years and cigarettes smoked.
• High body-mass index (BMI)
• Diabetes
• Exposure to chemicals – petroleum compounds, some pesticides, some dyes, chemicals for metal refining, polycyclic aromatic hydrocarbons (PAHs) and chlorinated hydrocarbons

For information and advice on food, diet and nutrition, ask your genetic counsellor or Sunnybrook oncologist for a referral to our Sunnybrook dietitians.

Canadian Cancer Society

• Risk factors for pancreatic cancer
• Known risks
• Possible risk factors
• Unknown risk factors

American Cancer Society

• Can pancreatic cancer be prevented?