Читать книгу The SAGE Encyclopedia of Stem Cell Research - Группа авторов - Страница 240

In spite of the concept of “BRCAness” described above, the data do not support that sporadic triple-negative breast cancers have a higher degree of sensitivity to platinum agents than other breast cancer subtypes. In addition, there are no data that demonstrate improved survival outcomes when platinum agents are used (as a single agent or in combination) over other standard treatment. Women may reduce their risk of breast cancer by maintaining a healthy weight, drinking less alcohol, being physically active, and breastfeeding their children. These modifications might prevent 38% of breast cancers in the United States. The benefits of moderate exercise, such as brisk walking, are seen at all age groups, including postmenopausal women. Marine omega-3 polyunsaturated fatty acids appear to reduce the risk.

Removal of both breasts before any cancer has been diagnosed or any suspicious lump or other lesion has appeared (a procedure known as prophylactic bilateral mastectomy) may be considered in people with BRCA1 and BRCA2 mutations, which are associated with a substantially heightened risk for an eventual diagnosis of breast cancer. BRCA testing is recommended in those with a high family risk after genetic counseling. It is not recommended routinely. This is because there are many different forms of changes in BRCA genes, ranging from harmless mutations to obviously dangerous frame shift mutations. The effect of most of identifiable changes in the genes is uncertain. Testing in an average-risk person is particularly likely to return one of these indeterminate, useless results.

The selective estrogen receptor modulators (such as tamoxifen) reduce the risk of breast cancer but increase the risk of thromboembolism and endometrial cancer. There is no overall change in the risk of death. They are thus not recommended for the prevention of breast cancer in women at average risk but may be offered for those at high risk. The benefit of breast cancer reduction continues for at least five years after stopping a course of treatment with these medications.