Breast cancer is one of the most common cancers among women, affecting about one in eight women in their lifetime. Some women have a higher risk of developing breast cancer due to inherited genetic mutations, such as BRCA1 and BRCA2. These mutations can also increase the risk of ovarian cancer and other cancers in both women and men.
However, having a BRCA mutation does not mean that cancer is inevitable or that nothing can be done to prevent it. In fact, there are many ways to reduce the risk of cancer and improve the quality of life for people living with a BRCA mutation. These include lifestyle changes, preventive surgeries, medications, and regular screenings.
Lifestyle Changes Can Make a Difference
According to the World Health Organization, about 30 to 40 percent of cancer cases can be attributed to lifestyle factors, such as smoking, alcohol consumption, obesity, and physical inactivity. These factors can also affect the development of cancer in people with BRCA mutations.
Therefore, adopting a healthy lifestyle can help lower the risk of cancer and enhance well-being for people with BRCA mutations. Some of the lifestyle changes that can make a difference are:
- Maintaining a healthy body weight through a balanced diet that is rich in fruits, vegetables, whole grains, legumes, nuts, seeds, and healthy fats. A healthy weight can also reduce the risk of other chronic diseases, such as diabetes and heart disease.
- Quitting smoking or avoiding exposure to secondhand smoke. Smoking is a major risk factor for many cancers, including breast cancer. It can also interfere with the effectiveness of some cancer treatments.
- Limiting alcohol intake or avoiding it altogether. Alcohol can increase the levels of estrogen in the body, which can stimulate the growth of breast cancer cells. Alcohol can also damage DNA and increase the risk of other cancers.
- Opting for Mediterranean dietary patterns that emphasize plant-based foods, fish, olive oil, and moderate amounts of wine. Studies have shown that this type of diet can lower the risk of breast cancer and improve survival rates among women with BRCA mutations.
- Exercising regularly for at least 150 minutes per week of moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity. Exercise can help maintain a healthy weight, boost immunity, reduce stress, and lower the risk of breast cancer and other cancers.
- Controlling stress levels by practicing relaxation techniques, such as meditation, yoga, breathing exercises, or mindfulness. Stress can affect the immune system and increase inflammation in the body, which can contribute to cancer development and progression.
- Getting regular medical care including cancer screenings and genetic counseling. People with BRCA mutations should start screening for breast cancer at an earlier age (usually between 25 and 30) and do it more often (usually every six to 12 months) than people without BRCA mutations. Screening methods may include mammograms, MRIs, ultrasounds, or clinical breast exams. People with BRCA mutations should also consider screening for ovarian cancer (usually with blood tests and ultrasounds) and other cancers (such as prostate cancer for men). Genetic counseling can help people with BRCA mutations understand their risk of cancer and their options for prevention and treatment.
Preventive Surgeries Can Reduce the Risk Dramatically
Another way to reduce the risk of cancer for people with BRCA mutations is to undergo preventive surgeries that remove the organs that are most likely to develop cancer. These surgeries are called prophylactic mastectomy (removal of both breasts) and prophylactic oophorectomy (removal of both ovaries).
According to the National Cancer Institute, prophylactic mastectomy can reduce the risk of breast cancer by about 95 percent for women with BRCA mutations. Prophylactic oophorectomy can reduce the risk of ovarian cancer by about 80 percent and the risk of breast cancer by about 50 percent for women with BRCA mutations.
However, these surgeries are not without risks and side effects. They can cause physical and emotional changes, such as loss of fertility, early menopause, sexual dysfunction, depression, anxiety, and body image issues. They can also increase the risk of other health problems, such as osteoporosis, heart disease, and cognitive decline.
Therefore, the decision to have preventive surgeries should be made after careful consideration of the benefits and risks, and in consultation with a medical team that includes a genetic counselor, a surgeon, an oncologist, a gynecologist, and a psychologist.
Medications Can Also Help Prevent Cancer
Another option for reducing the risk of cancer for people with BRCA mutations is to take medications that can block or lower the levels of hormones that can stimulate the growth of cancer cells. These medications are called chemoprevention.
The most commonly used chemoprevention drugs for breast cancer prevention are tamoxifen and raloxifene. These drugs belong to a class of drugs called selective estrogen receptor modulators (SERMs), which can block the effects of estrogen on breast tissue. Studies have shown that tamoxifen can reduce the risk of breast cancer by about 50 percent and raloxifene by about 38 percent for women with BRCA mutations.
Another class of drugs that can be used for breast cancer prevention are aromatase inhibitors (AIs), such as anastrozole, letrozole, and exemestane. These drugs can lower the levels of estrogen in the body by inhibiting an enzyme called aromatase, which converts other hormones into estrogen. Studies have shown that AIs can reduce the risk of breast cancer by about 53 percent for women with BRCA mutations.
However, chemoprevention drugs also have side effects and risks. They can cause symptoms such as hot flashes, vaginal dryness, mood swings, headaches, nausea, and fatigue. They can also increase the risk of blood clots, strokes, endometrial cancer (for tamoxifen), and bone loss (for AIs).
Therefore, the decision to use chemoprevention drugs should be made after weighing the benefits and risks, and in consultation with a medical team that includes a genetic counselor and an oncologist.
Living Well With a BRCA Mutation Is Possible
Having a BRCA mutation can be scary and overwhelming, but it does not mean that cancer is inevitable or that nothing can be done to prevent it. There are many ways to reduce the risk of cancer and improve the quality of life for people living with a BRCA mutation. These include lifestyle changes, preventive surgeries, medications, and regular screenings.
The most important thing is to be informed and proactive about one’s health and to seek support from family, friends, and health professionals. Living well with a BRCA mutation is possible with the right knowledge, choices, and care.
