Jane Brody in The New York Times:
Efforts to reduce deaths from breast cancer in women have long focused on early detection and post-surgical treatment with drugs, radiation or both to help keep the disease at bay. And both of these approaches, used alone or together, have resulted in a dramatic reduction in breast cancer mortality in recent decades. The average five-year survival rate is now 90 percent, and even higher — 99 percent — if the cancer is confined to the breast, or 85 percent if it has spread to regional lymph nodes. Yet, even though a steadily growing percentage of women now survive breast cancer, the disease still frightens many women and their loved ones. It affects one woman in eight and remains their second leading cancer killer, facts that suggest at least equal time should be given to what could be an even more effective strategy: prevention. Long-term studies involving tens of thousands of women have highlighted many protective measures that, if widely adopted, could significantly reduce women’s chances of ever getting breast cancer. Even the techniques now used to screen for possible breast cancer can help identify those women who might be singled out for special protective measures.
For example, the United States Preventive Services Task Force recently updated recommendations for offering risk-reducing medications to women whose personal or family history or findings on a mammogram suggest they face more than the average risk of developing breast cancer. The task force found “convincing evidence” of at least moderate preventive benefit from three well-established cancer-blocking drugs: tamoxifen, raloxifene and aromatase inhibitors. Dr. Lydia E. Pace of Brigham and Women’s Hospital said that “a lot of studies of preventive medication have shown a moderate reduction in risk of developing breast cancer.” But, she added, the drugs reduce the risk of those breast cancers that are generally the most curable and the least likely to cause death and have yet to be shown to reduce the overall risk of dying from the disease.