Early research on a drug to prevent breast cancer
Full article: https://www.nature.com/nm/journal/vaop/ncurrent/full/nm.4118.html
Many researchers are interested in non-surgical options to reduce the higher-than-average risk of developing breast cancer in BRCA mutation carriers. This research study identified a type of drug, called a “RANK ligand inhibitor,” that may prevent breast cancer. Among mice that were genetically engineered to have no BRCA1 genes, those that were given the drug developed tumors less frequently than those that did not. While this is an exciting early study for BRCA mutation carriers, more work and human clinical trials need to be done before this can be used as a prevention therapy in humans. (7/12/16)
Update added 11/24/19: The RANK ligand inhibitor, denosumab is currently being studied as a possible breast and ovarian cancer preventive agent in human clinical trials.
The National Comprehensive Cancer Network (NCCN) provides breast cancer risk management guidelines for people with BRCA1 and BRCA2 mutations. We recommend that you speak with a genetics expert who can look at your personal and family history of cancer and can help you to determine the best risk management plan.
Screening for women:
- Learn to be aware of changes in breasts beginning at age 18.
- Clinical breast exam every 6-12 months beginning at age 25.
- Annual breast MRI with contrast (or mammogram if MRI is unavailable) beginning at age 25 and continuing until age 75.
- Annual mammogram at age 30 until age 75 (consider 3D mammography if available).
- Screening after age 75 should be considered on an individual basis.
Risk reduction for women:
- Women should have a discussion with their doctors about of the advantages and disadvantages of risk-reducing mastectomy.
- Research has shown that risk-reducing mastectomy can lower the risk for breast cancer in high risk women by about 90%. Despite this, mastectomy has not been shown to help high risk women live longer.
- Even after mastectomies, some breast tissue-and therefore some breast cancer risk remains.
- Women should have a conversation with their doctor about the possible benefits of tamoxifen or other estrogen-blocking drugs to reduce breast cancer risk in women with BRCA2 mutations. Research on the benefit of these drugs to reduce breast cancer risk in women with BRCA1 mutations has been mixed.
Risk management in men:
- Breast self-exam training and education beginning at age 35.
- Clinical breast exam every 12 months beginning at age 35.
- In men with enlarged breasts, (gynecomastia) consider annual mammogram in men with gynecomastia beginning at age 50 or 10 years younger then the earliest case of male breast cancer in the family (whichever comes first).
Questions To Ask Your Health Care Provider
- I am a BRCA1 mutation carrier. What can I do to lower my breast cancer risk?
- I am a BRCA mutation carrier who has not had cancer. Are there clinical trials looking at new ways to prevent cancer, and do I qualify for them?
- Are there currently drugs available to lower the risk of breast cancer in BRCA mutation carriers?
Open Clinical Trials
The following are breast cancer screening or prevention studies enrolling people at high risk for breast cancer.
Additional risk-management clinical trials for people at high risk for breast cancer may be found here.
FORCE is a national nonprofit organization, established in 1999. Our mission is to improve the lives of individuals and families affected by adult hereditary cancers.