Breast Cancer Prevention: Current Approaches and Future Directions

Abstract

The topic of breast cancer prevention is very broad. All aspects of the topic, therefore, cannot be adequately covered in a single review. The objective ofthis review is to discuss strategies in current use to prevent breast cancer, as well as potential approaches that could be used in the future. This reviewdoes not discuss early detection strategies for breast cancer, including breast cancer screening. The breast is the most common site among womenworldwide of noncutaneous cancer. Many clinical and genetic factors have been found to increase a woman’s risk of developing the disease. Currentstrategies to decrease a woman’s risk of developing breast cancer include primary prevention, such as avoiding tobacco, exogenous hormone use andexcess exposure to ionizing radiation, maintaining a normal weight, exercise, breastfeeding, eating a healthy diet and minimizing alcohol intake.Chemoprevention medications are available for those at high risk, though they are underutilized in eligible women. Mastectomy and/or bilateraloophorectomy are reasonable strategies for women who have deleterious mutations in genes that dramatically increase the risk of developing cancerin either breast. There are a variety of strategies in development for the prevention of breast cancer. Personalized approaches to prevent breast cancerthat are being developed focus on advances in precision medicine, knowledge of the immune system and the tumor microenvironment and their rolein cancer development. Advances in our understanding of how breast cancer develops are allowing investigators to specifically target populations whoare most likely to benefit. Additionally, prevention clinical trials are starting to evaluate multi-agent cancer prevention approaches, with the hope ofimproved efficacy over single agents. Finally, there is a push to increase the use of chemopreventive agents with proven efficacy, such as tamoxifenand raloxifene, in the prevention of breast cancer.