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What is chemoprevention?

Chemoprevention is the use of drugs (natural or synthetic chemical agents) to reverse, block or prevent the appearance of cancer in certain risk groups.

Selective Estrogen Receptor Modulators such as tamoxifen and raloxifene (SERMs: Selective Estrogen Receptor Modulators) are drugs that bind to estrogen receptors and act as estrogen agonists in certain tissues (eg bone tissue) and as estrogen antagonists in others (uterus and breasts). Because they antagonize the estrogenic effect on the breast, SERMs have become excellent candidates for use in breast cancer chemoprevention

Aromatase inhibitors (AIs) potentially suppress the conversion of androgen to estrogen and block estrogen production not only in normal tissues, but also in neoplastic cells. Due to their different mechanism of action, they are better tolerated than tamoxifen and have less cardiovascular and endometrial risk. The safety profile of AIs is superior to tamoxifen with the exception of the potential increase in osteoporosis due to estrogen depletion.

Chemoprevention drugs should never be used without specialist advice. If used without the knowledge of an oncologist, medications can be harmful rather than beneficial to your health.


Chemoprevention Pills

What is breast cancer risk reduction surgery?

Prophylactic or risk-reducing surgery is one of the resources that can be used by women who are at high risk of developing breast cancer. Surgical resources are prophylactic mastectomy or adenectomy. The technique is based on the removal of glandular breast tissue, with total preservation of the skin and immediate reconstruction, with a silicone implant or filling the breast with intra-abdominal fat tissue or with a skin and fat flap from the abdominal wall or back.

It is noteworthy that no mastectomy technique can guarantee the total removal of the mammary gland, due to the impossibility of defining its real limits, since it is very intimate with the skin and extends to the armpit. Surgery is estimated to provide a 90% risk reduction, so the more radical the surgery, the greater the protection.

Prophylactic mastectomy can be applied in three situations: synchronous contralateral mastectomy for the treatment of the primary tumor, metachronic, when performed in a second step, and bilateral procedure in high-risk women.

The benefit of prophylactic surgery varies according to the risk of developing the disease: in women with a lifetime risk of 40%, prophylactic surgery adds three years of life; in those where the risk is 85%, this number rises to more than five years.

In the case of a first-degree relative with breast cancer, the ideal is that the mastectomy is performed before the patient reaches the age of diagnosis of the first-degree relative. However, doctors recommend preventive mastectomy only for women who already have children.

An evaluation must be carried out by a multidisciplinary team: breast cancer specialist, oncologist, plastic surgeon, psychologist and geneticist to define whether there is an indication for surgery, to know if the patient is prepared for an eventual unsatisfactory aesthetic result, to define the best surgical technique and best option for reconstruction. The individualized selection of the patient is essential.

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Sorocaba Medical Center


Rua Sorocaba, 464 - room 202

Tel. 21 2537-0138 / 2539-5093

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Americas Medical City

Barra da Tijuca

Av. Jorge Curi, 550 - rooms 252/253

Tel. 21 3264-4866 / 3264-4863

    Tuesday and Thursday

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