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Breast cancer is not only a burning public issue, but very soon we shall see genetic testing for a woman's predisposition to breast cancer. Many women will be demanding to know their degree of risk and will need counselling to cope with that information. This book is particularly aimed at primary health care professionals, including physicians, medical assistants, nurses and counsellors, who daily deal with questions from women concerned about their risk of developing breast cancer. To answer such questions, this book has combined a guide to identifying women at higher risk to breast cancer, with a balanced review of approaches which aim to reduce that risk. The book provides practical general measures which may reduce risk for women at average risk. For women at clearly increased risk various protective options with different levels of efficacy and acceptability are discussed. Central to the book is the patient-centered view. We need to face reality that it still will take many years before the current clinical trials of preventive measures provide meaningful results. Meanwhile, women who seek to diminish their risk of breast cancer need all the available information. They must be given full responsibility to make an informed decision on their own health care. Reducing Breast Cancer Risk in Women is a practical handbook, technicalities have been deliberately kept to a minimum, making it concise and easy to read.
Preface. Introduction; Susan M. Love. Part One: Recognizing Increased Breast Cancer Risk. 1. Who Develops Breast Cancer? B.A. Stoll. 2. Risk from Family History; B.A. Stoll. 3. Childbearing and Related Risk Factors; B.A. Stoll. 4. Risk from Benign Breast Disease; B.A. Stoll. 5. Risk from Age, Race and Social Class; M. Ewertz. 6. Assessing a Woman's Genetic Risk; D.E. Goldgar, C.M. Goldgar. 7. Ethics and Economics of Genetic Testing for Breast Cancer; R.A. Hiatt. Part Two: Advising the High Risk Woman. 8. Counseling the High Risk Woman; V.G. Vogel. 9. Mastectomy for Cancer Prevention; M.J. Houlihan, R.M. Goldwyn. 10. Trial of Tamoxifen Therapy for Protection; B.A. Stoll. 11. Trial of Vitamin A Analogues for Protection; A. Costa, F. Formelli, R. Torrisi, A. Decensi. 12. Trial of Low Fat Diet for Protection; R.T. Chlebowski. 13. Trial of Ovarian Suppression for Protection; D.V. Spicer, E.A. Krecker, M.C. Pike. 14. Compliance by High Risk Women; H.T. Lynch, J.F. Lynch, T. Conway. Part Three: Avoidance of Possible Risk Factors. 15. Dietary Guidelines; M.D. Holmes, D.J. Hunter, W.C. Willett. 16. Risks Associated with Obesity; K.L. Radimer, C. Bain. 17. Choosing Hormonal Contraception; K.F. McGonigle, G.R. Huggins. 18. Choosing Hormone Replacement Therapy; R.L. Theriault, L.L. Boehnke, R.V. Sellin. 19. Clinical Programs for Breast Cancer Protection; M.M.Henderson, A. McTiennan. 20. Nurses' Role in Educating Women on Risks; N. Entrekin, L. Summerlot. Part Four: Perspectives and Viewpoints. 21. Women's Perspectives on Breast Cancer Protection; J. Marshall. 22. A Patient's View of Breast Cancer Trials; H. Thornton. 23. Should we Aim at Prevention in Youth? A.L. Frazier, G.A. Colditz. 24. Role and Limitations of Mammography in Screening; A.B. Miller. 25. Mind and Breast Cancer Risk; B. Leedham, B.E. Meyerowitz. 26. Avoidable Environmental Links to Breast Cancer; D.L. Davis, H.L. Bradlow. 27. Asking the Right Questions; B.A. Stoll. Index.