Paget’s Carcinoma: Prevention

For prevention of Paget’s carcinoma or breast carcinoma, attention must be paid to reducing individual risk factors.

If BRCA gene status is positive (see Laboratory Diagnostics for details), risk-reducing mastectomy (RRM; removal of the mammary gland) is indicated.

Behavioral risk factors

  • Diet
    • High-fat diet – a high-fat diet with a high proportion of red meat, i.e. muscle meat of pork, beef, lamb, veal, mutton, horse, sheep, goat, increases, a low-fat diet decreases the risk of breast carcinoma
    • Avoid foods with acrylamide – formed during frying, grilling, and baking; used to make polymers and dyes; acrylamide is metabolically activated to glycidamide, a genotoxic metabolite; an association between exposure to acrylamide and risk of estrogen receptor-positive breast cancer has been demonstrated.
    • Micronutrient deficiency (vital substances) – see micronutrient therapy.
  • Pleasure food consumption
    • Alcohol (> 10 g/day)
    • Tobacco (smoking, secondhand smoke – in pre-menopausal women) – It has long been known that smoking increases the risk of breast cancer (mammary carcinoma). Now a study found that passive smoking may also increase the risk of breast cancer.The researchers also observed a relationship between dose and risk of breast cancer: the more and the longer women smoked passively, the greater the increase in the risk of developing breast cancer.
  • Late first gravidity (pregnancy) – after the age of 30 – circa three times increased risk.
  • Short breastfeeding period – the shorter the breastfeeding period, the higher the risk of developing breast cancer. This revealed a meta-study
  • Psycho-social situation
    • Shift work/night work, especially the alternation of early, late and night shifts.
  • Overweight (BMI ≥ 25; obesity) – a five kg/m2 increase in BMI in postmenopause (after menopause) increases the risk by a relative 12%; for premenopausal breast cancer (breast cancer before menopause), there is a negative associationBreast cancer patients with overweight or obesity are more likely to suffer from a more aggressive cancer and have lower survival than patients with normal weight; increased BMI at diagnosis of breast cancer is associated with increased all-cause mortality (total mortality)
  • Android body fat distribution (abdominal, truncal, central body fat; abdominal circumference ≥ 88 cm) is associated with increased risk of estrogen receptor-negative breast cancer

X-rays

  • Exposure to ionizing radiation

Prevention factors (protective factors)

  • Breastfeeding (> 6 months)
  • Non-steroidal anti-inflammatory drugs (NSAIDs)

Intensified prevention program (in high-risk patients)

  • Palpation (palpation) of the mamma (breast) by the physician every six months* .
  • Mammary sonography (breast ultrasound) every six months* .
  • Mammography every twelve months (from the age of 30, with high breast density from the age of 35).
  • Mamma MRI (magnetic resonance imaging of the breast) every twelve months (cycle-dependent in premenopausal women) until involution (regression) of the glandular parenchyma (ACRI-II).

* From 25 years of age or five years before the earliest age of onset of disease in the family.