Carol Secter

The Cancer Prevention Centre of the Sir Mortimer B.Davis/Jewish General Hospital convened a meeting under this title on the evening of Monday, February 17th. The Centre's director, Dr. Michael Pollack,reviewed the problems inherent in designing prevention programs for targeted groups (based on risk assessment) as opposed to programs designed for universal groups (i.e., all women) and then led a small group discussion.

Dr. Pollack listed and explained the major factors used in risk assessment — genetics, age at menarche (first menstrual period) or first pregnancy, density of the breasts, and history of oral contraceptive or hormone therapy use. Exposure to carcinogens was also presented as a risk factor, but no details about its assessment or long-term effects were provided.

Current recommendations regarding modifiable risk factors were;

• Altering diet and exercise regimens
• Limiting calories to fit metabolic needs
• Avoiding exogenous estrogen (with the exception of osteoporosis treatment)
• Ablative surgery (removal of the ovaries) where a high familial risk of ovarian or breast cancer exists
• Taking tamoxifen, although the absolute benefits of this are small and the population that would benefit from taking it is not yet clear.

It was explained that some current issues being researched related to prevention of breast cancer are: (a) the rate of epithelial cell renewal, based on the premise that a slower turnover means fewer chances for genetic mutations; and (b) the probability of survival of cells with DNA damage. One member of the group asked if there were any ongoing investgations of pairing estrogen levels to ingestion of tamoxifen as a preventative.

The Centre plans more of these small group sessions. Advance registration is required and medicare cards are registered.