A new study suggests that ulipristal acetate, a drug already used for other medical conditions, may help prevent breast cancer in premenopausal women at high risk by blocking progesterone-driven growth of luminal progenitor cells, which can give rise to cancer. Treatment with the drug reduced breast density, decreased collagen levels (especially collagen 6), and softened breast tissue, creating an environment less favorable for cancer development and highlighting a potential preventive strategy for women with a strong family history of the disease. Seeking commentary, including: (1) Why is breast cancer risk higher in premenopausal and menopausal women? (2) How does this medication help reduce women's risk? (3) What else can women do to help reduce their risk of breast cancer?

There are several ways women can help prevent breast cancer, but two of the best are to monitor hormone levels and learn their genetic risks. While things like diet and exercise can be effective in helping prevent breast cancer, there are other ways that can be monitored through a doctor's knowledge and intervention. Since all women go through hormonal changes as they age, it is important for them to address their pre and post menopause hormone levels cautiously, as supplementing them with replacement therapies can increase risks. In addition, it is also vital for your doctor to know your family's health history and genetics, as people can be at greater risk if they possess certain genetic markers. By managing your hormone replacement therapy as well as sharing your genetic history with your doctor, you can better prevent breast cancer.

(1) Why is breast cancer risk higher in premenopausal and menopausal women? Hormonal changes are involved in breast cancer risk. If breast cells are still growing premenopausally, then higher exposure to estrogen and/or progesterone over the life course should stimulate more growth of these cells and have greater potential for inappropriate cells. With menopause, the activity of these hormones declines, but the combination of years of exposure and age-related alterations in DNA repair makes women more vulnerable to mutations that can spawn cancer. (2) How does this medication help reduce women's risk? Ulipristal acetate operates by blocking the receptors for progesterone. Because progesterone can stimulate the growth of some breast cells, including those that may become cancerous, this drug helps to block that pathway. By reducing breast density and collagen deposits, it is, in fact, deconditioning/biologically aging the breast environmental tissue to harbor a less favorable microenvironment for cancer cells, a non-invasive targeted preventive for women who have a strong first-degree family history of breast cancer. (3) What else can women do to help reduce their risk of breast cancer? Lifestyle choices matter a lot. Moderate body weight, regular physical activity, limited alcohol, and a diet rich in whole foods and antioxidants all help to balance hormones and decrease inflammation. Regular screenings, knowledge of family history, and bringing up potential genetic testing options with a healthcare provider are also important.