Women 'should take tamoxifen' to prevent breast cancer, guidance has come

More women at risk of breast cancer because of their family history should take tamoxifen as preventive measure, 'historic' new guidance has said for the first time.

It is the first time the drug has been officially recommended as a preventive measure in women who have not yet been diagnosed with breast cancer and the new guidelines could save thousands of lives.

The move has been hailed as a 'historic step in the prevention of cancer'.

Families with a strong history of breast cancer should be offered genetic testing to establish the risk to younger women, the National Institute for Health and Clinical Excellence said.

According to their individual risk women between the ages of 30 and 49 should be offered tamoxifen for five years which has been shown to reduce the chances of developing cancer.

A recent study showed that 29 cancers and nine deaths could be prevented for every 1,000 women taking tamoxifen for five years.

means just over 500,000 women in England and Wales, covered by the Nice guideline, could eventually be offered the drug.
Breast cancer is the most common cancer in the UK with around 50,000 women and 400 men diagnosed with the condition each year. The guidance also applies to men.
One in 20 breast cancers are caused by BRCA1 or BRCA2 genes that can be passed down through families and other genes have also been linked to the disease.
Professor Gareth Evans, an oncologist at Christie Hospital, said only about 1% of the female population were considered "high-risk".
But for some of those women, taking tamoxifen could be an alternative to having a preventative mastectomy, or breast removal.
"That surgery can reduce the risk by 90-95%, so it doesn't eliminate the risk. It's impossible to remove every last breast cell and depending on whether women keep their nipple or not, and that's a big decision for some women, the risk may only be reduced by about 90%," he told BBC Breakfast.
"We think that in about half of women, tamoxifen actually reduces the risk by 70% - if we can actually identify which women get that extra benefit, that may be enough for those very high-risk women to change their minds and say 'I'll go for the tamoxifen instead'."
But Prof Evans said these drugs were not vaccines.
"We're a long way from a vaccine, the problem is breast cancer isn't one disease really, it's many different types of breast cancer through many different genetic routes," he said.
"The likelihood of developing a single vaccine against breast cancer is many, many years away.
"But it has something akin to a vaccine in that it reduces your chances of ever getting the problem."
Women at high or moderate risk should also be offered annual screening tests instead of the standard three-yearly and may be advised to start them at an earlier age.
Women carrying the gene have opted for preventive mastectomies because they are at such high risk of developing breast cancer.



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