‘Historic step’ for women at high risk of breast cancer

Cancer campaigners have lauded measures proposed by the UK health regulator that could see high risk post-menopausal women offered drugs to help prevent them getting breast cancer.

The new National Institute of Health and Clinical Excellence (Nice) guidelines on familial breast cancer could also see the age some women are first offered mammograms lowered.

At present, all women aged between 50 and 70 are invited for breast screening but the service could be extended to women aged 40 and up if they are deemed to be at high or moderate risk of developing the disease.

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The NHS may also start offering genetic screening to see whether people with a history of breast cancer carry faulty genes that can increase the risk.

Nice has launched a draft consultation to see whether drugs tamoxifen or raloxifene should be offered to high-risk post-
menopausal women in England and Wales.

A previous clinical trial found tamoxifen, taken for five years, 
reduced the risk of developing invasive breast cancer by about 50 per cent in post-menopausal women who were at increased risk of getting the disease. Another trial found that five years of raloxifene reduces breast cancer risk in such women by about 38 per cent.

Under the new plans, high risk post-menopausal women could be offered the drugs for a period of five years unless they have a history of thromboembolic disease or endometrial cancer.

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Chris Askew, chief executive of Breakthrough Breast Cancer, said: “This draft guideline represents an historic step for the prevention of breast cancer – it is the first time drugs have ever been recommended for reducing breast cancer risk in the UK. This is exciting as, even though most women do not have a significant family history of the disease, it’s crucial those who do have an array of options to help them control their risk.

“An update to this guideline is long overdue and we’re especially pleased it has been extended to include both women who have had breast cancer, and men, for the first time. Once finalised, this guideline will pose new challenges for the NHS as it will need to deliver on its recommendations, including a potentially large increase in genetic testing.”

Professor Mark Baker, director of the Centre for Clinical Practice at Nice, said: “This guideline was last updated in 2006. Since then there has been new evidence published and new advances made in a number of clinical areas.”