NICE recommends two breast cancer drugs to at-risk women

The National Institute of Health and Care Excellence (Nice) has updated its guidance for breast cancer, which means that women at risk from this disease due to their family history now have more options than ever to prevent it.

A family history of breast cancer is usually down to the BRCA1 or BRCA2 genes – Cancer Research UK estimates that people who carry the BRCA gene have between a 60-90% chance of developing breast cancer.

One option for people with the BRCA gene is to have surgery to remove their breasts to prevent developing disease.

However, in the new guidance, NICE now recommends that either tamoxifen or raloxifene should be offered for 5 years to postmenopausal women with a uterus and at high risk of breast cancer, unless they have a past history or may be at increased risk of thromboembolic disease or endometrial cancer.

“Our updated guideline now gives women more options in how they manage their risk of breast cancer; those with a ‘moderate’ or ‘high’ risk of developing breast cancer because of their family history but who have not had the disease themselves can now be offered tamoxifen or raloxifene for five years to prevent it.

“Although neither drug is licensed as a preventative treatment in the UK, clinical evidence shows they are an effective option for many women and could be preferable to surgery.”

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE.

While neither tamoxifen nor raloxifene have been approved in the UK, both are approved for use in the United States. Evidence shows that both treatments are equally effective in preventing breast cancer, and can reduce a person’s risk by between 30 and 40%.

Around 50,000 women and 400 men are diagnosed with breast cancer in the UK every year. One in five cases is usually associated with a family history of breast cancer.

The UK regulatory body also halved the threshold for offering genetic testing to a relative has breast and / or ovarian cancer.

“This is a truly historic moment in the treatment of women at increased breast cancer, as we are witnessing a fundamental change of clinical practice driven by medical research. We strongly welcome NICE’s decision to recommend chemoprevention treatments and a broadening of access to genetic testing and surveillance. Having varied options available to women at an increased risk enables more effective prevention, detection and treatment of the disease.”

Baroness Delyth Morgan, Chief Executiver of Breast Cancer Campaign.


Related news:

Breast cancer: women at risk should be given daily pill, say NHS guidelines (The Guardian)

Tamoxifen and raloxifene: Women to be offered daily pill to prevent breast cancer (The Telegraph)

Reference links:

NICE press release

NICE guidelines for Familial breast cancer

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