Breast cancer has received much news coverage in the last 48 hours with headlines claiming there is a ‘Drug that prevents breast cancer for 20 years’ (Daily Mail) and ‘500000 women to be offered breast cancer drugs’ (Guardian).
Why are breast cancer drugs in the news?
The news stories are based on draft guidance on familial breast cancer published by the National Institute for Health and Clinical Excellence (NICE).
As the NICE document is a draft it is open to consultation. This means it could change and its recommendations are not set in stone.
The guidance contains new recommendations on the testing prevention and monitoring of familial breast cancer.
Most of the news stories focused on the recommendation that women at high risk of breast cancer should be offered the drugs tamoxifen or raloxifene as a preventive treatment. Neither drug is currently licensed for this in the UK although they are in some other countries.
What is familial breast cancer?
Breast cancer is the most common cancer in women in the UK. So even if you have a relative with breast cancer it doesn't necessarily mean you’re more likely to get it yourself.
Most breast cancers are not due to inherited (genetic) factors and do not affect the lifetime risk for other relatives.
A small number of women have an increased risk of developing breast cancer because they have a significant family history. This may be due to an altered breast cancer gene. The two genes that are most often found in hereditary breast cancer are called BRCA1 and BRCA2.
What’s new about the draft guidance?
One new recommendation is the use of drugs to help prevent breast cancer in women at high risk. The guidelines recommend:
- tamoxifen should be offered for five years for pre-menopausal women at high risk of breast cancer and considered for women at moderate risk of developing breast cancer within the next 10 years
- tamoxifen or raloxifene should be offered for five years for post-menopausal women at high risk of breast cancer and considered for women at moderate risk of developing breast cancer within the next 10 years
- these drugs should not be offered to women who have a history of blood clots or endometrial (womb) cancer or who have had a risk-reducing bilateral mastectomy.
Do these drugs have any side effects?
Common side effects of tamoxifen include:
- hot flushes
- night sweats
- vaginal dryness or irritation
- loss of sex drive
- indigestion or mild nausea
- irregular or lighter periods (periods may stop while taking tamoxifen)
Common side effects of raloxifene include:
- flu-like symptoms
- hot flushes
- leg cramps
- gallstones
What else do the guidelines recommend?
NICE recommends increased screening with mammography for longer both for women at increased risk and for those who have had a breast cancer diagnosis and who are at high risk or confirmed BRCA1 and BRCA2 gene carriers.
For the first time women under 40 who’ve been newly diagnosed with triple negative breast cancer could be referred to a genetic team for further assessment.
In addition risk-reducing bilateral mastectomy should be raised as an option for all women at high risk of breast cancer.
Also for the first time the guidance outlines risk-reducing surgery to breast and ovaries after breast cancer for women with a known or suspected BRCA1 or BRCA2 gene
The guidelines could also mean more people may be able to consider genetic testing.
Where can I find more information?
You can find out more about breast cancer in families and risk of breast cancer on our website.
If you’re concerned about any aspect of breast cancer then you can call our free Helpline on 0808 800 6000.
You can also read the draft guidance in full on the NICE website.