Preventing breast cancer, where possible, can save lives. To mark Breast Cancer Awareness Month 2017, we discuss some opportunities that are being missed to prevent more cases of breast cancer, as outlined in our new policy report.
A wide range of factors can affect a person’s risk of developing breast cancer, including genes, lifestyle and environment. Although nothing can be done to change the biggest risk factors (being a woman and getting older), there are things that can be done to reduce others, including making healthier lifestyle choices and taking cancer preventing medicines where family history puts people at greater risk. Medicines can also be taken to prevent breast cancer from spreading to other parts of the body.
Our new report, Good Enough: Breast Cancer in the UK looks at available data across the patient pathway, from prevention and early diagnosis to treatment and care. Over the past ten years, progress has been made and thanks to research, we believe that we should be able to prevent 30% of breast cancer cases by 2050. However, we are concerned that progress is stalling and there are several issues that need to be addressed if the results of research are to reach patients and save lives.
Research has shown that drinking less alcohol, staying active and maintaining a healthy weight can reduce a person’s risk of developing breast cancer. UK governments and the NHS have recognised the importance of promoting a healthy lifestyle for cancer prevention, and have updated or developed new strategies to reflect this. However, in some nations these commitments have been undermined by cuts to public health funding.
Meanwhile, levels of alcohol consumption, obesity and physical activity across the four nations are a cause for concern; in particular, the percentage of women who are overweight or obese has increased over the last decade, with the highest percentage of overweight women being over 45 years old.
Sarah, 54, is an opera singer living in Cardiff, Wales. Sarah does all she can to reduce her risk of developing breast cancer; she said:
As well as being physically active, I take care in what I eat and my alcohol consumption is minimal, as drinking is known to be associated with breast cancer. Being proactive goes a long way to dissipating my anxiety of this disease, which took my mother far too soon.
In some cases, breast cancer runs in families. 15% of women who develop breast cancer have a significant family history of the disease, and about 5% have inherited a fault in a gene linked to breast cancer. Women with a family history of breast cancer might choose to take cancer preventing medicines (chemoprevention), such as tamoxifen, anastrozole or raloxifene to reduce their risk of developing the disease.
The effectiveness of cancer preventing medicines was discovered after their patents had expired, meaning that the manufacturer no longer has exclusive rights over making the drug. This means that the manufacturer would make far less money from the sale of the drug and there is therefore no incentive for them to license the drug for this new use. Because they’re not licensed, just under half of GPs are unaware that tamoxifen can be used to prevent breast cancer. This means that many women at increased risk of developing breast cancer are missing out on the opportunity to reduce their breast cancer risk.
Preventing secondary breast cancer
Research has also shown that for post-menopausal women, a group of medicines called bisphosphonates can reduce their risk of developing secondary breast cancer by nearly a third within ten years.
Because bisphosphonates are also not licensed for preventing secondary breast cancer, patient access is variable. Bisphosphonates are routinely available in less than 20% of Clinical Commissioning Groups (CCGs) in England, two of the three cancer network areas in Scotland and in two of the three cancer centres in Wales. Read about our off-patent drugs campaigning for more information.
What needs to be done?
We want to send the message that Breast Cancer Now is ready to work with the Governments and the NHS across the UK to take action now. We want to see:
- Governments and the NHS taking action to improve patient access to off-patient medicines, including chemoprevention and bisphosphonates
- Governments and the NHS across the UK developing robust strategies to tackle lifestyle factors, and putting sufficient funding behind their commitments