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NICE recommends tamoxifen for women at risk of breast cancer

Healthy women with a family history of breast cancer could be prescribed cancer drugs for five years, under new guidance published by NICE.

Anti-oestrogen drugs tamoxifen and raloxifene have been found to reduce the risk of breast cancer, but are not yet licensed for this use in the UK. The course of drugs could be offered to women with a three-in-ten chance of developing breast cancer, and considered for those with a one-in-six chance.

Women with a 10% risk of inheriting one of the two genes that lead to a particularly high chance of developing breast cancer will be offered genetic screening. NICE said it would be cost effective to screen even more women, but the NHS did not yet have the capacity to do it.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: “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.”

Baroness Delyth Morgan, chief executive of Breast Cancer Campaign, said: “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.”

Professor Gareth Evans, a consultant in clinical genetics at St Mary's Hospital and member of the Guideline Development Group, said: “The whole guideline is a major move forward in that more women than ever before now face the possibility of doing something tangible to reduce their risk of breast cancer. That can only be a good thing.”

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