New recommendations for preventative treatment for women with a familial risk of breast cancer

New guidelines in the UK recommend that healthy post-menopausal women with a familial risk of developing breast cancer be prescribed the medicine anastrazole in a bid to help ward off the disease.

The recommendation comes from the UK’s drug regulator, the National Institute for Health and Care Excellence (NICE), which has just updated its familial breast cancer guidelines.

The Institute already recommends that healthy pre-menopausal women with the BRCA gene mutations be prescribed the hormone therapy, tamoxifen, for at least five years.

Clinical trials have shown that women with either the BRCA1 or BRCA2 gene mutation who take tamoxifen have a reduced risk of breast cancer recurring. This treatment plan is only suitable for pre-menopausal women who do not have an increased risk of blood clots or endometrial cancer.

Now, NICE is advising that post-menopausal women with the BRCA gene mutations be offered the hormone therapy, anastrazole, to help reduce their risk of breast cancer, unless they have a severe risk of osteoporosis.

The recommendation comes after clinical studies found the drug cut the risk of the disease in post-menopausal women by more than 50 percent in the first five years of use, but with fewer side effects than other preventive options.

According to NICE, new evidence shows anastrozole is more effective than tamoxifen in post-menopausal women. 

The institute’s Professor Mark Barker says that if 1,000 women at high risk of breast cancer took anastrozole for five years, 35 cases of breast cancer would be prevented, compared to 21 if they took tamoxifen.

“The evidence examined by the committee suggests anastrozole will not only reduce the number of breast cancer cases in postmenopausal women compared to tamoxifen, but it is also a more cost effective option. This is good news for women,” Professor Baker says.

BCAC chairperson, Libby Burgess, says the NICE guidelines should be a discussion point between women with either the BRCA1 or BRCA2 gene mutation and their specialists.

“These recommendations are made off the back of comprehensive analysis of data from a range of clinical trials.  Recommendations such as this are not made lightly and are evidence-based to offer the greatest protection to women with a familial risk of breast cancer. 

“Women in this position should definitely discuss these treatment options with their healthcare team,” Libby says.

3 April 2017

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