Preventative breat cancer healthcare- new choice of drugs or mastectomy
Women at high genetic risk of breast cancer could soon have a new treatment option other than double mastectomy – preventive drugs.Draft recommendations from the drugs watchdog in England and Wales, the National Institute for Curbing Expenditure (NICE), say such women should be given the option of taking tamoxifen or another drug called raloxifene for five years to cut their lifetime risk of the disease.
Until now, women facing a future with a strong likelihood that they would one day develop breast cancer have had only two real options – live in hope that it would never actually happen or have both of their breasts removed.
About one in every 100 women over the age of 30 falls into the high-risk category for breast cancer that Emma was in. Because of their family and genetic history, another two in every 100 women are at moderate risk and may also benefit from preventive therapy, experts say.
Prof Gareth Evans, an oncologist at Christie Hospital, says for some of those women, taking tamoxifen could be an alternative to having a preventative mastectomy, or breast removal.
“That surgery can reduce the risk by 90-95%, so it doesn’t eliminate the risk,” he says.
“It’s impossible to remove every last breast cell and depending on whether women keep their nipple or not, and that’s a big decision for some women, the risk may only be reduced by about 90%.
“We think that in about half of women, tamoxifen actually reduces the risk by 70% – if we can actually identify which women get that extra benefit, that may be enough for those very high-risk women to change their minds and say, ‘I’ll go for the tamoxifen instead’.”
Tamoxifen is not suitable for every woman and can cause side-effects, like hot flushes. Research suggests that up to half of women given tamoxifen to stop a breast cancer returning stop taking the drug prematurely.
Women who want to try for a baby would also need to come off the drug for at least three months before trying to conceive.
Tags: Cancer, cancer drugs, cancer survival, cosmetic surgery, NHS Deaths, NICE blight, red tape