NICE backs use of drugs for breast cancer prevention

The National Institute for Health and Care Excellence has now published updated familial breast cancer guidelines which advocate the use of three medicines to reduce the risk of developing the disease.

The cost regulator recommends that doctors prescribe either tamoxifen, raloxifene and now anastrozole to potentially hundreds of thousands of 'healthy' women who have no personal history of breast cancer but have a higher risk of developing it.

According to the guidelines, doctors should offer tamoxifen for five years to premenopausal women at high or moderate risk of breast cancer, unless they have a past history or may be at increased risk of thromboembolic disease or endometrial cancer, and anastrozole for five years to postmenopausal women unless they have severe osteoporosis.

For postmenopausal women at high risk of breast cancer with severe osteoporosis, but no history or increased risk of thromboembolic disease or endometrial cancer, tamoxifen should for offered, or raloxifene as an alternative to for women with a uterus.

Use of anastrozole is a new component of the updated guideline, included on the back of clinical studies showing that 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 demonstrated 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 and for NHS budgets," noted professor Mark Baker, director of the centre for guidelines at NICE.