NICE- The National Institute for Health and Care Excellence in their conference says that hundreds of thousands of healthy women should take pills to cut their risk of breast cancer.
NICE give three drugs to choose from tamoxifen, raloxifened and anastrozole. The cheaper is anastrozole and has fewer side-effects and more effective.
Trials show that per 1,000 patients taking anastrozole for five years, 35 cancer cases would be prevented compared with 21 for tamoxifen.
Which treatment is best for each woman will depend on her situation. If she is pre-menopausal, anastrozole won’t be suitable because it knocks out the female hormone oestrogen, creating, in effect, a drug-induced menopause.
Clinical trials show anastrozole avoids two of tamoxifen’s more serious side-effects – an increased risk of developing a blood-clotting disease, and an increased risk of developing womb cancer.
But anastrozole can make bones weaker and so it is not recommended for women with osteoporosis.
Not all of the tablets are licensed for use as breast cancer prevention drugs. Doctors can still prescribe them off-label.
“This updated guideline is a great first step but we now need to ensure that these risk-reducing options actually make their way to patients that could benefit. Ultimately, if the full potential of anastrozole is to be realised for post-menopausal women, there needs to be far greater awareness and support for GPs in prescribing off-label treatments.”
Some women find that the side-effects of these breast cancer pills are significant enough to stop them taking the medication.
Common side-effects, affecting at least one in every 10 women on the tablets, include hot flushes and sweats.