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Breast cancer health centre

Breast cancer and family history

By
WebMD UK Health News
Medically Reviewed by Dr Keith David Barnard
69x75_tamoxifen

15th January 2013 -- For the first time in the UK, preventive drugs are being recommended for reducing breast cancer.

Draft guidelines from the medicines advisor for England and Wales, The National Institute for Health and Clinical Excellence (NICE), say women and men with a strong family history of breast cancer could be offered medication on the NHS to try to prevent the disease.

The charity Breakthrough Breast Cancer is calling the plan an "historic step".

However, the new guidelines are expected to be a challenge for the NHS as a large increase in genetic testing may be needed. 

Updated guidance

Breast cancer guidelines were last updated in 2006. The updated guidelines on familiar breast cancer include:

  • When to offer genetic testing
  • Monitoring strategies
  • The use of breast cancer drugs tamoxifen or raloxifene as preventive treatments. These treatments don’t currently have UK marketing authorisation to be used in this way, but preventive or prophylactic use of tamoxifen has been used in other countries, such as the US, for some time now.

 

Breast cancer in the UK

Breast cancer is the most common cancer in the UK.

Around 50,000 women and 400 men are diagnosed with the condition each year. Most cases are not linked to a family history of breast cancer, but if there has been breast cancer in the family, the risk of developing the disease is higher and often occurs at a younger age.

The stronger the family link is, the higher the breast cancer risk.

NICE says a person's risk depends on:

  • The nature of the family history
  • The number of relatives who have developed breast, ovarian or related cancers
  • The age at which relatives developed breast cancer
  • The age of the person

In a statement, Professor Mark Baker, director of the NICE Centre for Clinical Practice says: "The causes of cancer are complex and not fully known. However, we do know that having a family history of breast, ovarian or a related cancer can significantly increase the risk of developing breast cancer, including developing the cancer at a younger age. It is also more likely that people with family members affected by cancer who then develop breast cancer themselves could develop a separate tumour in the other breast following initial treatment. This is why it’s wise for any person with a family history of cancer to receive appropriate investigations and screening that would otherwise be unnecessary if a family history did not exist."

Reaction

Reacting to the plans in a statement, Breakthrough Breast Cancer chief executive Chris Askew says: "This draft guideline represents an historic step for the prevention of breast cancer - it is the first time drugs have ever been recommended for reducing breast cancer risk in the UK.  This is exciting as, even though most women do not have a significant family history of the disease, it’s crucial that those who do have an array of options to help them control their risk.

"An update to this guideline is long overdue and we’re especially pleased it has been extended to include both women who have had breast cancer, and men, for the first time. Once finalised, this guideline will pose new challenges for the NHS as it will need to deliver on its recommendations, including a potentially large increase in genetic testing."

Published on January 15, 2013

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