UK prescribes tamoxifen to prevent breast cancer in high risk women

Wednesday June 26, 2013.

The UK National Health Service (NHS) has issued new guidelines recommending the drug tamoxifen be prescribed to women with a high risk of breast cancer.

International studies show that tamoxifen can reduce the incidence of breast cancer in high-risk women by as much as 40%; however, there is no demonstrable reduction in mortality in the preventative setting.

In New Zealand, there are no restrictions on the prescription of tamoxifen, a relatively low cost drug that is widely used in breast cancer treatment. However, it is not currently widely prescribed for prevention – high-risk women are more likely to have more frequent screening, including MRIs, or to have a preventive mastectomy. Preventive tamoxifen may be a third option for these women.

Oncologist Anna Bashford, medical adviser to the New Zealand Breast Cancer Foundation, says the decision to prescribe tamoxifen in a preventative capacity should be made with caution and on a case by case basis.

“Tamoxifen has unpleasant side-effects for many women, including nausea and menopausal symptoms like hot flushes,” she says. “In addition, it carries an increased risk of embolism (blood clots) and of endometrial cancer. For some women, their very high breast cancer risk may outweigh the downsides of tamoxifen, but for many, especially those with a more moderate risk, it won’t.”

Women with multiple cases of breast or ovarian cancer in their families, or with relatives whose breast cancer was diagnosed under age 50, should discuss their genetic risk with their doctor.

To read more about the NHS guidelines: