One woman in eight develops breast cancer, with about 55,000 new cases a year and 11,400 deaths from the disease
A new era of cancer-prevention treatments was ushered in last week with news that women can now halve their risk of developing breast tumours thanks to a 4p-a-day tablet to be offered on the NHS.
Prescribing watchdogs the National Institute for Health and Care Excellence recommended that the drug, anastrozole, should be made available to women who are over 50 and deemed to have a high risk of developing the disease.
It is already taken by women who have had breast cancer in order to prevent it from recurring.
Younger women with similarly high risks are currently offered another medication, tamoxifen, as a preventative measure.
Both medications act on the female sex hormone oestrogen, which is known to trigger the development and growth of breast-cancer cells.
One woman in eight develops breast cancer, with about 55,000 new cases a year and 11,400 deaths from the disease. Scientists estimate that if all women currently at high and medium risk were offered anastrozole for five years, 39,000 could be spared breast cancer.
So, should you be on the ‘wonder tablet’? Here, Britain’s leading experts give their verdict…
Professor Jack Cuzick, director of the Wolfson Institute of Preventive Medicine in London and head of the Centre for Cancer Prevention at Queen Mary University of London, says: ‘The approach in cardiology for a long time now has been to assess the risk of a patient having a heart attack or stroke and, if appropriate, give drugs like statins to reduce that risk.
Professor Jack Cuzick (pictured) is the director of the Wolfson Institute of Preventive Medicine in London
‘We can now take a similar approach with breast cancer. It’s fairly easy to find out your breast-cancer risk by using an online survey like IBIS risk calculator, ems-trials.org/riskevaluator, which asks questions about lifestyle and family history of diseases.
‘If this flags up a concern, a GP can refer women to a NHS genetic counsellor or a breast specialist.
‘Anastrozole works by stopping oestrogen being produced in fat tissues, a process called aromatisation. In post-menopausal women whose ovaries have stopped producing oestrogen, this is the best way of providing protection.
‘We already knew from studying women who had breast cancer that anastrozole was better than tamoxifen at preventing it from coming back. It made sense to look at this medication for prevention, too.
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‘Our previous studies showed that pre-menopausal women who took tamoxifen, which blocks the action of oestrogen in the body rather than preventing it from being produced, for five years, gain a substantial level of protection.
‘Five years of treatment seems to offer almost lifetime benefit and results in minimum damage, meaning the benefits far outweigh the risk.’
Professor Peter Schmid, of Leaders in Oncology, is a Professor of Cancer Medicine and Lead of the Centre of Experimental Cancer Medicine at Barts Cancer Institute.
He says: ‘The main concern about taking anastrozole or tamoxifen is that oestrogen is integral in maintaining bone health. Before starting therapy, women should be given a bone-density scan. If problems are flagged up, another drug can be given to prevent osteoporosis.
Professor Peter Schmid, of Leaders in Oncology, is a Professor of Cancer Medicine and Lead of the Centre of Experimental Cancer Medicine at Barts Cancer Institute
‘All women will experience some bone loss but this returns after the drug is stopped. Otherwise, side effects are similar to menopause, which is individual for all women.
‘The most common are hot flushes and problems with sleep, but these often pass. A small group of patients say the side effects are too detrimental to their quality of life to continue, a majority are willing to accept the side effects and they are not significant enough.
‘It is important to highlight that this should only be offered to high-risk women – those with a 30 per cent or more lifetime risk of developing breast cancer.
‘There is also no point in giving this to women of any age – over 50 or not – who have not yet gone through the menopause as the drug will not work on them.’
Dr Marilyn Glenville is Britain’s leading nutritionist specialising in women’s health and author of more than a dozen books on the subject, including the bestseller Natural Solutions For The Menopause.
She says: ‘There is a risk with drug developments like this for patients to think a pill gives total protection. In fact, maintaining a healthy body weight – importantly, watching out for body-fat percentage – is extremely important.
Dr Marilyn Glenville (pictured) is Britain’s leading nutritionist specialising in women’s health
‘Other proven ways to reduce risk of breast cancer: reduce alcohol intake to no more than one unit per day, exercise 30 minutes daily, and breastfeed children for six months. The latter is not something you can change, but if you have done this in younger years, you are of lower risk.
‘Diet is key, intake of Vitamin D specifically. As well as being important for bone health, it stops proliferation of breast cancer cells, a link which has been shown in several studies.
‘Also eating enough cruciferous vegetables such as kale and broccoli, and omega 3, through oily fish, eggs and flax seeds. Flax seeds also inhibit oestrogen production in fat tissue.
‘Anything that’s going to control excess oestrogen is going to help. These may not be huge changes, but combined, they could make a huge difference.’