Drug that can halve breast cancer risk offered to 289,000 women in England | Breast cancer

Almost 300,000 women at higher risk of developing breast cancer are being given access to a drug that can halve their risk in a “major step forward” in the fight against the disease.

An estimated 289,000 women in England who are at moderate or high risk of breast cancer will from Tuesday be able to take the tablet to try to prevent it from developing, NHS bosses said.

The drug, anastrozole, is being made available to women who are in greater danger because they have been through menopause and have a major family history of Britain’s commonest form of cancer. It displays “remarkable” potential to reduce the number of people who go on to develop the disease, the head of the NHS said last night.

Every year, around 56,000 women in the UK are diagnosed with breast cancer – about 150 a day. While survival rates have improved, it still claims about 11,500 lives each year.

“It’s fantastic that this vital risk-reducing option could now help thousands of women and their families avoid the distress of a breast cancer diagnosis,” said Amanda Pritchard, NHSC England’s chief executive. The drug will be taken as a 1mg tablet once a day for five years.

The move to make anastrozole available to all eligible women represents a potential new frontier in the fight against Britain’s big killers because it is the first time that a drug which is already used to treat a condition has been “repurposed” to prevent the same disease from appearing.

Not everyone who elects to go on the medication will continue doing so for the full five-year course because of the side-effects involved, which include hot flushes, weakness, pain or stiffness in joints and arthritis. Skin rash, nausea, headaches, brittle bones and depression are also side-effects.

How many cases it prevents depends on how many women decide to use it. But even if just a quarter of the 289,000 newly eligible women decide to take the pill, it could prevent 2,000 of them from being diagnosed with the disease, NHS England said.

Post-menopausal women who have either seen relatives develop breast cancer at a younger age or several relatives develop it will be able to access the treatment. The NHS says that in the first instance they should visit their GP, who may refer them to a breast cancer or family history clinic.

Anastrozole is known as an aromatase inhibitor. It works by reducing the amount of the hormone oestrogen that a woman’s body makes by blocking the enzyme aromatase.

NHS England is able to offer the drug because the Medicines and Healthcare products Regulatory Agency has licensed it to be used as a preventative medicine.

“Allowing more women to live healthier lives, free of breast cancer, is truly remarkable, and we hope that licensing anastrozole for a new use today represents the first step to ensuring this risk-reducing option can be accessed by all who could benefit from it,” said Pritchard.

Experts in the disease hope the drug’s availability will prompt at-risk women to take it. “The extension of anastrozole’s licence to cover it being used as a risk-reducing treatment is a major step forward that will enable more eligible women with a significant family history of breast cancer to reduce their chances of developing the disease,” said Baroness Delyth Morgan, chief executive of the charity Breast Cancer Now.

Dr David Crosby, head of prevention and early detection at Cancer Research UK, said: “Approaches to help prevent breast cancer at high risk are badly needed, so this is a welcome announcement.

“We carried out some of the key work on developing these kinds of drugs, known as aromatose inhibitors, and 10 years ago our clinical trial showed that anastrozole could halve the risk of some women developing breast cancer, with minimal side-effects.”

Anastrozole is the first product of the pioneering Medicines Repurposing Programme, under which a consortium of key health bodies are examining the potential of existing drugs to be used for different purposes.

When that approach was adopted during the pandemic, it led to tocilizumab, an arthritis drug, and dexamethasone, a steroid, being deployed as treatments for Covid-19.

Meanwhile, women with vaginal bleeding who may have womb cancer could in future be spared having a potentially painful surgical biopsy thanks to a new test developed by a leading expert in women’s cancer.

The WID-qEC test, developed by Prof Martin Widschwendter of University College London, is more accurate than imaging at ruling out womb cancer. It could save 90% of women who are undergoing or have just been through the menopause from having a biopsy to diagnose the disease or rule it out, according to the results of research co-funded by the charity Eve Appeal and published in the Lancet Oncology.

The test will be commercially available in Austria and Switzerland from early 2024 and could become available in the UK soon afterwards, said Widschwendter.

Athena Lamnisos, the Eve Appeal’s chief executive, said many women who have a hysterectomy and biopsy when they are investigated for abnormal bleeding find it “extremely painful” and then face an “agonising” wait to get the result.

“Saving thousands of women from needing to go through the pain of tests and speeding up the wait before cancer being ruled out or diagnosed and starting treatment is very welcome progress,” she added.

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