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New guide for prevention of breast cancer

MIDDLE-AGED women at high risk of breast cancer due to their family history should have annual screening and take tamoxifen as preventive measure, new guidance has said.

WOMEN with a strong family history of breast or ovarian cancer should be offered genetic tests, an expert group in the UK has stated.

They should also be offered annual screening tests instead of the standard three-yearly and may be advised to start them at an earlier age.

The National Institute for Health and Clinical Excellence (NICE) also recommended that women at high risk be offered the anti-cancer drug tamoxifen.

Tamoxifen has not been used in this way before and is not currently licensed for prevention in women who have not been diagnosed with breast cancer.

A recent study found taking tamoxifen for five years as a preventive measure prevented 29 breast cancer cases and nine breast cancer deaths per 1,000 women treated.

Experts hailed the guidance as a "historic step for the prevention of cancer" and urged for it to be implemented urgently.

One in 20 breast cancers are caused by BRCA1 or BRCA2 genes that can be passed down through families.

Women carrying the gene have opted for preventive mastectomies because they are at such high risk of developing breast cancer.

The guidance said the risks and benefits of this surgery should be discussed and they should be referred for counselling before the operation.

The new draft guidance said where possible the family member who has suffered cancer should have genetic tests to determine if they are carrying a fault that could have been passed on. Where that is impossible, the nearest family member at risk should be offered the test, it said.

Women at high risk of an inherited cancer should be offered annual mammograms from the age of 40.

Annual MRI scans, which are more accurate at detecting tumours in younger women, should be offered to those as young as 20 if they have a certain faulty gene.

Chris Askew, Chief Executive of Breakthrough Breast Cancer, said: "This draft guideline represents a historic step for the prevention of breast cancer -- it is the first time drugs have ever been recommended for reducing breast cancer risk.

"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.

"Breakthrough Breast Cancer will strive to ensure the final recommendations are implemented swiftly. We urge women with concerns about their family history of breast cancer to speak to their doctor."

hnews@herald.ie