Breast cancer drugs may help high-risk, healthy women

Doctors should talk about breast cancer-reducing drugs with women and offer tamoxifen or raloxifene to those that have a high risk of cancer and aren't likely to suffer side effects, a government-backed panel said on Monday.

The drugs work by blocking the effects of estrogen in breast tissue, lowering the chance of hormone-related cancers. But they also increase the risk of blood clots and hot flashes, among other side effects - so they shouldn't be handed out to everyone, the U.S. Preventive Services Task Force (USPSTF) said in its new draft guidelines.

"Currently only a minority of women for whom the medication might be indicated are actually taking it," said Dr. Mark Ebell, a member of the Task Force from the University of Georgia College of Public Health in Athens.

"I don't think there's a right or wrong answer for women," he told Reuters Health. "The main thing is just for women to be aware of this as an option and to talk to their doctor if they think they might be at increased risk."

Women are considered at high risk if they have a five-year chance of developing breast cancer of at least one in 60. Tools such as the Gail model take into account a woman's age, race, personal history of breast exams and family history of cancer to estimate her own risk of breast cancer.

A review conducted for the USPSTF and published concurrently found tamoxifen (marketed as Nolvadex and Soltamox) and raloxifene (Evista) decreased women's chances of developing breast cancer by 30 to 56 percent.

Both drugs also doubled the risk of blood clots and tamoxifen increased the chance of endometrial cancer and cataracts, according to findings published in the Annals of Internal Medicine.

The review did not include studies that focused on women with breast-cancer related BRCA gene mutations.

Angie Fagerlin, a bioethicist from the University of Michigan Medical School and the Ann Arbor VA, said it's important to consider an approximately 50-percent relative reduction in breast cancer risk in context.

For a woman who starts out with a one in 40 chance of developing cancer, she told Reuters Health, "Your risk goes from 2.5 to 1.25 (percent). It's a 1 percent difference in your risk of breast cancer, having to take a drug every day for five years that has some side effects."

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Breast cancer drugs may help high-risk, healthy women