500,000 women to be offered breast cancer drugs A consultant analyses a mammogram. Updated advice on familial breast cancer could lead to nearly 550,000 women becoming eligible for preventative drugs. More than half a million women at risk of breast cancer should be offered drugs by the NHS for the first time to stop it developing, according to official health advice that could lead to a historic shift from treatment of the country's most common cancer to its prevention. All women over 30 in England and Wales judged to be at moderate or high risk of breast cancer would be able to take one of two drugs to reduce their risk under the draft guideline drawn up by the National Institute for Health and Clinical Excellence (Nice). At present 2% of women in that age group are classed as at moderate risk and another 1% at high risk on the basis of family history of breast cancer and, in some cases, a genetic test to establish if they are carrying a faulty version of either the BRCA1, BRCA2 or TP53 genes, which greatly increase breast cancer risks. Nice's updated advice on familial breast cancer could lead to nearly 550,000 women becoming eligible for the drugs. One of them, tamoxifen, is already used as a breast cancer treatment. The other, raloxifene, is used to treat the brittle bone disease osteoporosis. Under the proposals tamoxifen would be given to pre-menopausal women as well as some who have been through the menopause, while only the latter would receive raloxifene. Breast cancer charities hailed the move. "This draft guideline represents a historic step for the prevention of breast cancer," said Chris Askew, the chief executive of Breakthrough Breast Cancer. It is the first time drugs have ever been recommended for reducing breast cancer risk in the UK. 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. Lady Morgan, his counterpart at the Breast Cancer Campaign, said: "We're really pleased to see these guidelines include recommendations which could really benefit women at high risk of breast cancer. The biggest changes are preventative drug treatments for breast cancer being considered for the first time and wider access to genetic testing, which could bring about earlier diagnoses. Both drugs are already used in other countries to prevent breast cancer, for example in the United States, where they have been approved for that purpose by the federal Food and Drug Administration. Nice's advice could give some women at high risk of breast cancer an alternative to having both breasts removed in a double mastectomy to reduce their risk, as the TV presenter Sharon Osbourne revealed in November that she had done. About one in five of the 50,000 women a year in the UK who develop breast cancer have a significant family history of it. Of those, about 2,400 have a faulty version of BRCA1 or BRCA2, while between 4,800 and 7,200 others involve other genetic factors. Nice is recommending that pre-menopausal women at high risk should be offered tamoxifen unless they have a history of thromboembolic disease or endometrial cancer, and that post-menopausal women with the same medical history who are at high risk should be offered either drug, in both cases for five years. In addition, doctors should consider prescribing tamoxifen to pre-menopausal women at moderate risk of developing breast cancer within the next 10 years, and either drug to post-menopausal women with the same risk, again in both cases for five years, Nice's guideline says. Askew said the recommendations were long overdue and needed to be swiftly implemented. Such a rapid change faces obstacles, including the fact that neither drug is licensed in the UK for the purposes Nice for which would like them deployed. Martin Ledwick, head information nurse at Cancer Research UK, said: "These updated guidelines take into account the latest research into how a woman's family history of breast cancer can influence her risk of developing the disease. It's good to see preventative treatments and the significance of the TP53 mutations being included. A Department of Health spokeswoman said: "We want women identified as being at high risk of breast and ovarian cancers to be given high-quality services based on their individual needs. This draft guidance will help healthcare professionals support the needs of their patients and we encourage organisations or individuals with an interest to give their feedback.