Media release

Effective breast cancer prevention drugs underused

Women at high risk of breast cancer are missing out on drugs that have been shown to reduce the risk of developing the disease, according to an article in the December issue of the Medical Journal of Australia.

Associate Professor Kelly Philips, from the Peter MacCallum Cancer Centre in Melbourne and coauthors, said that there is level 1 (strong) evidence that selective oestrogen receptor modulators (SERMs) reduce breast cancer risk by up to 40% in women at high or moderate risk of breast cancer, but these agents were rarely discussed with women.

Fewer than 3% of 3788 women at high risk of breast cancer enrolled in a national study had used SERMs, such as tamoxifen or raloxifene, for prevention. 

The authors said that while online tools are now available to help doctors to assess a woman’s breast cancer risk and therefore whether she might benefit from SERMs, there is an urgent need for doctors to incorporate use of these tools into their practice and to discuss SERMs as an option for women found to be at increased risk.

“Improved education and decision support for clinicians may help reduce the controversy surrounding the use of SERMs for breast cancer prevention and ultimately reduce breast cancer incidence”, they wrote.

Doctors may be reluctant to prescribe these drugs because they are not subsidised on the Pharmaceutical Benefits Scheme; however, they are relatively inexpensive (less than $1 per day for tamoxifen) and likely to be within the means of most patients, the authors wrote.

Concern about side effects was another probable barrier to uptake; however, there could be an overestimation of the risk of rare side effects, because doctors tend to convey relative, rather than absolute, risks they wrote. For example, although tamoxifen doubles the risk of blood clots, a pre-menopausal woman’s baseline risk is very small. In fact the absolute risk is similar to that of women taking the oral contraceptive pill.  

The authors highlighted that the National Breast and Ovarian Cancer Centre had recently revised its guide, which now suggests consideration of SERMs for women with moderate or high risk of breast cancer. 

The Medical Journal of Australia is a publication of the Australian Medical Association.


The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA or the MJA unless that is so stated.

CONTACTS:   Emma Liepa Ph: 03 9656 5883
  Communications and Brand Manager Mob: 04 1714 0309
  Peter Mac Media Unit (On behalf of Associate Professor Kelly-Anne Phillips) 

 

 

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