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High risk women say no to preventative breast cancer drugs

Despite the current recommendations from the U.S. Preventative Services Task Force, (USPSTF) women are saying “no” to preventative breast cancer drugs. The two drugs, tamoxifen and raloxifene, are recommended for women at high-risk for breast cancer and at low-risk for side effects. USPSTF recently renewed and clarified the 2002 guidelines for these drugs. The renewal included guidelines for physicians about prescribing the two drugs.

What is high-risk?

Women who are at high-risk for breast cancer either have a strong family history of breast cancer, including a direct-line relative like a parent or sibling, or they have an identified BRCA1 or BRCA2 gene mutation.

What is chemoprevention?

Chemoprevention is the use of prescription drugs to prevent a certain disease. In the case of breast cancer, the USPSTF recommends tamoxifen and raloxifene for women at high-risk for breast cancer.

What are the risks?

Tamoxifen and raloxifene have side effects. In addition to serious medical issues, both drugs cause menopausal symptoms such as hot flashes, night sweats, mood swings, and decreased sex drive. Women who are in their child bearing years may not be able to conceive while taking these drugs. Neither drug should be taken during pregnancy or by women who are breast feeding.

Tamoxifen can cause cancer of the uterus, stroke, and blood clots in the lungs—which can be fatal. It is used as chemoprevention for breast cancer and for women who already have certain types of breast cancer.

Raloxifene does not have the same risk for uterine cancer, but it carries the same risk for stroke and blood clots in the lungs. It is used to treat osteoporosis in post-menopausal women. This drug is used for chemoprevention for breast cancer but it is not used to treat women who currently have breast cancer.

Does it work?

Both tamoxifen and raloxifene only work to prevent estrogen-positive breast cancers. This is the most common form of invasive breast cancer in women. The breast cancer cells feed on estrogen. However, neither drug will prevent non-estrogen based cancers. Women who have concerns about their breast cancer risk should consult with a physician.

Lynda Altman was diagnosed with breast cancer in Nov. 2011. She is passionate about women’s health issues and helping all women get access to accurate healthcare information. Lynda writes a blog called Homeschooling When Mom has Cancer. Get notices when this page is updated by clicking on the subscribe link, by email, or contact Lynda @fusgeyer on Twitter.