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Women With High Breast Cancer Risk Should Consider Preventive Drugs, USPSTF States

Women With High Breast Cancer Risk Should Consider Preventive Drugs, USPSTF States

September 24, 2013 — Women with at least a 3% chance of developing breast cancer over the next five years should consider taking one of two FDA-approved breast cancer drugs, as long as they have a low risk for related side effects, according to a U.S. Preventive Services Task Force recommendation, the Los Angeles Times' "Science Now" reports (Healy, "Science Now," Los Angeles Times, 9/23).

The recommendation remains the same as USPSTF's last announcement on the issue, which it released in 2002. The latest recommendation is based on a systematic research review published in the Annals of Internal Medicine (Phend, MedPage Today, 9/23).

Specifically, the panel said the chemotherapy drug tamoxifen or the osteoporosis drug raloxifene should be considered for women whose five-year risk for breast cancer is calculated to be at least 3% by one of two reliable risk calculators -- one from the National Cancer Institute and another from the Breast Cancer Surveillance Consortium. However, for women with certain risk factors, such as a family history of stroke or blood clots, the chance of adverse effects from the drugs could outweigh the potential benefits ("Science Now," Los Angeles Times, 9/23).

The panel's endorsement applies to women with no history of breast cancer, ductal carcinoma in situ or lobular carcinoma in situ (MedPage Today, 9/23). The recommendation does not apply to women who have the BRCA-1 or BRCA-2 gene mutations, nor to women who are younger than age 35 or older than age 79 ("Science Now," Los Angeles Times, 9/23).

Overall, USPSTF issued a grade B endorsement for the drugs for eligible women and a grade D on preventive treatment for women who did not meet the guidelines.

Uptake Low

Clifford Hudis -- chief of breast cancer medicine at Memorial Sloan-Kettering Cancer Center and president of the American Society of Clinical Oncology -- noted that although the recommendation has remained consistent, eligible women's uptake of the drugs has been low.

"In the clinic, if we focus on the group of people most likely to benefit, where the risk-to-benefit ratio is greatest, maybe the uptick will actually go up because the people taking it will get a definable, measurable, meaningful benefit," he said.

According to the panel's review, the drugs' side effects appear to account for much of the low uptake rate (MedPage Today, 9/23).