Breast cancer: How anostrozole can lower risk

Evan Walker
Evan Walker TheMediTary.Com |
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Anastrozole can reduce breast cancer risk after menopause, but does it come with its own risks? Image credit: shironosov/Getty Images.
  • A drug used as a breast cancer treatment has been authorized for use as a preventative drug in post-menopausal women at high risk of breast cancer, in England, United Kingdom.
  • Previous research shows that this drug can reduce the risk of breast cancer by 49%.
  • The Medicines and Healthcare Products Regulatory Agency hopes this decision increases awareness among high risk women about the possibility of using this preventive treatment.

The Medicines and Healthcare Products Regulatory Agency (MHRA) in the United Kingdom has recently authorized the breast cancer drug anastrozole as a preventative medication.

The official press release describes it as “a hormone treatment used for breast cancer in post-menopausal women.”

This authorization means that women at high risk of breast cancer will be able to access a 5-year course of the medicine shown to reduce the risk of developing this cancer.

Anastrozole is a type of drug called an aromatase inhibitor. Prof. Cuzick explained that it works by disrupting the production of estrogen, which drives some breast cancers.

Most estrogen is made in the ovaries in women of reproductive age, but this decreases significantly after menopause. However, “for post-menopausal women, [estrogens are] going to be introduced by changes in fatty tissue,“ noted Prof. Cuzick.

“So there is an enzyme that actually takes fatty tissue and does some of the work. It’s a complicated process, but it’s a key thing that converts it towards estrogen. It’s not one step, its several steps and anastrozol stops the working of that particular gene. So it stops the production [of estrogen].”

– Prof. Jack Cuzick

When taken preventatively the drug is taken once a day, every day, for 5 years.

Women at moderate and increased risk of breast cancer should consider taking the drug, said Prof. Cuzick. However, he admitted that determining breast cancer risk was a challenge as there are many factors that can increase risk.

“Basically, 5% [increased risk] is the level at which you should consider it, 8% risk at 10 years is the level we think you should definitely be taking in. So that’s the current situation,” he said.

Prof. Cuzick explained that the preventive effect of Health">tamoxifen, which is recommended for women at high risk of breast cancer who are premenopausal, has been studied at lower doses.

“One of our next research projects will be to look at the extent to which we can introduce lower doses and still prevent estrogen production, but yet have minimal side effects. So that will be the next step,” he said.

Lester Barr, cofounder of the nonprofit organization Prevent Breast Cancer, told MNT that, following the MHRA decision, “[p]ost-menopausal women with a family history of breast cancer, who are themselves at moderate or high risk of breast cancer, can be prescribed anastrozole to lessen their risk of developing the disease.“

“These women should speak to their GP [general practitioner or family doctor] and ask whether they are eligible for referral to a family history clinic. If so, a specialist there will assess their risk in more detail and then discuss anastrozole with them as just one of the options that can lower breast cancer risk for high-risk women,” said Barr.

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