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Reducing your risk

In the general population approximately 1 in 8 or 12.5% of women will develop breast cancer. There are several factors which determine a woman’s risk of breast cancer which include: hormonal factors, age, lifestyle choices, family history, and inherited genetic mutations. By assessing these factors it is possible to estimate whether a woman has an increased risk of breast cancer. Women with an estimated lifetime risk of breast cancer over 17% have an increased risk of breast cancer and are usually offered increased breast screening.

How do I know if I am at increased risk of hereditary breast cancer?

Women with an increased risk of hereditary breast cancer may have one or more of the following factors:

  • one close relative (mother or sister) diagnosed with breast cancer before 40 years old
  • two relatives (including either mother or a sister) diagnosed with breast cancer  
  • one close relative diagnosed with bilateral breast cancer
  • one relative diagnosed with male breast cancer
  • one relative diagnosed with ovarian cancer
  • Three relatives with breast cancer at any age
  • Jewish ancestry and a relative with breast/ovarian or prostate cancer

Women at increased risk of hereditary breast cancer have several options.

These include:

  • Increased breast cancer screening (risk >17%): usually with mammograms but possibly also with breast MRI
  • Risk reducing surgery (mastectomy) for those at high risk (risk > 30%)
  • Medication to lower the risk of breast cancer, known as chemoprevention (risk at least 17%)

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Medication to reduce your risk of breast cancer

Recent guidelines have suggested that women with an increased risk (over 17%) of breast cancer may benefit from taking medication to lower the risk of breast cancer. Currently there are two medications which can lower the risk of a woman developing breast cancer: Tamoxifen and Raloxifene.

There are side effects for both of these medications so it is important to carefully consider the options. In addition, although current guidelines recommend offering these medications it is important to be aware that they are unlicensed in the UK for this purpose.

The current guidelines are to:

  • Offer Tamoxifen for 5 years to pre-menopausal women
  • Offer Tamoxifen for 5 years to post-menopausal women without a womb (i.e. have had a hysterectomy)
  • Offer Raloxifene or Tamoxifen for 5 years to post-menopausal women with a womb

Benefits of medications

If taken for five years, Tamoxifen has been shown to reduce the risk of developing breast cancer by about 30-40%. Raloxifene can be used in post-menopausal women to lower the risk of breast cancer.

Raloxifene also lowers the risk of fractures in post-menopausal women and has been used to treat osteoporosis.

Risks of medications

Tamoxifen has been shown to have cause an increased risk of blood clots in all women (approximately 1%) and womb cancer in post menopausal women (approximately 1%). Raloxifene also causes a risk of these side effects however the risk is lower than with Tamoxifen.


Women often report symptoms similar to the menopause including hot flushes, sweats, nausea, leg cramps, and an increase (or decrease) in migraines. Unfortunately sometimes these symptoms may be so intrusive that they cause a woman to stop taking these medications.

Other considerations

Tamoxifen may reduce a woman’s long term fertility and needs to be stopped 2 months before trying to conceive. Tamoxifen also needs to be stopped 6 weeks before any surgery. Although the guidelines do not recommend an age at which these medications should be prescribed all the studies have offered them to women over the age of 35.

Women with a personal history of / or increased risk of clots or womb cancer should not take these medications.

If you are interested in learning more about chemoprevention, please contact us at 0800 331 7717. Initially you will be sent a family history questionnaire, which will be analysed by one of our genetic counsellors. During a one hour consultation, your personal risk of breast cancer will be explained and your options discussed. Following this conversation if you decide you would like to take Tamoxifen or Raloxifene the genetic counsellor will ask your GP to prescribe these medications.

The cost for a one hour consultation to assess the suitability of Tamoxifen or Raloxifene, is £150.

Fill out your details and one of our friendly staff will call you back within 1 working day to book your consultation with a Genetic Counsellor.

or if your prefer, call 0800 331 7177 to book now

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