The UK Medicines and Health Products Agency (MHRA) announced that the breast cancer drug anastrozole can be used to prevent breast cancer, mainly for high-risk women (including women with a family history of major diseases). The medication is taken once a day for 5 years.
In general, drugs such as tamoxifen, raloxifene, anastrozole, and exemestane are chemopreventive measures to reduce the occurrence of breast cancer. However, chemoprevention is only for people who are at high risk of breast cancer. On December 12, Yuan Peng, chairman of the Breast Cancer Group of the Oncologist Branch of the Chinese Medical Doctor Association and chief physician of the Department of Medical Oncology of the Cancer Hospital of the Chinese Academy of Medical Sciences, said in an interview with the reporter of the People's ** Health Client that because of the long time of medication and the increase in endometrial cancer, osteoporosis and other clinical diseases, the number of people who choose to pass chemoprevention is very small.
Screenshot of the official website of the Medicines and Health products Regulatory Agency (MHRA) in the United Kingdom.
According to the MHRA announcement, anastrozole has been authorized for breast cancer in postmenopausal women, and the newly approved indication is for the prevention of moderate or high-risk postmenopausal women. The evidence is based on the IBIS-II study, an international randomised, double-blind, placebo-controlled trial, which showed fewer women developing breast cancer in the anastrozole prevention group compared with the placebo group.
Clinical trials of anastrozole for breast cancer prevention are only for people at high risk of developing more than 5% of breast cancer over the next 10 years. Yuan Peng explained that when enrolling in a clinical study, the high-risk assessment includes a number of criteria, such as the presence of first-degree relatives (parents, children) with breast cancer under the age of 50;Patients with two or more breast or ovarian cancers in their first or second degree relatives;or have never given birth or have a first-time child over the age of 30 and have an immediate family member with breast cancer......
According to Yuan Peng, family history of breast cancer is an important risk factor, but family history does not mean genetic abnormalities. If there is a family history of breast cancer, genetic testing is usually chosen to determine whether the causative gene is inherited. If there is a genetic gene for breast cancer, guidelines in Europe and the United States include prophylactic mastectomy for prevention. However, the incidence of breast cancer in China is much lower than that in Europe and the United States, and there is a risk of excessive medical treatment in prophylactic resection, and there is little clinical application in China. The second prevention option is chemoprophylaxis, but prevention is not for all types of breast cancer, and the main reduction in the incidence of hormone receptor-positive breast cancer is when taking anastrozole. Some drugs have been approved for many years for the prevention of breast cancer, but because of the long time of taking the drug and the lack of recommendation from clinicians, the patient acceptance is relatively low.
Lan Bo, Secretary-General of the Breast Cancer Quality Control Expert Committee of the Beijing Cancer Quality Control Center and Deputy Chief Physician of the Department of Internal Medicine of the Cancer Hospital of the Chinese Academy of Medical Sciences, told the People's ** Health Client reporter: "There are very few cases of using oral drugs to prevent breast cancer in China. On the one hand, most of the clinical trials of preventive drugs are done abroad, and there are few domestic population data, and models such as the Gail model to assess the high-risk risk of breast cancer are also based on the Western population, which is not necessarily suitable for Chinese. On the other hand, there will be adverse drug reactions. Tamoxifen, for example, can cause hot flashes, night sweats, fatty liver, and increase the risk of venous thromboembolism and endometrial cancer. Anastrozole will cause bone loss, elevated blood lipids, etc. ”
Lan Bo said that as far as the prevention and treatment of breast cancer in China is concerned, the promotion of chemoprevention is still relatively limited. The focus is still on education, screening, and improving the health awareness of the whole people. At present, there is still a gap between the early diagnosis rate of breast cancer and that of Western countries, and it is necessary to have regular health check-ups, and if you really have breast cancer, you should diagnose and treat it early in time, which can already play a great role in the prevention and treatment of breast cancer.