Many women would consider breast removal to reduce breast cancer risk

A new international survey - connected to a study taking place at the University of Dundee - reveals that around one in
five women would consider having both breasts removed to help reduce their risk of developing breast cancer if told they were
at an increased risk of developing the disease.


The survey asked over 1500 women from around the world what choices they would make if told they were at high risk of
developing breast cancer. Of the UK women who were questioned, up to one in three said they would consider having a double
mastectomy.


Breast cancer experts wanted to learn more about women's attitudes to breast cancer worldwide as they take the first step in
trying to prevent up to 80 per cent of hormone sensitive breast cancers. With nearly half the women saying they were
concerned about developing breast cancer, the study highlights the need for all prevention options, particularly new ones, to
be clearly explained. Women in the UK are particularly worried with around 60 per cent saying they are concerned about breast
cancer.


When asked if they would consider taking part in a trial investigating a preventive treatment for breast cancer, around 50
per cent of the women said they would consider it. Around 45 per cent of the women in the survey said they would consider
taking a daily tablet as a preventive step against breast cancer.


In the UK there are around 41,000 women diagnosed with breast cancer every year. Around 80 per cent of these are
post-menopausal women.


Scientists based at the University of Dundee are involved in one of the first worldwide prevention trials, called IBIS-II1,
which is investigating whether a drug already used to treat breast cancer may have the ability to prevent the disease.



This landmark trial involves postmenopausal, high risk women taking a once-a-day pill containing the drug anastrozole.
Previous trials investigating this drug as a treatment for breast cancer have shown that it reduces the risk of developing
cancer in the opposite breast by over 50 per cent2.


The female hormone, oestrogen, is known to be the most important cause of breast cancer in post-menopausal women and
anastrozole works by stopping oestrogen being produced.


This is the first time the drug is being investigated as a preventive measure. Cancer Research UK scientists are looking for
6,000 women from around the world to take part in the trial.


"The IBIS-II study is extremely important for women with an increased risk of developing breast cancer" commented Professor
Jack Cuzick, Cancer Research UK's lead researcher on the trial. "It is vitally important that women come forward to
participate in the trial. It could provide them with a valuable option in helping to control breast cancer. Many of us
already take medications to prevent heart disease so just imagine the possibilities if, in the future, we could use a simple,
once-a-day medication, to reduce the occurrence of breast cancer. For those women faced with the reality of being at high
risk of developing breast cancer, this trial has the potential to change their lives."















He adds: "With over 30,000 post-menopausal women being diagnosed with breast cancer in the UK every year, i t's vital that we
look for effective ways of preventing the disease."


Dr Lesley Walker, Director of Cancer Information at Cancer Research UK, says: "It is extremely rare for women to undergo a
double mastectomy for preventive reasons and as an option, it is most relevant to women with a very strong family history of
breast cancer. The global launch of IBIS-II aims to provide women with a new, far less radical option for preventing breast
cancer at a time when numbers of women being diagnosed with the disease and concern about it, is so high. Through trials like
this, women and researchers are working together to help discover clear and safe options for helping to prevent breast
cancer."


Professor Alastair Thompson, Professor of Surgical Oncology at Ninewells Hospital and Medical School, is the local trial
co-ordinator in Dundee. He said, "We urge all women who are concerned about breast cancer to speak with their doctor.
Understanding your risk of developing breast cancer and knowing what options are available are essential for all women. We
are asking those women who are eligible for the trial to come forward and help us to find a way to help prevent breast
cancer."


To be eligible to take part in the IBIS II programme, women must be post-menopausal, not taking HRT and have at least twice
the normal risk of breast cancer - for example someone whose mother or sister had breast cancer before the age of 50, or who
has two family members with the disease.


Post-menopausal women who are interested in taking part should contact research nurses Gillian Little and Mhairi Hawkes on
01382 633850.


For more information on the trial log on to the IBIS website (ibis-trials), CancerHelp UK (cancerhelp.uk)


About the survey


Research was carried out by NOP World, a global market research agency, in April 2005 using their Telebus survey. The
nationally representative survey was conducted in six countries (Australia, Belgium, Brazil, Germany, Italy and the United
Kingdom) via the telephone with 1,565 women aged 45+.


Worldwide, more than a million women are diagnosed with breast cancer every year, accounting for a tenth of all new cancers
and 23 per cent of all female cancer cases.


1 IBIS-II


The International Breast Cancer Intervention Study II (IBIS-II) has been designed to investigate the new breast cancer drug,
anastrozole, in women in 25 countries, who are at an increased risk of breast cancer.

The study is currently recruiting women and will run for 4-6 years.

The IBIS II study is a randomised, blinded placebo controlled clinical trial.

The study is divided into two parts:


The IBIS-II Prevention part of the study aims to recruit 6,000 post-menopausal women who are at increased risk of developing
breast cancer. A number of factors for increased risk can make a woman eligible to enter the study and these are set
according to the different age groups. Women can take part in the trial if they are aged between 40-70 years and are not on
HRT.


The second part of the study, IBIS-II (DCIS), will recruit 4,000 women who have been diagnosed with and had surgery to remove
a particular early form of breast cancer, which is not growing or spreading, known as DCIS (Ductal carcinoma in situ). As
well as being at high risk of developing more advanced forms of breast cancer, these women are also more likely to develop a
new tumour in the opposite breast. This part of the trial is designed to determine which of the two drugs, anastrozole or
tamoxifen, can best prevent new cancers, both in the breast affected by DCIS and in the opposite breast.


UK trial centres currently open for recruitment are:



-- Belfast City Hospital, Belfast

-- Royal Bournemouth Hospital, Bournemouth

-- Royal Sussex County Hospital, Brighton

-- Frenchay Breast Care Centre, Bristol

-- Bristol Royal Infirmary, Bristol

-- University of Wales College of Medicine, Cardiff

-- Essex County Hospital, Colchester

-- Chelmsford & Essex Centre, Chelmsford

-- Cheltenham General Hospital, Cheltenham

-- Countess of Chester Hospital, Breast Unit, Chester

-- Derby City General Hospital, Derby

-- Ninewells Hospital, Dundee

-- Western General Hospital, Edinburgh

-- St Margaret's Hospital, Epping

-- Western Infirmary, Glasgow (prevention only)

-- Guy's NHS Trust, London

-- Royal Marsden, London

-- The Academic Surgical Unit, University of Hull, Hull

-- Leeds General Infirmary, Leeds

-- St. James's Hospital, Leeds

-- Royal Liverpool University Hospital, Liverpool

-- Macclesfield Hospital, Macclesfield

-- Withington Hospital, Manchester

-- Northwick Park & St Marks Hospitals, Harrow

-- Royal Oldham Hospital, Oldham

-- Weston Park Hospital, Sheffield

-- Royal South Hants Hospital, Southampton (DCIS only)

-- Morriston Hospital, Swansea

-- Mermaid centre, Truro

-- Worthing Hospital, Worthing

-- Yeovil Hospital, Yeovil


2ATAC study - Arimidex and Tamoxifen Alone or in Combination, results published ATAC Trialists' Group. Results of the ATAC
(Arimidex, Tamoxifen, Alone or in Combination) trial after completion of 5 years' adjuvant treatment for breast cancer.
Lancet 2005; 365 (9453): 60-62.



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