Question to the Department of Health and Social Care:

To ask the Secretary of State for Health, what plans he has for the NHS to prescribe (a) tamoxifen to reduce the risk of breast cancer for those with a family history of the disease and (b) bisphosphonates to reduce the risk of secondary breast cancer in menopausal women.

The use of tamoxifen to reduce the risk of breast cancer for those with a family history of the disease is one of a number of options recommended for consideration by patients and clinicians within the National Institute for Health and Care Excellence (NICE) Clinical Guideline 164 (last updated during March 2017). The guideline identifies a number of patient groups in a number of different ways, such as risk level, pre/post menopause and whether or not patients have osteoporosis. The provision of tamoxifen is a matter for local clinical commissioning groups (CCGs) and NHS England expects CCGs to take account of NICE guidelines and local population needs when making commissioning decisions.

NHS England recognises that bisphosphonates may have benefits for some women in preventing secondary breast cancer, however the provision of biophosphates is a matter for CCGs. NICE is considering the evidence on bisphosphonates and will be updating its clinical guidelines to take account of their use. We understand that this work is due to complete in 2018. However, subject to local commissioning policy, clinicians are already able to prescribe bisphosphonates for the treatment of secondary breast cancer where they judge it to be the most clinically appropriate treatment for an individual patient.