Hidden Options: Breast Cancer Prevention Drugs

Christine Taylor, VBCF Intern

Risk Reduction Options Beyond Surgery

For those with a high risk of developing breast cancer, the spectrum of preventative measures ranges from minimal interventions to significant surgical procedures. 

• Regular Screening: Alternating between breast MRI and mammograms every six months.
• Hormone-Suppressing Medications: Drugs like tamoxifen and raloxifene.
• Prophylactic Mastectomy: A major surgical intervention to remove breast tissue preemptively.

Each of these options can either decrease the risk of developing advanced breast cancer or even outright prevent the development of the disease. Still, they all also come with their own set of risks and pros and cons that make them unfeasible for the public at large to adopt.

The Barrier of Awareness

Despite the list of potential options, the fact that medications to lower the risk of estrogen-receptor-positive breast cancer are available is unfortunately not well-known information for the general public, which includes many patients who could likely benefit from the treatments¹. Instead, many believe that the only options to prevent breast cancer are surgical, which, of course, comes with a lengthy list of potential risks and other implications. While these medications are certainly not without risk, patients can’t decide if something is the right option for them if they haven’t been informed that the option is available.

This highlights the importance of having detailed, thorough conversations with healthcare providers to explore risk factors, screening options, genetic testing, and treatment availability. Ultimately, patients cannot know what options are available to them without having a conversation with their provider, and many patients don’t know that the options exist to explore having a conversation about them.

The Cost Barrier: A Significant Hurdle

Unfortunately, lack of information is not the only barrier for patients who may benefit from taking a medication to lower their risk. Tamoxifen² and raloxifene³, the two medications approved by the FDA for the prevention of estrogen-receptor-positive breast cancer, can cost up to hundreds of dollars for a three-month supply, which quickly adds up over time. Insurance coverage and programs such as those offered through GoodRx can reduce the cost of these medications, but that doesn’t remove the barrier entirely. Similar to how many patients get inconclusive mammogram results and then decide going back in to get further testing is cost-prohibitive and, ultimately, worth the risk, many patients who may benefit from a medication to lower their risk may also decide that the cost is ultimately too much to justify it.

Advocacy for Accessibility

At VBCF, we believe no one should ever have to choose between paying their bills and receiving appropriate medical care. That’s why we’ve worked to support legislation that requires insurance companies to offer coverage of diagnostic imaging and maximum monthly out-of-pocket costs for medications. For more information on our advocacy efforts, please visit our Advocacy page.

1. https://www.statnews.com/2023/11/13/breast-cancer-prevention-drugs-anastrozole/- ↩︎
2. https://www.goodrx.com/tamoxifen?form=tablet&dosage=20mg&quantity=90&label_ove
   rride=tamoxifen ↩︎
3. https://www.goodrx.com/raloxifene ↩︎