Women reaching midlife should be given the option of taking three inexpensive medicines to help reduce their risk of breast cancer and protect against other health conditions, according to cancer specialist Dr Andrea De Censi.
His proposed combination includes hormone replacement therapy (HRT), low-dose tamoxifen and cholesterol-lowering statins for women who need them.
De Censi believes the treatments could be introduced when women attend their first routine breast cancer screening at the age of 50.
He says HRT could help protect bone and brain health, while exercise and resistance training would support muscle strength. Low-dose statins would address cardiovascular risks, with tamoxifen providing an additional measure against breast cancer.
He described the proposed combination as a way of improving women’s health and supporting longevity.
Low-Dose Tamoxifen at the Centre of the Proposal
The most controversial part of the proposal is the suggestion that low-dose tamoxifen should be offered more widely to women aged 50 and above.
Tamoxifen blocks the effects of oestrogen, a hormone that can encourage the growth of certain breast cancers. It is commonly prescribed to women who have been treated for breast cancer to reduce the risk of the disease returning.
It is also offered to some women considered to have a higher-than-average risk of developing breast cancer, following research indicating that it can help prevent the disease.
However, fewer than one in seven eligible women reportedly take the medication, partly because of concerns about its possible side effects.
These include hot flushes, joint pain, tiredness, weight gain and night sweats. Taking tamoxifen during pregnancy can also cause birth defects.
Research Suggests Reduced Breast Cancer Risk
De Censi supports the wider use of a lower dose of tamoxifen, sometimes referred to as “baby tam”.
Research suggests that taking the medication for five years could reduce a woman’s risk of developing breast cancer by approximately 20 per cent over the following decade.
The proposed low-dose treatment costs about 45p per dose. Women would receive roughly a quarter of the standard dose, which De Censi believes could reduce the likelihood and severity of side effects.
He estimates that women taking the lower dose might experience as little as one hot flush a day.
The specialist argues that offering the medication more widely could provide an affordable preventive option, including for women who are not currently classified as being at particularly high risk.
Experts Question Whether Wider Tamoxifen Use Is Justified
The proposal has not received universal support. Evidence remains limited on how effectively low-dose tamoxifen prevents breast cancer among women who do not already have an elevated risk.
Some specialists have also raised concerns about whether the potential side effects could outweigh the benefits for otherwise healthy women.
The discussion comes as breast cancer continues to affect large numbers of women in the UK. Approximately 59,000 women are diagnosed each year, while the disease accounts for more than 11,000 deaths annually.
Maintaining a healthy weight, exercising regularly and limiting alcohol consumption are among the measures women can take to reduce their risk.
Specialist Wants Tamoxifen to Be Combined With HRT
De Censi also believes low-dose tamoxifen could make more women comfortable with using HRT to manage menopause symptoms.
Millions of women have avoided hormone replacement therapy because of concerns about its possible association with breast cancer.
Those concerns intensified after the publication of the Women’s Health Initiative study in 2002, which linked certain forms of HRT to increased risks of breast cancer and cardiovascular problems.
De Censi said the findings brought an end to a trial he was conducting involving approximately 2,000 women. The research was examining whether tamoxifen could protect against the potential breast cancer risks associated with HRT.
He now wants to revisit the approach, arguing that tamoxifen could help counter possible breast cancer risks while women receive the benefits of hormone therapy.
HRT is used to relieve symptoms associated with menopause, including hot flushes, sleep difficulties and mood changes.
HRT Benefits for Heart and Brain Health Remain Under Investigation
De Censi believes the potential role of HRT extends beyond treating menopausal symptoms.
Some studies have suggested that women who begin hormone therapy around the time of menopause may have a lower risk of cardiovascular disease. Other research has explored possible links between HRT use and better brain health.
However, findings on dementia remain mixed, and HRT is not currently recommended specifically to prevent dementia or cardiovascular disease.
The specialist also highlighted research involving certain forms of hormone therapy, including skin patches and gels, which has associated their use with lower overall mortality.
He cited a large Danish study that found an association between HRT use and a 15 to 20 per cent reduction in deaths. Such observational findings, however, cannot establish that the treatment itself caused the reduction.
De Censi said his work was increasingly focused on several conditions affecting women as they age, including cardiovascular disease, dementia, osteoporosis, age-related muscle loss and depression.
Low-Dose Statins Proposed for Women With Raised Cholesterol
The third part of the proposed combination involves statins, medicines widely used to lower cholesterol and reduce the risk of heart attacks and strokes.
De Censi suggests that women with raised cholesterol could be offered a very low dose, which he calls “baby statins”.
His proposed regimen would involve taking half the lowest licensed dose every other day.
The approach is intended to address concerns about statin side effects, which can include muscle pain, weakness and digestive problems.
Some studies have also linked statin use to a lower risk of breast cancer returning in women who have previously been treated. However, there is less evidence that the medicines prevent breast cancer from developing in the first place.
The suggested low-dose, alternate-day regimen is not an established standard treatment, and it remains unclear whether it would provide sufficient protection against cardiovascular disease.
Proposed Treatment Could Begin in Women’s 50s
Under De Censi’s proposal, women could begin the treatments in their 50s, taking low-dose tamoxifen for five years and potentially continuing HRT for up to a decade.
He stressed that medication would not replace healthy lifestyle choices, including a balanced diet and regular physical activity.
He also identified psychological counselling and meditation as possible elements of a wider approach to maintaining health during midlife and beyond.
Further Research Needed Before the Combination Becomes Standard Care
The proposed three-drug approach is not currently an established medical recommendation.
Larger clinical trials would be needed to determine whether combining HRT with low-dose tamoxifen provides the expected protection against breast cancer and whether the potential benefits outweigh the risks.
Further evidence would also be required to establish the safety and effectiveness of the suggested low-dose statin regimen.
De Censi believes the approach could eventually form part of a broader strategy to address several major health conditions affecting women after menopause.
