Women offered NHS breast cancer drug
By Anonymous on Jun 25, 2013 03:03 am 24 June 2013 Last updated at 21:56 ET By Michelle Roberts Health editor, BBC News online
Angelina Jolie revealed last month that she had undergone a preventative double mastectomy
Thousands of women in England and Wales with a family history of breast cancer are to be offered drugs on the NHS to help prevent the disease.
The National Institute for Health and Care Excellence says Tamoxifen or Raloxifene taken daily for five years can cut breast cancer risk by 40%.
Its guidance - the first of its kind in Europe - means 500,000 women now have a choice other than mastectomy.
But experts say women still need to carefully weigh up their options.
One in every five breast cancers has a family link.
Having close relatives - a mother, sister or aunt - with breast cancer increases a woman's chance of getting the disease, as does inheriting certain genes like BRCA1 and BRCA2.
Hollywood actress Angelina Jolie revealed last month that she had undergone a preventative double mastectomy to cut her own chance of developing breast cancer because she carries one of these risky genes.
Risk reduction The new guidelines from NICE are the first in Europe to recommend that healthy women are given drugs to prevent breast cancer. It is likely that Northern and Scotland will soon follow suit.
Continue reading the main story Know your risk
- Women in general have a 1- in-8 chance of developing breast cancer
- But some are at higher risk than this because of their family history
- Having a mother or sister diagnosed with breast cancer doubles your risk of breast cancer, for example
- If several members of your family have had particular types of cancer, or if a relative was diagnosed with breast cancer at a young age, your risk of developing breast cancer may be increased further
- Moderate risk means you have at least a 1-in-6 risk of getting breast cancer by the end of your life, while high risk means you have a 3-in-10 risk
- Inherited genes - like BRCA1 and BRAC2 - increase your lifetime risk by up to 90%
- Most breast cancers have no family link
NICE says women in England and Wales who are aged over 35 and at "moderate" or "high" risk of breast cancer due to their family history or genes should be considered for preventative drug therapy.
By this they mean women with at least a one in six chance of developing the disease.
Taking a Tamoxifen or Raloxifene tablet every day for five years could nearly halve their breast cancer risk and this protective effect should last for at least a decade, studies suggest.
While this sounds like a good and simple choice, experts say women need to carefully weigh up their options.
Surgery to remove both breasts would bring a woman's lifetime risk down to virtually zero.
And Tamoxifen can be unpleasant to take, causing side-effects such as hot flushes and blood clots.
Up to half of breast cancer patients prescribed the drug as a treatment for their tumour give up taking it, research suggests.
'Fantastic leap forward' NICE said the decision about the best treatment should be a joint one between the patient and the medical team.
Dr Caitlin Palframan, of Breakthrough Breast Cancer, said the guidelines were a game-changer.
"Our strongest tool in the fight against breast cancer is prevention, and these new guidelines are a fantastic leap forward in the way we prevent breast cancer developing in those at highest risk," she said.
Sean Duffy, national clinical director for cancer at NHS England, said: "It is earth-shattering for women who find out they are at high risk of developing breast or ovarian cancer.
"As a health service, it's our duty to provide the best possible evidence-based advice on the options that are available, focusing on the patient's personal circumstances.
"[The NICE guidance] adds a further dimension to the options available for women who are at risk of developing ovarian and breast cancer."
Breast cancer is the most common cancer in the UK, with about 50,000 women and 400 men diagnosed with the condition each year.
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Taliban assault in Kabul secure zone
By Anonymous on Jun 25, 2013 02:47 am 24 June 2013 Last updated at 22:31 ET 
A series of explosions and gunfire have been heard in the centre of the Afghan capital, Kabul.
A witness told the Reuters news agency reported that the presidential palace was being attacked.
Kabul police chief Mohammad Zahir told the AFP news agency he could not confirm the location of the attack, but said it began at 06:30 (02:00 GMT).
The attack comes only days after Nato handed over security for the whole of Afghanistan to forces.
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Inquiry 'needed into police ethics'
By Anonymous on Jun 25, 2013 03:31 am 25 June 2013 Last updated at 02:46 ET 
A Leveson-style inquiry is needed to investigate the ethics of the police, according to a lawyer who represented the family of Stephen Lawrence.
The home secretary has said claims that police tried to smear the family will be looked at by two existing inquiries.
But Michael Mansfield QC said there were broader issues about "accountability and transparency" that should be investigated.
Stephen's father, Neville, has also backed a judge-led inquiry.
Black teenager Stephen, 18, was stabbed to death in an unprovoked attack by a gang of white youths as he waited at a bus stop in south-east London in April 1993.
Undercover officer Peter Francis told the Guardian and Channel 4's Dispatches programme that after Mr Lawrence's killing he posed as an anti-racism campaigner in a hunt for "disinformation" to use against those criticising the police.
Working as part of the Metropolitan Police's now-disbanded Special Demonstration Squad, which specialised in gathering intelligence on political activists, he said he had come under pressure to find "any intelligence that could have smeared the campaign" - including whether any of the family were political activists, involved in demonstrations or drug dealers.
'Not good enough' Mr Mansfield told BBC Radio 4's Today programme: "It's a squad that existed for a very long time. A squad of that size, involving those numbers, involving public expenditure of this kind does not go without authorisation from a very high level.
"I think that's why the public need to have something like the Leveson inquiry in relations to the ethics of the police in a so-called democracy."
Former Metropolitan Police Deputy Assistant Commissioner Brian Paddick has also criticised the government's response.
"All Theresa May seems to have done is say, 'Oh, another set of allegations, we'll feed them into existing inquiries,' and that for me is not good enough.
"We need a laser-focused investigation to come up with answers quickly, to try and prevent further damage to the reputation of the police."
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Brazil leader promises major reforms
By Anonymous on Jun 24, 2013 11:05 pm 24 June 2013 Last updated at 16:43 ET 
Brazil's President Dilma Rousseff has pledged to invest 50 billion reais ($25bn, £16bn) in public transport, following nationwide street protests.
She also proposed a referendum on political reform.
More than a million Brazilians have taken to the streets to demonstrate against rising transport prices and the expense of staging the 2014 World Cup.
Ms Rousseff is now holding discussions with state governors and mayors to try to find ways to end the unrest.
Meanwhile further demonstrations are planned on Monday, with hundreds of people blocking the main road to Brazil's busiest port, Santos.
More rallies are also due to take place in the cities of Rio de Janeiro and Sao Paulo.
Two female protesters were killed in the state of Goias when a car hit a protest barricade.
The deaths bring the total number of lives lost because of the protests to four.
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Qatari emir hands power to son Tamim
By Anonymous on Jun 25, 2013 03:11 am 24 June 2013 Last updated at 10:34 ET 
The Qatari Emir Sheikh Hamad bin Khalifa al-Thani is to announce he is ceding power to his son, reports say.
Rumours had been circulating for days that Crown Prince Tamim bin Hamad al-Thani, 33, was being prepared to take over leadership of the Gulf emirate.
The Qatar-based al-Jazeera television station reported that Sheikh Hamad told a meeting of the "ruling family and top advisers" of his decision on Monday.
A formal announcement is expected on Monday evening.
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Killer Ian Brady to address tribunal
By Anonymous on Jun 25, 2013 12:08 am 25 June 2013 Last updated at 00:08 ET
Ian Brady is fed through a tube in his nose
Moors Murderer Ian Brady is expected to speak publicly later, as a tribunal over his mental health draws to an end.
It would be the first time he has spoken publicly for nearly 50 years.
The 75-year-old argues he is no longer mentally ill and should be moved from a high-security hospital to prison.
Brady, along with his accomplice Myra Hindley, tortured and murdered five children aged from 10 to 17, burying some of their victims' bodies on Saddleworth Moor in the Peak District.
The last time Brady was heard in public was in 1966 at Chester Assizes, where he denied the murders.
He was eventually found guilty of three and jailed for life. He and Hindley later confessed to the other two. Hindley died in prison in 2002, aged 60.
Brady has been held in Ashworth Hospital, a high-security psychiatric hospital in Maghull, Merseyside, since 1985.
'Makes toast' Brady's legal team say he has a severe personality disorder but is not mentally ill and could be treated in prison rather than hospital.
But staff at Ashworth say he remains a paranoid schizophrenic who should stay at the hospital.
His reasons for wanting to return to prison remain unclear, although it is thought he might try to starve himself to death in prison.
He has been on hunger strike since 1999 but doctors at Ashworth can force-feed Brady through a tube in his nose under mental health law.
On Monday, a nurse told the tribunal that, despite his hunger strike, Brady often took the food made available to him, and he "makes himself toast every morning".
The serial killer looks likely to be the final witness at the tribunal, which is sitting at Ashworth Hospital and will be relayed to the press and public on TV screens at Manchester Civil Justice Centre.
The judgement of the panel will be released at a later date yet to be fixed.
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