In women at high risk for breast cancer, a long-term drug treatment can cut the risk of developing the disease in half. Researchers supported by the National Institutes of Health have now identified two gene variants that may predict which women are most likely to benefit from this therapy — and which should avoid it.

The work represents a major step toward truly individualized breast cancer prevention in women at high risk for the disease based on their age, family history of breast cancer, and personal medical history.

“Our study reveals the first known genetic factors that can help predict which high-risk women should be offered breast cancer prevention treatment and which women should be spared any unnecessary expense and risk from taking these medications,” said the study’s lead scientist, James N. Ingle, M.D., professor of oncology at the Mayo Clinic in Rochester, Minn. “We also discovered new information about how the drugs tamoxifen and raloxifene work to prevent breast cancer.”

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