A "landmark study" shows a drug can more than halve the development of breast cancer in high-risk women.
A trial on 4,000 women, published in the Lancet, showed anastrozole was more effective, cheaper and had fewer side effects than current medications.
It stops the production of the hormone oestrogen, which fuels the growth of the majority of breast cancers.
Doctors and campaigners are asking health services to consider offering the drug to healthy women.
The study at Queen Mary University of London has followed women with a high risk of breast cancer, based on their family history, for an average of five years.
It showed that out of 2,000 high-risk women given no treatment there were 85 cases of breast cancer in the study.
But in the same number of women given anastrozole there were 40 cases, with virtually no side-effects.
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