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At the moment, risk-reduction options are limited and can include drugs such as tamoxifen that lower risk but may have unwanted side effects.

In patients with hormone-sensitive breast cancer tumour growth is mainly driven by oestrogen and patients are therefore treated with oestrogen-suppressing drugs, often tamoxifen.

A new study has shown that variation in the microbiota of the human gut impacts the pharmacokinetics of tamoxifen and thus the effectiveness of the drug.

For example, for breast cancer survivors taking long-term estrogen inhibitor medications, such as tamoxifen, certain supplements may interfere with the metabolism of the estrogen inhibitor, potentially making it less effective.

Following her treatment, Brown suffered from fatigue and brain fog on the tamoxifen she took for years to prevent cancer recurrence.