Women with a family history of breast cancer could be offered preventative medication on the NHS under new plans outlined by the health regulator.
Officials are examining whether women who are at "high risk" of developing the disease should be offered hormone therapy to prevent breast cancer.
Charity Breakthrough Breast Cancer said the consultation is an "historic step" for the prevention of the disease which claims the lives of 12,000 people in the UK each year.
The National Institute of Health and Clinical Excellence (Nice) has launched a draft consultation to see whether drugs tamoxifen or raloxifene should be offered to high-risk post-menopausal women in England and Wales.
A previous clinical trial found that tamoxifen, taken for five years, reduced the risk of developing invasive breast cancer by about 50% in post-menopausal women who were at increased risk of getting the disease.
Another trial found that five years of raloxifene reduces breast cancer risk in such women by about 38%.
Under the new plans, high risk post-menopausal women could be offered the drugs for a period of five years unless they have a history of thromboembolic disease or endometrial cancer.
The new Nice guidelines on familial breast cancer could also see the age that some women are first offered mammograms lowered.
At present, all women aged between 50 and 70 are invited for breast screening but the service could be extended to women aged 40 and up if they are deemed to be at high or moderate risk of developing the disease.
The NHS may also start offering genetic screening to see whether people with a history of breast cancer carry faulty genes that can increase the risk of the disease.
Chris Askew, chief executive of Breakthrough Breast Cancer, said: "This draft guideline represents an historic step for the prevention of breast cancer - it is the first time drugs have ever been recommended for reducing breast cancer risk in the UK.
"This is exciting as, even though most women do not have a significant family history of the disease, it's crucial that those who do have an array of options to help them control their risk.
"An update to this guideline is long overdue and we're especially pleased it has been extended to include both women who have had breast cancer, and men, for the first time.
"Once finalised, this guideline will pose new challenges for the NHS as it will need to deliver on its recommendations, including a potentially large increase in genetic testing."
Professor Mark Baker, director of the Centre for Clinical Practice at Nice, said: "The causes of cancer are complex and not fully known.
"However, we do know that having a family history of breast, ovarian or a related cancer can significantly increase the risk of developing breast cancer - including developing the cancer at a younger age.
"It is also more likely that people with family members affected by cancer who then develop breast cancer themselves could develop a separate tumour in the other breast following initial treatment.
"This is why it's wise for any person with a family history of cancer to receive appropriate investigations and screening that would otherwise be unnecessary if a family history did not exist.
"This guideline was last updated in 2006. Since then there has been new evidence published and new advances made in a number of clinical areas."
Breast cancer is the most common cancer in the UK with around 50,000 women and 400 men diagnosed with the condition each year.