Excerpt

Update Information: In July 2018 we updated and replaced this guideline with NICE guideline NG101 on early and locally advanced breast cancer.

Breast cancer is the most common cancer in women and its management often presents patients and their healthcare professionals with difficult decisions about the most appropriate treatment. For all those affected by breast cancer (including family and carers) it is important to recognise the impact of this diagnosis, the complexity of treatment options and the wide ranging needs and support required throughout this period of care and beyond. We hope that this document will provide helpful and appropriate guidance to both healthcare professionals and patients on the diagnosis and subsequent management of early and locally advanced breast cancer.

Contents

• Foreword
• Key priorities
• Key research recommendations
• Recommendations
• Methodology
• Algorithm
• 1. Epidemiology
  • 1.1. Introduction
  • 1.2. Incidence
  • 1.3. Prognosis
  • 1.4. Mortality
  • 1.5. Survival
  • 1.6. Prevalence
  • 1.7. Treatment
  • 1.8. Summary
  • 1.9. Summary of findings from breast cancer teams peer review in England 2004–2007
  • References
• 2. Referral, diagnosis, preoperative assessment and psychological support
  • 2.1. Introduction to Breast Cancer
  • 2.2. Referral and Diagnosis
  • 2.3. Preoperative Assessment of the Breast and Axilla
  • 2.4. Preoperative Staging of the Axilla
  • 2.5. Providing Information and Psychological Support
  • References
• 3. Surgery for early breast cancer
  • 3.1. Surgery to the Breast
  • 3.2. Surgery to the Axilla
  • 3.3. Evaluation and Management of a Positive Sentinel Lymph Node
  • 3.4. Breast Reconstruction
  • References
• 4. Postoperative assessment and adjuvant treatment planning
  • 4.1. Introduction
  • 4.2. Predictive Factors
  • 4.3. Adjuvant Treatment Planning
  • 4.4. Timing of Adjuvant Treatment
  • References
• 5. Adjuvant systemic therapy
  • 5.1. Introduction
  • 5.2. Endocrine Therapy for Invasive Disease
  • 5.3. Endocrine Therapy for DCIS
  • 5.4. Chemotherapy
  • 5.5. Biological Therapy
  • 5.6. Assessment and Treatment for Bone Loss
  • References
• 6. Adjuvant radiotherapy
  • 6.1. Introduction
  • 6.2. Breast Conserving Surgery and Radiotherapy
  • 6.3. Post-Mastectomy Radiotherapy
  • 6.4. Dose Fractionation
  • 6.5. Breast Boost
  • 6.6. Radiotherapy to Nodal Areas
  • References
• 7. Primary systemic therapy
  • 7.1. Early Breast Cancer
  • 7.2. Locally Advanced or Inflammatory Breast Cancer
  • References
• 8. Complications of local treatment and menopausal symptoms
  • 8.1. Introduction
  • 8.2. Complications of Local Treatment
  • 8.3. Menopausal Symptoms
  • References
• 9. Follow-up
  • 9.1. Introduction
  • 9.2. Follow-up Imaging
  • 9.3. Clinical Follow-up
  • References
• Appendices
  • Appendix 1. Adjuvant! Online: review of evidence concerning its validity, and other considerations relating to its use in the NHS
  • Appendix 2. Algorithms taken from ‘Guidance for the management of breast cancer treatment-induced bone loss: A consensus position statement from a UK expert group (2008)’
  • Appendix 3. A cost effectiveness analysis of pretreatment ultrasound for the staging of the axilla in early breast cancer patients
  • Appendix 4
  • Appendix 5
  • Appendix 6. Guideline scope
  • Appendix 7. List of topics covered by each chapter
  • Appendix 8. People and organisations involved in production of the guideline

This guideline updates and replaces NICE technology appraisal guidance 109 (docetaxel), 108 (paclitaxel) and 107 (trastuzumab).

Full Guideline developed for NICE

Five NICE guidelines have been included on the Bookshelf as part of a pilot project. All NICE guidance is available on the NICE website at www​.nice.org.uk

While every effort has been made to ensure the accuracy of the information contained within this publication, the publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check current indications and accuracy by consulting other pharmaceutical literature and following the guidelines laid down by the manufacturers of specific products and the relevant authorities in the country in which they are practising.