This guideline covers diagnosis and surgical and pharmacological treatment of women and men with early and locally advanced breast cancer. It aims to improve early identification and treatment of breast cancer to prevent disease progression and reduce deaths.

NICE has produced separate advice for the care of people with advanced breast cancer and people who have a family history of the disease.

In March 2017 a new recommendation was added to section 1.6 (recommendation 1.6.9, dated 2017) after the evidence for genetic testing in women with triple negative breast cancer was reviewed.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • People with early and locally advanced breast cancer and their families and carers

Is this guideline up to date?

We reviewed the new evidence in November 2015 and we are updating this guideline. See the guideline in development page for progress on the update.

Guideline development process

How we develop NICE guidelines

This guideline includes recommendations from technology appraisal guidance TA107TA108 and TA109.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • National Institute for Health and Care Excellence (NICE)