Early and locally advanced breast cancer: diagnosis and treatment | Guidance and guidelines

Review decision: November 2015

We checked this guideline and decided that it should be updated. For details, see the update decision, decision matrix and the process for deciding if an update is needed. Details of the update will be available on the guidelines in development webpage in due course. No further checks of this guideline will be scheduled until this update is published.

The advice in this guideline covers:

some of the tests and treatments that patients with early and locally advanced breast cancer should be offered, in particular:
– reducing the amount of surgery under your arm
– breast reconstruction when breast conservation is not possible
– chemotherapy and endocrine treatments
– biological treatments.

It does not specifically look at:

the care of patients with advanced breast cancer or those with rare or non-cancerous tumours of the breast
the care of people who do not have breast cancer themselves but have a family history of the disease.

The NICE guideline on advanced breast cancer has been updated. It includes recommendations on exercise for people with or at risk of breast-cancer-related lymphoedema, and these are also relevant for people with early or locally advanced breast cancer. They can be found in section 1.5 of the guideline.

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

This guideline updates the following technology appraisals:

NICE and the Department of Health are currently reviewing the future position on updating technology appraisals within clinical guidelines, with particular reference to implications for the funding direction on technology appraisals. In the meantime, the technology appraisal guidance remains available and should continue to be followed. The statutory funding direction remains in place for the recommendations contained in the technology appraisal guidance.

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 are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The application of the recommendations in this guideline is not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.

Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users 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 compliance with those duties.