This guideline covers care and support for people with advanced (stage 4) breast cancer. It aims to help them and their healthcare professionals make shared decisions about tests and treatments to improve outcomes and quality of life.

In August 2017, we reviewed the evidence for assessing oestrogen receptor (ER) and human epidermal growth factor receptor 2 (HER2) status on disease recurrence and changed the recommendations in section 1.1. In July 2014, we reviewed the evidence for exercise for people with lymphoedema and added 2 new recommendations.


This guideline includes recommendations on:

Who is it for?

  • Healthcare professionals
  • Palliative care services
  • People with advanced breast cancer, their families and carers

Is this guideline up to date?

We checked this guideline in November 2015 and we are updating the recommendations on reassessing ER and HER2 status when disease recurs. See the guideline in development page for progress on the update.

Next review: 2017

Guideline development process

How we develop NICE guidelines

This guideline updates and replaces NICE technology appraisal guidance TA62 (May 2003), TA54 (December 2002) and TA30 (September 2001).

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.

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)