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.
A table of NHS England interim treatment regimens gives possible alternative treatment options for use during the COVID-19 pandemic to reduce infection risk. This may affect decisions for patients with advanced breast cancer. See the COVID-19 rapid guideline: delivery of systemic anticancer treatments for more details.
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:
- diagnosis and assessment
- providing information and support for decision making
- systemic disease-modifying therapy
- supportive care
- managing complications
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 January 2018. We found no new evidence that affects the recommendations in this guideline.
Guideline development process
This guideline updates and replaces NICE technology appraisal guidance TA62 (May 2003), TA54 (December 2002) and TA30 (September 2001).
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.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
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.