This guideline covers diagnosing and managing early and locally advanced breast cancer. It aims to help healthcare professionals offer the right treatments to people, taking into account the person's individual preferences.
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 early and locally advanced breast cancer. See the COVID-19 rapid guideline: delivery of systemic anticancer treatments for more details.
This guideline includes new and updated recommendations on:
- surgery to the breast and axilla
- breast reconstruction
- diagnostic assessment and adjuvant therapy planning
- endocrine therapy
- adjuvant chemotherapy for invasive breast cancer
- bisphosphonate therapy
- primary systemic therapy
These supplement the existing recommendations on:
- referral, diagnosis and preoperative assessment
- providing information and psychological support
- complications of local treatment and menopausal symptoms
Who is it for?
- Healthcare professionals
- Commissioners and providers of breast cancer services
- People with early and locally advanced breast cancer, their families and carers
Is this guideline up to date?
We checked the impact of the PERSEPHONE and PHARE trial on this guideline in June 2020. We will not update the guideline at this time.
Guideline development process
This guideline updates and replaces NICE guideline CG80 (February 2009), and NICE technology appraisal guidance 107, 108, 109 and 112 (published 2006).
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.