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This quality standard covers the care of people with breast cancer after they have been referred to a specialist team. It includes the management of early (ductal carcinoma in situ and invasive), locally advanced and advanced breast cancer; recurrent breast cancer; and familial breast cancer. It describes high-quality care in priority areas for improvement.
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Sections for QS12
- Quality statements
- Quality statement 1: Timely diagnosis
- Quality statement 2: Preoperative MRI scan
- Quality statement 3: Tumour profiling tests
- Quality statement 4: ER and HER2 receptor status
- Quality statement 5: Multidisciplinary team management of metastatic breast cancer
- Quality statement 6: Key worker
- Update information
Tocilizumab for the treatment of systemic juvenile idiopathic arthritis (TA238)
Evidence-based recommendations on tocilizumab (RoActemra), for treating systemic juvenile idiopathic arthritis in people aged 2 and over.
Evidence-based recommendations on lenalidomide (Revlimid) for treating myelodysplastic syndromes associated with an isolated deletion 5q cytogenetic abnormality in adults.
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Evidence-based recommendations on aflibercept (Eylea) for treating sight problems caused by macular oedema from central retinal vein occlusion in adults.
Etelcalcetide for treating secondary hyperparathyroidism (TA448)
Evidence-based recommendations on etelcalcetide (Parsabiv) for treating secondary hyperparathyroidism in adults with chronic kidney disease on haemodialysis.
Evidence-based recommendations on aflibercept (Eylea) for treating visual impairment caused by macular oedema after branch retinal vein occlusion.
Evidence-based recommendations on zolpidem and zopiclone for treating insomnia in adults.
EarlySense for heart and respiratory monitoring and predicting patient deterioration (MIB49)
NICE has developed a medtech innovation briefing (MIB) on EarlySense for heart and respiratory monitoring and predicting patient deterioration
Evidence-based recommendations on subfascial endoscopic perforator vein surgery. This involves cutting and closing off, or heating and sealing, perforator veins so that blood can no longer go through them.
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Sections for HTG32
Endoscopic radiofrequency ablation for gastro-oesophageal reflux disease (HTG318)
Evidence-based recommendations on endoscopic radiofrequency ablation for gastro-oesophageal reflux disease. This involves using heat from electrodes to change the tissues in the oesophagus, with the aim of reducing symptoms.
Evidence-based recommendations on high-intensity focused ultrasound for atrial fibrillation in association with other cardiac surgery. This involves using focused ultrasound energy to destroy cardiac tissue and disrupt abnormal electrical impulses.
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Sections for HTG119
Balloon catheter insertion for Bartholin's cyst or abscess (HTG204)
Evidence-based recommendations on balloon catheter insertion for Bartholin's cyst or abscess. This involves making a passage from the cyst or abscess through which the gland can drain by inflating a small, specially designed balloon.
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Sections for HTG204
Evidence-based recommendations on liposuction for chronic lymphoedema in adults. This involves using suction to remove fluid and fat through punctures in the skin.
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Wireless capsule endoscopy for investigation of the small bowel (HTG62)
Evidence-based recommendations on wireless capsule endoscopy for investigation of the small bowel. This involves the person swallowing a small capsule containing a tiny camera that takes pictures as it passes through the body.
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Sections for HTG62
Percutaneous endovascular forearm arteriovenous fistula creation for haemodialysis access (HTG597)
Evidence-based recommendations on percutaneous endovascular forearm arteriovenous fistula creation for haemodialysis access in adults. This involves using radiofrequency energy, or heat and pressure, to join an artery and vein in the forearm to create a fistula for haemodialysis access.
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Phrenic nerve pacing for congenital central hypoventilation syndrome (HTG725)
Evidence-based recommendations on phrenic nerve pacing for congenital central hypoventilation syndrome. This involves direct stimulation of the phrenic nerve, to produce the inhalation phrase of breathing.
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Evidence-based recommendations on selective internal radiation therapy for neuroendocrine tumours that have metastasised to the liver. This involves injecting tiny radioactive spheres into the blood vessels that supply the liver metastases.
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Cryotherapy as a primary treatment for prostate cancer (HTG91)
Evidence-based recommendations on cryotherapy as a primary treatment for prostate cancer. This involves using cold temperature to freeze and destroy cancer tissue as a first treatment for cancer that hasn't spread far from the prostate.
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Sections for HTG91
Ex-vivo hepatic resection and reimplantation for liver cancer (HTG190)
Evidence-based recommendations on ex-vivo hepatic resection and reimplantation for liver cancer. This involves removing the liver from the body, cutting away the diseased tissue, and reimplanting the remaining tumour-free liver into the patient.
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Sections for HTG190
Evidence-based recommendations on percutaneous insertion of a temporary heart pump for left ventricular haemodynamic support in high-risk percutaneous coronary interventions. This involves inserting temporary pump to support circulation during a heart operation.
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Percutaneous balloon valvuloplasty for fetal critical aortic stenosis (HTG471)
Evidence-based recommendations on percutaneous balloon valvuloplasty for fetal critical aortic stenosis. This involves placing a catheter into the baby’s heart, while the baby is still in the womb. The aim is to help the heart develop properly.
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Evidence-based recommendations on robot-assisted kidney transplant in adults. This involves the surgeon using a robot to help with a kidney transplant.
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Percutaneous mitral valve leaflet repair for mitral regurgitation (HTG513)
Evidence-based recommendations on percutaneous mitral valve leaflet repair for mitral regurgitation in adults. This involves attaching a clip to the leaflets of the mitral valve.
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Evidence-based recommendations on Barnett Continent Intestinal Reservoir (modified continent ileostomy) to restore continence after colon and rectum removal in adults. This involves using the ileum to create a pouch on the inside of the abdominal wall to collect waste.
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Deep brain stimulation for refractory epilepsy in adults (HTG550)
Evidence-based recommendations on deep brain stimulation for refractory epilepsy in adults. This involves implanting an electrical stimulator in the brain.
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Solriamfetol for treating excessive daytime sleepiness caused by obstructive sleep apnoea (TA777)
Evidence-based recommendations on solriamfetol (Sunosi) for treating excessive daytime sleepiness caused by obstructive sleep apnoea in adults.
Evidence-based recommendations on midostaurin (Rydapt) for untreated FLT3-mutation-positive acute myeloid leukaemia in adults.
Enzalutamide for hormone-relapsed non-metastatic prostate cancer (TA580)
Evidence-based recommendations on enzalutamide (Xtandi) for treating high-risk hormone-relapsed non-metastatic prostate cancer in adults.
Evidence-based recommendations on dostarlimab (Jemperli) with platinum-based chemotherapy for primary advanced or recurrent endometrial cancer with high microsatellite instability or mismatch repair deficiency in adults.
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Evidence-based recommendations on eribulin (Halaven) for locally advanced or metastatic (secondary) breast cancer in adults who have had 2 or more courses of chemotherapy.
Highly specialised technologies evaluation committee members
Biographies for each member of the highly specialised technologies evaluation committee.
Highly specialised technologies evaluation committee members
Biographies for each member of the highly specialised technologies evaluation committee.
Irritable bowel syndrome in adults: diagnosis and management (CG61)
This guideline covers diagnosing and managing irritable bowel syndrome (IBS) in people aged 18 and over. It details how to accurately diagnose IBS, and aims to improve the quality of life for adults with IBS by promoting effective management using dietary and lifestyle advice, pharmacological therapy and referral for psychological interventions.
NICE has developed a medtech innovation briefing (MIB) on FreeStyle Libre for glucose monitoring .
PLGF-based testing to help diagnose suspected preterm pre-eclampsia (HTG630)
Evidence-based recommendations on placental growth factor (PLGF)-based testing to help diagnose suspected preterm pre-eclampsia. The tests are: DELFIA Xpress PLGF 1-2-3, DELFIA Xpress sFlt-1/PLGF 1-2-3 ratio, Elecsys immunoassay sFlt-1/PLGF ratio, Triage PLGF Test.
NaviCam for diagnosing gastrointestinal tract conditions (MIB104)
NICE has developed a medtech innovation briefing (MIB) on NaviCam for diagnosing gastrointestinal tract conditions .
Transcranial direct current stimulation (tDCS) for depression (HTG382)
Evidence-based recommendations on transcranial direct current stimulation (tDCS) for depression. This involves electrical stimulation of the brain by applying a weak direct current to the scalp.
Assessing motility of the gastrointestinal tract using a wireless capsule (HTG351)
Evidence-based recommendations on assessing motility of the gastrointestinal tract using a wireless capsule. This involves swallowing a capsule that sends bowel information as it passes through the digestive system.
Intramedullary distraction for lower limb lengthening (HTG613)
Evidence-based recommendations on intramedullary distraction for lower limb lengthening in children, young people and adults. This involves surgically inserting a metal lengthening device in the shorter leg.
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Coronary sinus narrowing device implantation for refractory angina (HTG600)
Evidence-based recommendations on laparoscopic radical prostatectomy. This involves removing the prostate gland and some surrounding tissue using specialised instruments through small cuts in the abdomen (keyhole surgery).
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Evidence-based recommendations on aortic remodelling hybrid stent insertion for acute type A aortic dissection. This involves inserting a stent with material sewed on one end into part of the aorta.
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Supercapsular percutaneously assisted total hip arthroplasty for osteoarthritis (HTG626)
Evidence-based recommendations on supercapsular percutaneously assisted total hip arthroplasty for osteoarthritis in adults. This involves replacing a hip using smaller cuts than are used in standard surgery.
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Hysteroscopic mechanical tissue removal (hysteroscopic morcellation) for uterine fibroids (HTG590)
Evidence-based recommendations on hysteroscopic mechanical tissue removal (hysteroscopic morcellation) for uterine fibroids in adults. This involves cutting the fibroids into small pieces to remove them.
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Biodegradable subacromial spacer insertion for rotator cuff tears (HTG702)
Evidence-based recommendations on biodegradable subacromial spacer insertion for rotator cuff tears. This involves inserting a balloon-shaped device between the top of the shoulder blade and the upper arm bone to reduce pain and improve shoulder function.
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Evidence-based recommendations on subcutaneous implantable cardioverter defibrillator insertion for preventing sudden cardiac death. This involves placing a device under the skin of the chest, which detects and treats fast heartbeats called tachyarrhythmias.
Evidence-based recommendations on microwave ablation for treating liver metastases in adults. This involves using heat energy to destroy cancer cells.
Percutaneous mechanical thrombectomy for acute deep vein thrombosis of the leg (HTG516)
Evidence-based recommendations on percutaneous mechanical thrombectomy for acute deep vein thrombosis of the leg in adults. This involves removing the clot through a catheter inserted into the vein.
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MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy (HTG541)
Evidence-based recommendations on MRI-guided laser interstitial thermal therapy for drug-resistant epilepsy in adults and children. This involves inserting a laser into the area of the brain causing seizures.
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Swallowable gastric balloon capsule for weight loss (HTG561)
Evidence-based recommendations on swallowable gastric balloon capsules for weight loss in adults. This involves swallowing a capsule containing a balloon that is then filled with liquid to inflate it in the stomach.
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Evidence-based recommendations on daratumumab (Darzalex) with lenalidomide and dexamethasone for untreated multiple myeloma in adults, when a stem cell transplant is unsuitable.