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Breast cancer

All NICE products on Breast cancer. Includes any guidance, advice, NICE Pathways and quality standards.

Advanced breast cancer: diagnosis and treatment (CG81)

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.

Clinical guideline Published February 2009 Last updated August 2017

Early and locally advanced breast cancer: diagnosis and management (NG101)

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.

NICE guideline Published July 2018

Familial breast cancer: classification, care and managing breast cancer and related risks in people with a family history of breast cancer (CG164)

This guideline covers care for people with a family history of breast, ovarian or another related (prostate or pancreatic) cancer. It aims to improve the long-term health of these families by describing strategies to reduce the risk of and promote early detection of breast cancer (including genetic testing and mammography). It also includes advice on treatments (tamoxifen, raloxifene) and surgery (mastectomy).

Clinical guideline Published June 2013 Last updated March 2017

Advanced breast cancer

Everything NICE has said on diagnosing and treating advanced breast cancer in an interactive flowchart

NICE Pathway Published May 2011 Last updated August 2019

Early and locally advanced breast cancer

Everything NICE has said on diagnosing and treating early and locally advanced breast cancer in an interactive flowchart

NICE Pathway Published May 2011 Last updated March 2019

Breast cancer (QS12)

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.

Quality standard Published September 2011 Last updated June 2016

Familial breast cancer

Everything NICE has said on assessing and managing familial breast cancer and related risks in people with a family history in an interactive flowchart

NICE Pathway Published October 2011 Last updated September 2017

Guidance on the use of trastuzumab for the treatment of advanced breast cancer (TA34)

Evidence-based recommendations on the use of trastuzumab (Herceptin) for the treatment of advanced breast cancer

Technology appraisal guidance Published March 2002

Everolimus with exemestane for treating advanced breast cancer after endocrine therapy (TA421)

Evidence-based recommendations on everolimus (Afinitor) for treating advanced breast cancer in adults after endocrine therapy

Technology appraisal guidance Published December 2016

Trastuzumab emtansine for treating HER2-positive advanced breast cancer after trastuzumab and a taxane (TA458)

Evidence-based recommendations on trastuzumab emtansine (Kadcyla) for treating advanced HER2-positive breast cancer that has been treated before

Technology appraisal guidance Published July 2017 Last updated November 2017

Ribociclib with fulvestrant for treating hormone receptor-positive, HER2-negative, advanced breast cancer (TA593)

Evidence-based recommendations on ribociclib (Kisqali) for hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer in adults

Technology appraisal guidance Published August 2019

Abemaciclib with fulvestrant for treating hormone receptor-positive, HER2-negative advanced breast cancer after endocrine therapy (TA579)

Evidence-based recommendations on abemaciclib (Verzenios) for treating hormone receptor-positive, HER2-negative locally advanced or metastatic breast cancer

Technology appraisal guidance Published May 2019

Gemcitabine for the treatment of metastatic breast cancer (TA116)

Evidence-based recommendations on gemcitabine (Gemzar) for treating metastatic breast cancer

Technology appraisal guidance Published January 2007

Fulvestrant for the treatment of locally advanced or metastatic breast cancer (TA239)

Evidence-based recommendations on fulvestrant (Faslodex) for treating locally advanced or metastatic breast cancer

Technology appraisal guidance Published December 2011

Pertuzumab with trastuzumab and docetaxel for treating HER2-positive breast cancer (TA509)

Evidence-based recommendations on pertuzumab (Perjeta) for HER2-positive, locally recurrent or metastatic (secondary) breast cancer in adults

Technology appraisal guidance Published March 2018

Pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer (TA424)

Evidence-based recommendations on pertuzumab (Perjeta) for HER2-positive breast cancer in adults

Technology appraisal guidance Published December 2016

Intrabeam radiotherapy system for adjuvant treatment of early breast cancer (TA501)

Evidence-based recommendations on using Intrabeam radiotherapy during breast-conserving surgery for adults with early breast cancer

Technology appraisal guidance Published January 2018

Bevacizumab in combination with capecitabine for the first-line treatment of metastatic breast cancer (TA263)

Evidence-based recommendations on bevacizumab (Avastin) in combination with capecitabine for the first-line treatment of metastatic breast cancer

Technology appraisal guidance Published August 2012

Eribulin for treating locally advanced or metastatic breast cancer after 1 chemotherapy regimen (TA515)

Evidence-based recommendations on eribulin (Halaven) for treating locally advanced or metastatic (secondary) breast cancer in adults who have had only 1 course

Technology appraisal guidance Published March 2018

Pertuzumab for adjuvant treatment of HER2-positive early stage breast cancer (TA569)

Evidence-based recommendations on pertuzumab (Perjeta) for adjuvant treatment (with trastuzumab and chemotherapy) of HER2-positive early stage breast cancer

Technology appraisal guidance Published March 2019

Eribulin for treating locally advanced or metastatic breast cancer after 2 or more chemotherapy regimens (TA423)

Evidence-based recommendations on eribulin (Halaven) for treating locally advanced or metastatic breast cancer after 2 or more types of chemotherapy

Technology appraisal guidance Published December 2016

Bevacizumab in combination with a taxane for the first-line treatment of metastatic breast cancer (TA214)

Evidence-based recommendations on bevacizumab (Avastin) in combination with a taxane for the first-line treatment of metastatic breast cancer

Technology appraisal guidance Published February 2011

Breast reconstruction using lipomodelling after breast cancer treatment (IPG417)

Evidence-based recommendations on breast reconstruction using lipomodelling after breast cancer treatment

Interventional procedures guidance Published January 2012

Lapatinib or trastuzumab in combination with an aromatase inhibitor for the first-line treatment of metastatic hormone-receptor-positive breast cancer that overexpresses HER2 (TA257)

Evidence-based recommendations on lapatinib (Tyverb) or trastuzumab (Herceptin) combined with an aromatase inhibitor for the first-line treatment of..

Technology appraisal guidance Published June 2012

Fulvestrant for untreated locally advanced or metastatic oestrogen-receptor positive breast cancer (TA503)

Evidence-based recommendations on fulvestrant (Faslodex) for untreated locally advanced or metastatic (secondary) oestrogen-receptor positive breast cancer in

Technology appraisal guidance Published January 2018

Interstitial laser therapy for breast cancer (IPG89)

Evidence-based recommendations on interstitial laser therapy for treating breast cancer

Interventional procedures guidance Published September 2004

Abemaciclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer (TA563)

Evidence-based recommendations on abemaciclib (Verzenios) for treating locally advanced or metastatic, hormone receptor-positive, human epidermal growth factor

Technology appraisal guidance Published February 2019

Palbociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer (TA495)

Evidence-based recommendations on palbociclib (Ibrance) as initial endocrine-based therapy for hormone receptor-positive, HER2-negative, locally advanced or

Technology appraisal guidance Published December 2017

Ribociclib with an aromatase inhibitor for previously untreated, hormone receptor-positive, HER2-negative, locally advanced or metastatic breast cancer (TA496)

Evidence-based recommendations on ribociclib (Kisqali) as initial endocrine-based therapy for hormone-receptor positive, human epidermal growth factor receptor

Technology appraisal guidance Published December 2017

Endoscopic mastectomy and endoscopic wide local excision for breast cancer (IPG296)

Evidence-based recommendations on endoscopic mastectomy and endoscopic wide local excision for breast cancer (keyhole removal of breast tissue)

Interventional procedures guidance Published April 2009

Atezolizumab with nab-paclitaxel for treating PD L1-positive, triple-negative, advanced breast cancer [ID1522]

In development [GID-TA10433] Expected publication date: 05 February 2020

Technology appraisal guidance In development

Endoscopic axillary lymph node retrieval for breast cancer (IPG147)

Evidence-based recommendations on endoscopic axillary lymph node retrieval for breast cancer

Interventional procedures guidance Published December 2005

Brachytherapy as the sole method of adjuvant radiotherapy for breast cancer after local excision (IPG268)

Evidence-based recommendations on brachytherapy as the only type of adjuvant radiotherapy for breast cancer after local excision

Interventional procedures guidance Published July 2008

Talazoparib for treating BRCA 1 or 2 mutated advanced breast cancer after prior chemotherapy (ID1342)

In development [GID-TA10366] Expected publication date: 18 November 2020

Technology appraisal guidance In development

Menopause: diagnosis and management (NG23)

This guideline covers the diagnosis and management of menopause, including in women who have premature ovarian insufficiency. The guideline aims to improve the consistency of support and information provided to women in menopause.

NICE guideline Published November 2015

Tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer (DG34)

Evidence-based recommendations on tumour profiling tests to guide adjuvant chemotherapy decisions in early breast cancer

Diagnostics guidance Published December 2018

Intraoperative tests (RD‑100i OSNA system and Metasin test) for detecting sentinel lymph node metastases in breast cancer (DG8)

Evidence-based recommendations on the RD-100i OSNA system and Metasin test for detecting sentinel lymph node metastases in breast cancer

Diagnostics guidance Published August 2013

NICE looks to company to ensure a new treatment for advanced breast cancer with significant unmet need is cost-effective

Draft guidance published today (3 October 2019) by NICE does not recommend atezolizumab (also called Tecentriq and made by Roche) for treating people with a type of breast cancer called triple A breast cancer that has spread to other parts of the body and who can’t have surgery to remove it.

News Published October 2019 Last updated October 2019

AlignRT in breast cancer radiotherapy (MIB157)

Advice on the use of AlignRT (Vision RT) in breast cancer radiotherapy to aid local decision-making

Medtech innovation briefing Published August 2018

Pembrolizumab in combination with chemotherapy for neoadjuvant treatment of triple negative breast cancer [ID1500]

In development [GID-TA10399] Expected publication date: TBC

Technology appraisal guidance In development

Early and metastatic HER2-positive breast cancer: subcutaneous trastuzumab (ESNM13)

Summary of the evidence on subcutaneous trastuzumab for HER2-positive breast cancer to inform local NHS planning and decision-making

Evidence summary Published March 2013

MammaTyper in vitro diagnostic test for determining breast cancer subtypes (MIB135)

Advice on the use of the MammaTyper in vitro diagnostic test for determining breast cancer subtypes to aid local decision-making

Medtech innovation briefing Published January 2018

Palbociclib in combination with fulvestrant for treating advanced, hormone-receptor positive, HER2-negative breast cancer after endocrine therapy [ID916]

In development [GID-TA10095] Expected publication date: 18 December 2019

Technology appraisal guidance In development

Early breast cancer (preventing recurrence and improving survival): adjuvant bisphosphonates (ES15)

Summary of the evidence on adjuvant bisphosphonates for preventing recurrence or improving survival in people with early breast cancer

Evidence summary Published July 2017

Neratinib for treating early hormone receptor-positive HER2-positive breast cancer after adjuvant trastuzumab [ID981]

In development [GID-TA10107] Expected publication date: 20 November 2019

Technology appraisal guidance In development

Familial breast cancer. Taking a medicine to reduce the chance of developing breast cancer – Decision aid for postmenopausal women at high risk

Taking a medicine to reduce the chance of developing breast cancer: patient decision aid (postmenopausal high risk women) Copyright c...

Published March 2017 Last updated March 2017

Familial breast cancer. Taking tamoxifen to reduce the chance of developing breast cancer – Decision aid for premenopausal women at high risk

Taking a medicine to reduce the chance of developing breast cancer: patient decision aid (premenopausal high risk women) Copyright c...

Published March 2017 Last updated March 2017

Familial breast cancer. Taking a medicine to reduce the chance of developing breast cancer – Decision aid for postmenopausal women at moderately increased risk

Taking a medicine to reduce the chance of developing breast cancer: patient decision aid (postmenopausal moderate risk) Copyright c NICE...

Published March 2017 Last updated March 2017

Improving outcomes in breast cancer (CSG1)

This guideline covers how healthcare services for breast cancer should be organised. It aims to improve care for women with breast cancer by recommending which healthcare professionals should be involved in care.

Cancer service guideline Published August 2002