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

Evidence-based recommendations on familial (inherited) breast cancer and related risks for people with a family history of breast cancer

Clinical guideline Published June 2013 Last updated March 2017

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

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

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

CG81: Advanced breast cancer: diagnosis and treatment

Evidence-based recommendations on diagnosing and treating advanced (stage 4) breast cancer (invasive adenocarcinoma) for women and men

Clinical guideline Published February 2009 Last updated July 2014

Advanced breast cancer

Advanced breast cancer overview Managing advanced breast cancer Advanced breast cancer: managing complications Patient experience in adult NHS services Opioids for pain relief in palliative care Your responsibility when using NICE advice Advanced

NICE Pathway Published May 2011 Last updated December 2016

Early and locally advanced breast cancer

This interactive flowchart covers the diagnosis and treatment of early and locally advanced breast cancer.Breast cancer is the most common cancer in women. Most women with breast cancer do not have a family history of the disease, but it can be

NICE Pathway Published May 2011 Last updated March 2017

Familial breast cancer

This interactive flowchart covers the classification and care of people at risk of familial breast cancer, including those who have a personal history of breast cancer.Familial breast cancer typically occurs in people with an unusually high number

NICE Pathway Published October 2011 Last updated May 2017

CG80: Early and locally advanced breast cancer: diagnosis and treatment

Evidence-based recommendations on diagnosing and treating early and locally advanced (stage 1 & 2) breast cancer (adenocarcinoma) for women and men

Clinical guideline Published February 2009 Last updated March 2017

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

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

Hormonal therapies for the adjuvant treatment of early oestrogen-receptor-positive breast cancer (TA112)

Evidence-based recommendations on hormonal therapies (anastrozole/exemestane/letrozole) as extra treatment for early oestrogen-receptor-positive breast cancer

Technology appraisal guidance Published November 2006

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

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

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

Docetaxel for the adjuvant treatment of early node-positive breast cancer (TA109)

Evidence-based recommendations on docetaxel (Taxotere) for adjuvant treatment of early node-positive breast cancer

Technology appraisal guidance Published September 2006 Last updated March 2014

Paclitaxel for the adjuvant treatment of early node-positive breast cancer (TA108)

Evidence-based recommendations on paclitaxel (Taxol) for adjuvant treatment of early node-positive breast cancer

Technology appraisal guidance Published September 2006

Trastuzumab for the adjuvant treatment of early-stage HER2-positive breast cancer (TA107)

Evidence-based recommendations on trastuzumab (Herceptin) for adjuvant treatment of early-stage HER2-positive breast cancer

Technology appraisal guidance Published August 2006 Last updated March 2014

Interstitial laser therapy for breast cancer (IPG89)

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

Interventional procedures guidance Published September 2004

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

MIB44: EndoPredict gene expression profiling assay for assessing risk of breast cancer recurrence

Advice on the use of the EndoPredict gene expression profiling assay for assessing the risk of breast cancer recurrence to aid local decision-making

Medtech innovation briefing Published November 2015

MIB27: The Prosigna gene expression profiling assay for assessing long‐term risk of breast cancer recurrence

Advice on the use of the Prosigna gene expression profiling assay for assessing long-term risk of breast cancer recurrence to aid local decision-making

Medtech innovation briefing Published March 2015

MIB76: Axxent electronic brachytherapy system for early stage breast cancer

Advice on the use of the Axxent electronic brachytherapy system for treating early stage breast cancer to aid local decision-making

Medtech innovation briefing Published August 2016

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

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

Tibolone is not recommended for women with menopausal symptoms who have breast cancer.

...with menopausal symptoms who have breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Progestogens are not recommended for women with menopausal symptoms who have breast cancer.

...with menopausal symptoms who have breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not offer radiotherapy following mastectomy to patients with early invasive breast cancer who are at low risk of local recurrence (for example, most patients who are lymph node-negative).

...to patients with early invasive breast cancer who are at low risk of local recurrence...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Soy (isoflavone) is not recommended for the treatment of menopausal symptoms in women with breast cancer.

...menopausal symptoms in women with breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not routinely assess progesterone receptor status of tumours in patients with invasive breast cancer.

...tumours in patients with invasive breast cancer. Do Not Do Recommendation Details...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...to patients with early invasive breast cancer who are receiving tamoxifen alone...

Do not do recommendation Published June 2015

Do not offer adjuvant radiotherapy to the internal mammary chain to patients with early breast cancer who have had breast surgery.

...mammary chain to patients with early breast cancer who have had breast surgery...tumours in patients with invasive breast cancer. Do not offer adjuvant ovarian...ER)-positive early invasive breast cancer who are being treated with tamoxifen...

Do not do recommendation Published June 2015

Vitamin E is not recommended for the treatment of menopausal symptoms in women with breast cancer.

...menopausal symptoms in women with breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Red clover is not recommended for the treatment of menopausal symptoms in women with breast cancer.

...menopausal symptoms in women with breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not offer paclitaxel as an adjuvant treatment for lymph node-positive breast cancer.

...treatment for lymph node-positive breast cancer. Do Not Do Recommendation Details...to patients with early invasive breast cancer who are receiving tamoxifen alone...to patients with early invasive breast cancer who are at low risk of local recurrence...

Do not do recommendation Published June 2015

Black cohosh is not recommended for the treatment of menopausal symptoms in women with breast cancer.

...menopausal symptoms in women with breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Magnetic devices are not recommended for the treatment of menopausal symptoms in women with breast cancer.

...menopausal symptoms in women with breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not offer adjuvant radiotherapy to the axilla or supraclavicular fossa to patients with early breast cancer who have been shown to be histologically lymph node-negative.

...supraclavicular fossa to patients with early breast cancer who have been shown to be histologically...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

What are the options for women with inherited breast cancer?

Following Angelina Jolie?s decision to go public with the news that she has had a double mastectomy for breast cancer, we explore who is at risk and the treatment options available for women on the NHS.

News Published May 2013

The routine use of magnetic resonance imaging (MRI) of the breast is not recommended in the preoperative assessment of patients with biopsy-proven invasive breast cancer or ductal carcinoma in situ (DCIS).

...with biopsy-proven invasive breast cancer or ductal carcinoma in situ...tumours in patients with invasive breast cancer. Do not offer adjuvant ovarian...ER)-positive early invasive breast cancer who are being treated with tamoxifen...

Do not do recommendation Published June 2015

Do not offer a dual energy x-ray absorptiometry (DEXA) scan to patients with early invasive breast cancer who are receiving tamoxifen alone, regardless of pretreatment menopausal status.

...to patients with early invasive breast cancer who are receiving tamoxifen alone...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer radiotherapy following...

Do not do recommendation Published June 2015

Do not offer adjuvant radiotherapy to the axilla after axillary lymph node dissection (ALND) for early breast cancer.

...dissection (ALND) for early breast cancer. Do Not Do Recommendation Details...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not offer adjuvant ovarian ablation/suppression to premenopausal women with estrogen receptor (ER)-positive early invasive breast cancer who are being treated with tamoxifen and, if indicated, chemotherapy.

...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...to patients with early invasive breast cancer who are receiving tamoxifen alone...

Do not do recommendation Published June 2015

Do not offer ultrasound for routine post-treatment surveillance in patients who have been treated for early invasive breast cancer or ductal carcinoma in situ (DCIS).

...been treated for early invasive breast cancer or ductal carcinoma in situ...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not offer hormone replacement therapy (HRT) (including oestrogen/progestogen combination) routinely to women with menopausal symptoms and a history of breast cancer. HRT may, in exceptional cases, be offered to women with severe menopausal symptoms and with whom the associated risks have been discussed.

...menopausal symptoms and a history of breast cancer. HRT may, in exceptional cases...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015

Do not offer magnetic resonance imaging (MRI) for routine post-treatment surveillance in patients who have been treated for early invasive breast cancer or ductal carcinoma in situ (DCIS).

...been treated for early invasive breast cancer or ductal carcinoma in situ...ER)-positive early invasive breast cancer who are being treated with tamoxifen...treatment for lymph node-positive breast cancer. Do not offer a dual energy x...

Do not do recommendation Published June 2015