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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 May 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

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

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

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

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

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

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

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

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

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

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

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

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

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

Interstitial laser therapy for breast cancer (IPG89)

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

Interventional procedures guidance Published September 2004

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

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

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

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

Metastatic malignant disease of unknown primary origin

Everything NICE has said on diagnosing and managing metastatic malignant disease of unknown primary origin in an interactive flowchart

NICE Pathway Published January 2013 Last updated July 2018

Denosumab for the prevention of skeletal-related events in adults with bone metastases from solid tumours (TA265)

Evidence-based recommendations on denosumab (XGEVA) for the prevention of skeletal-related events in adults with bone metastases from solid tumours

Technology appraisal guidance Published October 2012

Metastatic malignant disease of unknown primary origin in adults: diagnosis and management (CG104)

This guideline covers diagnosing and managing secondary cancers in people aged 18 and over when the site of the primary cancer is unknown. This includes people who have had treatment for cancer before. It aims to improve quality of life by offering advice on tests for identifying the site of the primary cancer and options for managing the person’s condition when this cannot be found.

Clinical guideline Published July 2010

Neutropenic sepsis: prevention and management in people with cancer (CG151)

This guideline covers preventing, identifying and managing neutropenic sepsis in children, young people and adults receiving treatment for cancer in the community and in secondary and tertiary care. It aims to reduce the risk of infection in people with neutropenia (low number of white blood cells) who are receiving anticancer treatment and improve management of neutropenic sepsis.

Clinical guideline Published September 2012

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

In development [GID-TA10366] Expected publication date: TBC

Technology appraisal guidance In development

Atezolizumab for untreated, locally advanced or metastatic, triple negative, PD-L1 positive breast cancer [ID1522]

In development [GID-TA10433] Expected publication date: 20 November 2019

Technology appraisal guidance In development

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

Ribociclib in combination with fulvestrant for treating advanced hormone-receptor positive, HER2-negative breast cancer [ID1318]

In development [GID-TA10285] Expected publication date: 14 August 2019

Technology appraisal guidance In development

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

In development [GID-TA10107] Expected publication date: 02 October 2019

Technology appraisal guidance In development

Breast cancer (locally advanced, metastatic) - eribulin (after chemotherapy) [ID964]

In development [GID-TA10030] Expected publication date: 21 December 2016

Technology appraisal guidance In development

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

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

Laparoscopic mobilisation of the greater omentum for breast reconstruction (IPG253)

Evidence-based recommendations on laparoscopic mobilisation of the greater omentum (keyhole surgery) for breast reconstruction

Interventional procedures guidance Published February 2008

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

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