Early and locally advanced breast cancer: diagnosis and treatment

NICE have updated their guidance on the management of early breast cancer to take into account developments since the 2009 iteration of this guidance. They recommend re-excision of breast tissue should be offered if DCIS or invasive cancer is present at the radial margins (tumour on ink). Re-excision should be considered if tumour is 0 to 2mm from radial margins. A similar conclusion is presented by ASCO. Following a literature review, the consensus statement from ABS is that, if excision of DCIS with a margin of 1mm or greater is achieved, routine re-excision is not warranted. This consensus statement can be found on the ABS guidance page under “Cancer Surgery”. Advice on breast reconstruction is now included in the guidance as is advice on extended endocrine therapy and lifestyle. Predict.nhs is recommended to aid decision making around adjuvant therapy and to estimate prognosis. There is no comment on tumour profiling tests to guide adjuvant chemotherapy decisions. The guidance around these is the subject of a separate NICE assessment process and will be published late 2018.

Classifications: Breast Cancer Treatment Service Guidance

Keywords: Early Breast Cancer Locally Advanced Breast Cancer