Recommendations for the Treatment of Breast Cancer

This guideline provides recommendations in light of the currently available evidence for best practices toward treatment of breast cancer patients. The guideline includes recommendations on surgery, chemotherapy, radiation therapy, endocrine therapy, biological therapy, and various other possible options for treatment. The guideline does not include recommendations for the diagnosis, staging, follow-up, and management of meta-static cancers. Use of complementary and alternative treatments, diet management, and lifestyle management are also not addressed in the guideline. 

It is recommended that if there is proven axillary lymph node disease, pre-operatively axillary lymph node clearance should be undertaken. If there is no proven axillary lymph node disease, then sentinel lymph node biopsy is recommended. Radiotherapy is recommended for patients with lymph node- breast cancer if the patients have a high risk of recurrence of the cancer after completion of the mastectomy. Patients who suffer with ductal carcinoma in situ are recommended for breast radiotherapy after a breast conservation surgery (allowing to retain the breast). Adjuvant chemotherapy should be used for patients with breast cancer where the benefits of the therapy justify the associated risk.

The two established surgical procedure for the treatment of invasive or in situ breast cancer are conservation surgery which involves removal of the tumor while retaining the breast, and mastectomy involving removal of the entire breast. It is recommended that patients with invasive breast cancer should have surgical management of the axilla.