Source: DGNews  |  Posted 2 years ago

LONDON -- February 25, 2009 -- The National Institute for Health and Clinical Excellence (NICE) has published new guidelines on best practice for the diagnosis and treatment of advanced breast cancer.

The guideline, produced for NICE by the National Collaborating Centre for Cancer, Cardiff, United Kingdom, will help clinicians to provide coherent and consistent care for patients with advanced breast cancer, providing a systematic framework to support patients with the disease and ensuring equal access to services across England and Wales.

Key recommendations include:
· Offer endocrine therapy as first-line treatment for the majority of patients with oestrogen receptor (ER)-positive advanced breast cancer.
· For patients who are receiving treatment with trastuzumab for advanced breast cancer, discontinue treatment with trastuzumab at the time of disease progression outside the central nervous system. Do not discontinue trastuzumab if disease progression is within the central nervous system alone.
· A breast cancer multidisciplinary team should assess all patients presenting with uncontrolled local disease and discuss the therapeutic options for controlling the disease and relieving symptoms.
· Consider offering bisphosphonates to patients newly diagnosed with bone metastases, to prevent skeletal-related events and reduce pain.
· Offer surgery followed by whole brain radiotherapy to patients who have a single or small number of brain metastases that could potentially be removed by surgery, a good performance status, and who have no or well-controlled other metastatic disease.

"It is important that being diagnosed with advanced breast cancer is not seen as an immediate death sentence; it can be managed effectively, allowing patients to have a reasonable quality of life," said John Winstanley, Royal Bolton Hospital, Bolton, United Kingdom. "This guideline pulls together the best ways to treat the cancer medically, helping relieve the symptoms and to support patients psychologically, emotionally, and practically."

SOURCE: National Institute for Health and Clinical Excellence