NCCN Updates Breast Cancer And Breast Cancer Risk Reduction Guidelines

Main Category: Breast Cancer
Article Date: 04 Feb 2009 - 0:00 PDT

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The National Comprehensive Cancer Network (NCCN) announces important updates to the NCCN Clinical Practice Guidelines in Oncology(TM) for Breast Cancer and Breast Cancer Risk Reduction. These changes reflect leading developments in the treatment of patients with breast cancer and represent the standard of clinical policy in oncology in both community and academic settings.

Notable diagnostic additions to the NCCN Guidelines include a recommendation for genetic counseling if the patient is high risk for hereditary breast cancer, as well as six new recommendations detailing when MRIs may be helpful in breast cancer evaluations.

Conversely, the updated NCCN Guidelines for Breast Cancer state that PET/CT scanning is not recommended for evaluation of newly diagnosed patients with early stage disease except in those clinical situations where other staging studies are equivocal or suspicious, and even in these situations that biopsy is recommended. The NCCN Guideline Panel Members for Breast Cancer note that although there is limited evidence demonstrating the utility of PET/CT scan in the staging of patients, they consider biopsy to be more likely to provide useful staging information.

The updated NCCN Guidelines continue to recognize bisphosphonates as the preferred intervention to treat osteoporosis in women with breast cancer, while the use of estrogen, progesterone, or selective estrogen receptor modulators is discouraged.

Significant additions were also made to the portion of the NCCN Guidelines providing recommendations for patients undergoing breast reconstruction following surgery. It is now recommended that women receive an evaluation detailing the likely cosmetic outcome of a lumpectomy prior to the actual surgery. Furthermore, women who are not satisfied with the cosmetic outcome following completion of breast cancer treatment should be offered a plastic surgery consultation.

Notable additions to the NCCN Guidelines for Breast Cancer Risk Reduction include updates to two risk-reduction agents, tamoxifen (Soltamox(TM), AstraZeneca) and raloxifine (Evista(R), Eli Lilly and Company). Tamoxifen is recommended for premenopausal women with a history of atypical hyperplasia to reduce breast cancer risk. For postmenopausal women, raloxifene is listed as equivalent to tamoxifen in reducing the risk of developing invasive breast cancer; however, it did not provide the same level of risk reduction for developing non-invasive breast cancer.

Breast cancer remains the second leading cause of cancer death after lung cancer in women in the United States. It is estimated that more than 180,000 new cases of breast cancer will be diagnosed in women in 2009.

NCCN Clinical Practice Guidelines in Oncology(TM) are developed and updated through an evidence-based process with explicit review of the scientific evidence by multidisciplinary panels of expert physicians from NCCN Member Institutions. The most recent version of this and all the NCCN Guidelines are available free of charge at http://www.nccn.org.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world's leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives.

The NCCN Member Institutions are: City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Comprehensive Cancer Center, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University, Columbus, OH; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/University of Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; The University of Texas M. D. Anderson Cancer Center, Houston, TX; and Vanderbilt-Ingram Cancer Center, Nashville, TN.

For more information on NCCN, please visit http://www.nccn.org.

National Comprehensive Cancer Network
http://www.nccn.org

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