title: UK guidance document: treatment of metastatic breast cancer.
abstract: Although there have been major improvements in the management of breast cancer, with a rapidly falling death rate despite an increasing incidence of the disease, metastatic breast cancer remains common and the cause of death in nearly 12 000 women annually in the UK. Numerous treatment options are available that either target the tumour or reduce the complications of the disease. Clinical decision making depends on knowledge of the extent and biology of the disease and available drug options, an understanding of the functional status, and also the wishes and expectations of the individual patient. In addition, the organisation of services and support of the patient are essential components of high-quality care. The National Institute for Health and Clinical Excellence (NICE) has produced guidelines for the treatment of advanced breast cancer, which in some areas have perhaps failed to appreciate the complexity of patient management. This guidance document aims to provide succinct practical advice on the treatment of metastatic breast cancer, highlight some limitations of the NICE guidelines, and provide suggestions for management where available data are limited.
authors.affiliation: Academic Unit of Clinical Oncology, Weston Park Hospital, University of Sheffield, Sheffield, UK.
authors.forename: R E
authors.initials: RE
authors.lastname: Coleman
authors.forename: G
authors.initials: G
authors.lastname: Bertelli
authors.forename: T
authors.initials: T
authors.lastname: Beaumont
authors.forename: I
authors.initials: I
authors.lastname: Kunkler
authors.forename: D
authors.initials: D
authors.lastname: Miles
authors.forename: P D
authors.initials: PD
authors.lastname: Simmonds
authors.forename: A L
authors.initials: AL
authors.lastname: Jones
authors.forename: I E
authors.initials: IE
authors.lastname: Smith
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary / Q000628:therapy*; D001932:Brain Neoplasms / Q000556:secondary / Q000628:therapy*; D001943:Breast Neoplasms / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D003657:Decision Making; D005260:Female; D017273:Goserelin / Q000627:therapeutic use; D006801:Humans; D010052:Ovariectomy; D010348:Patient Care Team; D017698:Postmenopause; D017697:Premenopause; D011878:Radiotherapy; D013629:Tamoxifen / Q000627:therapeutic use; D006113:United Kingdom
chemical_list: D047072:Aromatase Inhibitors; D013629:Tamoxifen; D017273:Goserelin