title: NCCN Guidelines Update: Breast Cancer.
abstract: The updates to management of early invasive breast cancer in 2016 are minor but have important treatment implications for patients. The NCCN Guidelines Panel for Breast Cancer has added endocrine therapy to its recommendations for the neoadjuvant treatment of patients with ER-rich tumors. For women who are premenopausal at diagnosis, the NCCN Guidelines suggest tamoxifen for 5 years, with or without ovarian suppression, or an aromatase inhibitor for 5 years combined with ovarian suppression or ablation. For HER2-positive patients, neoadjuvant pertuzumab is acceptable, and in advanced estrogen receptor-positive disease, palbociclib can be given with endocrine therapy. Hypofractionation is now the preferred approach for whole-breast irradiation after breast-conserving therapy. Regional nodal irradiation should be strongly considered for women with 1 to 3 positive lymph nodes and is indicated for those with 4 or more positive nodes.
authors.affiliation: Presented by William Gradishar, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, and Kilian E. Salerno, MD, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: William
authors.initials: W
authors.lastname: Gradishar
authors.affiliation: Presented by William Gradishar, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, Illinois, and Kilian E. Salerno, MD, Roswell Park Cancer Institute, Buffalo, New York.
authors.forename: Kilian E
authors.initials: KE
authors.lastname: Salerno
mesh_terms: D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D020360:Neoadjuvant Therapy