Evidence
Surveillance decision
We will not update the guideline on advanced breast cancer at this time.
We will amend the relevant sections of the guideline to cross-refer to the published NICE technology appraisals and other NICE guidance related to the diagnosis and treatment of advanced breast cancer. This amendment will include the removal of the footnote in NICE's technology appraisal guidance on the use of trastuzumab for the treatment of advanced breast cancer (TA34). Details are included in appendix A: summary of evidence from surveillance.
Reason for the decision
Assessing the evidence
We found 301 studies through surveillance of this guideline.
This included evidence on assessment, systemic disease-modifying therapy, supportive care and managing complications that supports current recommendations.
We also identified evidence that was not consistent with current recommendations on diagnosis, providing information and support, and management strategies for lymphoedema. We asked topic experts whether this evidence would affect current recommendations. Topic experts agreed that the new evidence was considered to be insufficient in volume and the results insufficiently conclusive to impact recommendations in these areas.
We found evidence on management of liver metastases, role of surgical resection of the primary tumour and predictors of treatment response, which were not covered in the guideline. This evidence was considered to be insufficient in volume and the results insufficiently conclusive to consider for inclusion in the guideline at this time.
Related NICE guidance
For any evidence relating to published or ongoing NICE technology appraisals, the guideline surveillance review deferred to the technology appraisal decision. Since publication of NICE guideline CG81, several technology appraisals have published in this area and are included in the NICE Pathway on advanced breast cancer.
We will amend the relevant sections of the guideline to cross-refer to the relevant published NICE technology appraisals. This amendment will include the removal of the footnote in NICE technology appraisal guidance 34.
We will amend the relevant section of the guideline to cross-refer to the published NICE diagnostics guidance related to the diagnosis of advanced breast cancer.
A statement will be added to the guideline noting that this is a clinical area in which new technologies are developed and assessed frequently and for clinicians to refer to the NICE Pathway on advanced breast cancer in conjunction with the guideline.
Overall decision
After considering all the evidence and views of topic experts and stakeholders, we decided that an update is not necessary for this guideline.
See how we made the decision for further information.
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