Recommendations for research
The guideline committee has made the following key recommendations for research.
Key recommendations for research
1 Surgery to the breast
What is the optimum tumour-free margin width after breast-conserving surgery for women with ductal carcinoma in situ (DCIS) and invasive breast cancer? [2018]
For a short explanation of why the committee made the recommendation for research, see the rationale section on surgery to the breast .
Full details of the evidence and the committee's discussion are in evidence review A: surgery to the breast.
2 Adjuvant bisphosphonate therapy
Which groups of people with early and locally advanced breast cancer would benefit from the use of adjuvant bisphosphonates? [2018]
For a short explanation of why the committee made the recommendation for research, see the rationale section on adjuvant bisphosphonate therapy .
Full details of the evidence and the committee's discussion are in evidence review G: adjuvant bisphosphonates.
3 Breast reconstruction
What are the long-term outcomes for breast reconstruction in women having radiotherapy to the chest wall? [2018]
For a short explanation of why the committee made the recommendation for research, see the rationale section on breast reconstruction .
Full details of the evidence and the committee's discussion are in evidence review I: postmastectomy radiotherapy.
4 Neoadjuvant endocrine therapy in premenopausal women
Is neoadjuvant endocrine therapy safe in premenopausal women with early breast cancer? [2018]
For a short explanation of why the committee made the recommendation for research, see the rationale section on neoadjuvant endocrine therapy .
Full details of the evidence and the committee's discussion are in evidence review J: neoadjuvant treatment of early and locally advanced breast cancer.
5 Neoadjuvant endocrine therapy in postmenopausal women
Is there a benefit for neoadjuvant endocrine therapy in postmenopausal women with early breast cancer? [2018]
For a short explanation of why the committee made the recommendation for research, see the rationale section on neoadjuvant endocrine therapy .
Full details of the evidence and the committee's discussion are in evidence review J: neoadjuvant treatment of early and locally advanced breast cancer.
Other recommendations for research
6 Neoadjuvant treatment
What are the indications for postmastectomy radiotherapy after neoadjuvant chemotherapy? [2018]
For a short explanation of why the committee made the recommendation for research, see the rationale section on radiotherapy after neoadjuvant chemotherapy.
Full details of the evidence and the committee's discussion are in evidence review J: neoadjuvant treatment of early and locally advanced breast cancer.
7 Strategies to reduce arm and shoulder problems
What is the most effective and cost-effective way of delivering the intervention (for example, type of physiotherapy or exercise, mode of delivery, number of sessions) to reduce arm and shoulder problems after breast cancer surgery or radiotherapy, and what is the acceptability of the intervention for different groups, such as:
-
women, men, trans people and non-binary people
-
people from minority ethnic family backgrounds
-
people with learning disabilities or cognitive impairment, or physical disabilities, or both
-
neurodiverse people? [2023]
For a short explanation of why the committee made the recommendation for research, see the rationale section on arm and shoulder mobility .
Full details of the evidence and the committee's discussion are in evidence review L: strategies for reducing arm and shoulder problems after breast cancer surgery or radiotherapy.
8 Adherence and satisfaction for interventions to reduce arm and shoulder problems
What is the adherence to, and satisfaction with, different intervention formats (for example, individual, group, virtual, and face to face) to reduce arm and shoulder problems after breast cancer surgery or radiotherapy, and what is the impact of greater adherence on effectiveness for different groups, such as:
-
women, men, trans people and non-binary people
-
people from minority ethnic family backgrounds
-
people with learning disabilities or cognitive impairment, or physical disabilities, or both
-
neurodiverse people? [2023]
For a short explanation of why the committee made the recommendation for research, see the rationale section on arm and shoulder mobility .
Full details of the evidence and the committee's discussion are in evidence review L: strategies for reducing arm and shoulder problems after breast cancer surgery or radiotherapy.
9 Effectiveness of 26 Gy in 5 fractions over 1 week regimen in people receiving breast reconstruction
What is the effectiveness of radiotherapy given in 26 Gy in 5 fractions over 1 week compared with 40 Gy in 15 fractions over 3 weeks in people with early or locally advanced invasive breast cancer who are offered breast reconstruction? [2023]
For a short explanation of why the committee made the recommendation for research, see the rationale section on dose fractionation of external beam radiotherapy .
Full details of the evidence and the committee's discussion are in evidence review M: effectiveness of different external beam hypofractionation radiotherapy regimens in people with early-stage or locally advanced invasive breast cancer.
10 Effectiveness of 26 Gy in 5 fractions over 1 week regimen in people receiving nodal irradiation
What is the effectiveness of radiotherapy given in 26 Gy in 5 fractions over 1 week compared with 40 Gy in 15 fractions over 3 weeks in people with early or locally advanced invasive breast cancer who are also offered nodal irradiation? [2023]
For a short explanation of why the committee made the recommendation for research, see the rationale section on dose fractionation of external beam radiotherapy .
Full details of the evidence and the committee's discussion are in evidence review M: effectiveness of different external beam hypofractionation radiotherapy regimens in people with early-stage or locally advanced invasive breast cancer.
11 Lymphovenous anastomosis
What is the effectiveness of lymphovenous anastomosis during axillary lymph node dissection for reducing the risk of secondary lymphoedema and what is the acceptability of the intervention for different groups, such as:
-
women, men, trans people and non-binary people
-
people from ethnic minority backgrounds
-
people with disabilities. [2025]
12 Vascularised lymph node transfer
What is the effectiveness of vascularised lymph node transfer during axillary lymph node dissection for reducing the risk of secondary lymphoedema, and what is the acceptability of the intervention for different groups, such as:
-
women, men, trans people and non-binary people
-
people from ethnic minority backgrounds
-
people with disabilities. [2025]
For a short explanation of why the committee made the recommendations for research on lymphovenous anastomosis and vascularised lymph node transfer, see the rationale section on lymphoedema: early identification and risk reduction .
Full details of the evidence and the committee's discussion are in evidence review O: non-pharmacological prevention of lymphoedema in people who have, or have had, breast cancer.
13 Lymphoedema core outcomes set
What are the most reliable, valid and clinically relevant outcomes and measures for assessing lymphoedema severity and clinical effectiveness of lymphoedema treatments? [2025]
14 Lymphoedema surgical intervention: lymphovenous anastomosis (LVA) and vascularised lymph node transfer (VLNT).
What is the effectiveness and cost effectiveness of lymphovenous anastomosis (LVA) and vascularised lymph node transfer (VLNT) in the management of breast-cancer-related lymphoedema, and what is the acceptability of the intervention for different groups, such as:
-
women, men, trans people and non-binary people
-
people from ethnic minority backgrounds
-
people with disabilities. [2025]
15 Breast oedema management
What are the most effective interventions for the management of breast oedema for people who have or have had breast cancer, and what is the acceptability of the intervention for different groups, such as:
-
women, men, trans people and non-binary people
-
people from ethnic minority backgrounds
-
people with disabilities. [2025]
For a short explanation of why the committee made the recommendations for research on lymphoedema core outcomes set, lymphoedema surgical intervention and breast oedema management, see the rationale section on lymphoedema management .
Full details of the evidence and the committee's discussion are in evidence review P: non-pharmacological management of lymphoedema in people who have, or have had, breast cancer.