The purpose of this guideline is to provide an evidence-based summary of best practice in the management of early breast cancer in order to promote best clinical practice in relation to the care and management of women with early breast cancer. The recommendations are based on clinical effectiveness and other considerations (including quality of life), but not on an analysis of cost effectiveness or quality of life years gained.
The guideline begins with a description of the context of breast cancer in New Zealand following a summary that includes all recommendations in the guideline (good practice points are found with the recommendations in specific chapters). The remainder of the guideline is then structured to mirror the clinical journey of the woman with early breast cancer, progressing from chapters on general principles of care and staging to chapters on interventions (including breast surgery, radiotherapy, chemotherapy and endocrine therapy) and follow-up. The treatment of women with a diagnosis of ductal carcinoma in situ is addressed in a separate chapter, and a further chapter addresses additional issues for special consideration that the Guideline Development Team (GDT) identified as of importance. Some of these issues were identified during guideline development after the formal systematic reviews had been conducted and where this is the case the relevant sections are based on non-systematic reviews of the evidence and the expert opinion of the GDT.
The major sections within each chapter reflect specific clinical questions (see Chapter 11, General section: methods). Each section includes a summary of the evidence identified that met inclusion criteria and a summary of the findings, and concludes with the recommendations and good practice points developed.