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Breast Neoplasms HELP
Based on 99,967 articles published since 2010
|||| 62 

These are the 99967 published articles about Breast Neoplasms that originated from Worldwide during 2010-2020.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12 · 13 · 14 · 15 · 16 · 17 · 18 · 19 · 20
1 Guideline Medication Use to Reduce Risk of Breast Cancer: US Preventive Services Task Force Recommendation Statement. 2019

Anonymous1931003 / Owens, Douglas K / Davidson, Karina W / Krist, Alex H / Barry, Michael J / Cabana, Michael / Caughey, Aaron B / Doubeni, Chyke A / Epling, John W / Kubik, Martha / Landefeld, C Seth / Mangione, Carol M / Pbert, Lori / Silverstein, Michael / Tseng, Chien-Wen / Wong, John B. ·Veterans Affairs Palo Alto Health Care System, Palo Alto, California. · Stanford University, Stanford, California. · Feinstein Institute for Medical Research at Northwell Health, Manhasset, New York. · Fairfax Family Practice Residency, Fairfax, Virginia. · Virginia Commonwealth University, Richmond. · Harvard Medical School, Boston, Massachusetts. · University of California, San Francisco. · Oregon Health & Science University, Portland. · Mayo Clinic, Rochester, New York. · Virginia Tech Carilion School of Medicine, Roanoke. · Temple University, Philadelphia, Pennsylvania. · University of Alabama at Birmingham. · University of California, Los Angeles. · University of Massachusetts Medical School, Worcester. · Boston University, Boston, Massachusetts. · University of Hawaii, Honolulu. · Pacific Health Research and Education Institute, Honolulu, Hawaii. · Tufts University School of Medicine, Boston, Massachusetts. ·JAMA · Pubmed #31479144.

ABSTRACT: Importance: Breast cancer is the most common nonskin cancer among women in the United States and the second leading cause of cancer death. The median age at diagnosis is 62 years, and an estimated 1 in 8 women will develop breast cancer at some point in their lifetime. African American women are more likely to die of breast cancer compared with women of other races. Objective: To update the 2013 US Preventive Services Task Force (USPSTF) recommendation on medications for risk reduction of primary breast cancer. Evidence Review: The USPSTF reviewed evidence on the accuracy of risk assessment methods to identify women who could benefit from risk-reducing medications for breast cancer, as well as evidence on the effectiveness, adverse effects, and subgroup variations of these medications. The USPSTF reviewed evidence from randomized trials, observational studies, and diagnostic accuracy studies of risk stratification models in women without preexisting breast cancer or ductal carcinoma in situ. Findings: The USPSTF found convincing evidence that risk assessment tools can predict the number of cases of breast cancer expected to develop in a population. However, these risk assessment tools perform modestly at best in discriminating between individual women who will or will not develop breast cancer. The USPSTF found convincing evidence that risk-reducing medications (tamoxifen, raloxifene, or aromatase inhibitors) provide at least a moderate benefit in reducing risk for invasive estrogen receptor-positive breast cancer in postmenopausal women at increased risk for breast cancer. The USPSTF found that the benefits of taking tamoxifen, raloxifene, and aromatase inhibitors to reduce risk for breast cancer are no greater than small in women not at increased risk for the disease. The USPSTF found convincing evidence that tamoxifen and raloxifene and adequate evidence that aromatase inhibitors are associated with small to moderate harms. Overall, the USPSTF determined that the net benefit of taking medications to reduce risk of breast cancer is larger in women who have a greater risk for developing breast cancer. Conclusions and Recommendation: The USPSTF recommends that clinicians offer to prescribe risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, to women who are at increased risk for breast cancer and at low risk for adverse medication effects. (B recommendation) The USPSTF recommends against the routine use of risk-reducing medications, such as tamoxifen, raloxifene, or aromatase inhibitors, in women who are not at increased risk for breast cancer. (D recommendation) This recommendation applies to asymptomatic women 35 years and older, including women with previous benign breast lesions on biopsy (such as atypical ductal or lobular hyperplasia and lobular carcinoma in situ). This recommendation does not apply to women who have a current or previous diagnosis of breast cancer or ductal carcinoma in situ.

2 Guideline The American Brachytherapy Society consensus statement on intraoperative radiation therapy. 2019

Tom, Martin C / Joshi, Nikhil / Vicini, Frank / Chang, Albert J / Hong, Theodore S / Showalter, Timothy N / Chao, Samuel T / Wolden, Suzanne / Wu, Abraham J / Martin, Douglas / Husain, Zain / Badiyan, Shahed N / Kolar, Matthew / Sherertz, Tracy / Mourtada, Firas / Cohen, Gilad N / Shah, Chirag. ·Department of Radiation Oncology, Taussig Cancer Institute, Cleveland, OH. · 21st Century Oncology, Michigan Healthcare Professionals, Farmington Hills, MI. · Department of Radiation Oncology, UCLA, Los Angeles, CA. · Department of Radiation Oncology, Massachusetts General Hospital, Boston, MA. · Department of Radiation Oncology, University of Virginia, Charlottesville, VA. · Departments of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY. · Department of Radiation Oncology, Ohio State University, Columbus, OH. · Department of Therapeutic Radiology, Yale University, New Haven, CT. · Department of Radiation Oncology, Washington University, St. Louis, MO. · Department of Radiation Oncology, Kaiser Capitol Hill, Seattle, WA. · Helen F. Graham Cancer Center & Research Institute, Christiana Care Health System, Newark, DE. · Department Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY. · Department of Radiation Oncology, Taussig Cancer Institute, Cleveland, OH. Electronic address: csshah27@hotmail.com. ·Brachytherapy · Pubmed #31084904.

ABSTRACT: PURPOSE: Although radiation therapy has traditionally been delivered with external beam or brachytherapy, intraoperative radiation therapy (IORT) represents an alternative that may shorten the course of therapy, reduce toxicities, and improve patient satisfaction while potentially lowering the cost of care. At this time, there are limited evidence-based guidelines to assist clinicians with patient selection for IORT. As such, the American Brachytherapy Society presents a consensus statement on the use of IORT. METHODS: Physicians and physicists with expertise in intraoperative radiation created a site-directed guideline for appropriate patient selection and utilization of IORT. RESULTS: Several IORT techniques exist including radionuclide-based high-dose-rate, low-dose-rate, electron, and low-energy electronic. In breast cancer, IORT as monotherapy should only be used on prospective studies. IORT can be considered in the treatment of sarcomas with close/positive margins or recurrent sarcomas. IORT can be considered in conjunction with external beam radiotherapy for retroperitoneal sarcomas. IORT can be considered for colorectal malignancies with concern for positive margins and in the setting of recurrent gynecologic cancers. For thoracic, head and neck, and central nervous system malignancies, utilization of IORT should be evaluated on a case-by-case basis. CONCLUSIONS: The present guidelines provide clinicians with a summary of current data regarding IORT by treatment site and guidelines for the appropriate patient selection and safe utilization of the technique. High-dose-rate, low-dose-rate brachytherapy methods are appropriate when IORT is to be delivered as are electron and low-energy based on the clinical scenario.

3 Guideline Screening for Breast Cancer in Average-Risk Women: A Guidance Statement From the American College of Physicians. 2019

Qaseem, Amir / Lin, Jennifer S / Mustafa, Reem A / Horwitch, Carrie A / Wilt, Timothy J / Anonymous1701060. ·American College of Physicians, Philadelphia, Pennsylvania (A.Q.). · Kaiser Permanente Northwest, Portland, Oregon (J.S.L.). · University of Kansas Medical Center, Kansas City, Kansas (R.A.M.). · Virginia Mason Medical Center, Seattle, Washington (C.A.H.). · Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota (T.J.W.). ·Ann Intern Med · Pubmed #30959525.

ABSTRACT: Description: The purpose of this guidance statement is to provide advice to clinicians on breast cancer screening in average-risk women based on a review of existing guidelines and the evidence they include. Methods: This guidance statement is derived from an appraisal of selected guidelines from around the world that address breast cancer screening, as well as their included evidence. All national guidelines published in English between 1 January 2013 and 15 November 2017 in the National Guideline Clearinghouse or Guidelines International Network library were included. In addition, the authors selected other guidelines commonly used in clinical practice. Web sites associated with all selected guidelines were checked for updates on 10 December 2018. The AGREE II (Appraisal of Guidelines for Research and Evaluation II) instrument was used to evaluate the quality of guidelines. Target Audience and Patient Population: The target audience is all clinicians, and the target patient population is all asymptomatic women with average risk for breast cancer. Guidance Statement 1: In average-risk women aged 40 to 49 years, clinicians should discuss whether to screen for breast cancer with mammography before age 50 years. Discussion should include the potential benefits and harms and a woman's preferences. The potential harms outweigh the benefits in most women aged 40 to 49 years. Guidance Statement 2: In average-risk women aged 50 to 74 years, clinicians should offer screening for breast cancer with biennial mammography. Guidance Statement 3: In average-risk women aged 75 years or older or in women with a life expectancy of 10 years or less, clinicians should discontinue screening for breast cancer. Guidance Statement 4: In average-risk women of all ages, clinicians should not use clinical breast examination to screen for breast cancer.

4 Guideline British Menopause Society consensus statement on the management of estrogen deficiency symptoms, arthralgia and menopause diagnosis in women treated for early breast cancer. 2019

Marsden, Jo / Marsh, Mike / Rigg, Anne / Anonymous1180980. ·1 King's College Hospital, London, UK. · 2 Guy's and St Thomas' Hospital, London, UK. ·Post Reprod Health · Pubmed #30776968.

ABSTRACT: This guidance document by the British Menopause Society provides an overview of the management of women experiencing estrogen deficiency symptoms and arthralgia following a breast cancer diagnosis. It is now recommended that breast cancer patients are referred to health care professionals with an expertise in menopause for the management of such symptoms, which in turn often involves liaison with patients' breast cancer teams. However, as many women initially present to primary health care professionals for advice, this statement is aimed to support the latter in such consultations by providing information about symptom aetiology, current management strategies and controversies and identifying useful practice points.

5 Guideline The American Brachytherapy Society consensus statement for electronic brachytherapy. 2019

Tom, Martin C / Hepel, Jaroslaw T / Patel, Rakesh / Kamrava, Mitchell / Badiyan, Shahed N / Cohen, Gil'ad N / Shah, Chirag. ·Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH. · Department of Radiation Oncology, Brown University, Providence, RI; Department of Radiation Oncology, Tufts University School of Medicine, Boston, MA. · Department of Radiation Oncology, Sutter Health, Los Gatos, CA. · Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, CA. · Department of Radiation Oncology, Washington University, St Louis, MO. · Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY. · Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic Foundation, Cleveland, OH. Electronic address: csshah27@hotmail.com. ·Brachytherapy · Pubmed #30497939.

ABSTRACT: PURPOSE: Brachytherapy is utilized in the treatment of many different malignancies; although traditionally performed with low-dose-rate or high-dose-rate techniques, more recently, electronic brachytherapy (EB) has emerged as a potential alternative. At this time, there are no evidence-based guidelines to assist clinicians in patient selection for EB and concerns exits regarding differences in dosimetry as compared to traditional brachytherapy techniques. As such, the American Brachytherapy Society appointed a group of physicians and physicists to create a consensus statement regarding the use of EB. METHODS AND MATERIALS: Physicians and physicists with expertise in brachytherapy created a site-directed consensus statement for appropriate patient selection and utilization of EB based on a literature search and clinical experience. RESULTS: EB has been utilized to deliver accelerated partial breast irradiation with, thus far acceptable local control and toxicity rates including a randomized trial that used EB to deliver intraoperative radiotherapy; however, prospective data with large patient numbers and long-term follow up are needed. Increasing numbers of patients have been treated with EB for nonmelanomatous skin cancers; although, preliminary data are promising, there is a lack of data comparing EB to traditional radiotherapy techniques as well as a lack of long-term follow up. For treatment of the vaginal cuff with EB, small retrospective studies have been reported without long-term follow up. CONCLUSIONS: In light of a randomized trial in breast showing higher rates of recurrence and the lack of prospective data with mature follow up with other sites, as well as concerns regarding dosimetry, it is not recommended that EB be utilized for accelerated partial breast irradiation, nonmelanomatous skin cancers, or vaginal cuff brachytherapy outside prospective clinical trials at this time.

6 Guideline Adjuvant Endocrine Therapy for Women With Hormone Receptor-Positive Breast Cancer: ASCO Clinical Practice Guideline Focused Update. 2019

Burstein, Harold J / Lacchetti, Christina / Anderson, Holly / Buchholz, Thomas A / Davidson, Nancy E / Gelmon, Karen A / Giordano, Sharon H / Hudis, Clifford A / Solky, Alexander J / Stearns, Vered / Winer, Eric P / Griggs, Jennifer J. ·1 Dana-Farber Cancer Institute, Boston, MA. · 2 American Society of Clinical Oncology, Alexandria, VA. · 3 Breast Cancer Coalition of Rochester, Rochester, NY. · 4 MD Anderson Cancer Center, Houston, TX. · 5 University of Pittsburgh Cancer Institute and UPMC Cancer Center, Pittsburgh, PA. · 6 BC Cancer Agency, Vancouver, British Columbia, Canada. · 7 Memorial Sloan Kettering Cancer Center, New York, NY. · 8 Interlakes Oncology and Hematology PC, Rochester, NY. · 9 Johns Hopkins School of Medicine, Baltimore, MD. · 10 University of Michigan, Ann Arbor, MI. ·J Clin Oncol · Pubmed #30452337.

ABSTRACT: PURPOSE: To update the ASCO clinical practice guideline on adjuvant endocrine therapy based on emerging data about the optimal duration of aromatase inhibitor (AI) treatment. METHODS: ASCO conducted a systematic review of randomized clinical trials from 2012 to 2018. Guideline recommendations were based on the Panel's review of the evidence from six trials. RESULTS: The six included studies of AI treatment beyond 5 years of therapy demonstrated that extension of AI treatment was not associated with an overall survival advantage but was significantly associated with lower risks of breast cancer recurrence and contralateral breast cancer compared with placebo. Bone-related toxic effects were more common with extended AI treatment. RECOMMENDATIONS: The Panel recommends that women with node-positive breast cancer receive extended therapy, including an AI, for up to a total of 10 years of adjuvant endocrine treatment. Many women with node-negative breast cancer should consider extended therapy for up to a total of 10 years of adjuvant endocrine treatment based on considerations of recurrence risk using established prognostic factors. The Panel noted that the benefits in absolute risk of reduction were modest and that, for lower-risk node-negative or limited node-positive cancers, an individualized approach to treatment duration that is based on considerations of risk reduction and tolerability was appropriate. A substantial portion of the benefit for extended adjuvant AI therapy was derived from prevention of second breast cancers. Shared decision making between clinicians and patients is appropriate for decisions about extended adjuvant endocrine treatment, including discussions about the absolute benefits in the reduction of breast cancer recurrence, the prevention of second breast cancers, and the impact of adverse effects of treatment. Additional information can be found at www.asco.org/breast-cancer-guidelines .

7 Guideline Recommendations for hypofractionated whole-breast irradiation. 2018

Anonymous6790976 / Freitas, Nilceana Maya Aires / Rosa, Arthur Accioly / Marta, Gustavo Nader / Hanna, Samir Abdalla / Hanriot, Rodrigo de Morais / Borges, Allisson Bruno Barcelos / Gondim, Guilherme Rocha Melo / Pellizzon, Antonio Cassio Assis / Veras, Igor Moreira / Almeida Júnior, Wilson José de / Fernandez, Claudia Regina Scaramello Hadlich Willis / Batalha Filho, Eronides Salustiano / Castilho, Marcus Simões / Kuhnen, Felipe Quintino / Najas, Rosa Maria Xavier Faria / Affonso Júnior, Renato José / Leite, André Campana Correia / Ribeiro, Homero Lavieri Martins / Freitas Junior, Ruffo / Oliveira, Harley Francisco de. ·. Radiotherapy Department of the Araújo Jorge Hospital of the Góias State Association Against Cancer, Goiânia/GO, Brasil. · . Radiotherapy Department of the Bahia State Portuguese Hospital, Salvador/BA and President of the Brazilian Radiotherapy Society (SBRT), São Paulo/SP, Brasil. · . Department of Radiology and Oncology, Division of Radiation Oncology, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil. · . Department of Radiation Oncology, Hospital Sírio-Libanês, São Paulo, Brazil. · . Radiotherapy Department of the Oswaldo Cruz German Hospital, São Paulo/SP, Brasil. · . Radiotherapy Department, Barretos Cancer Hospital, Barretos/SP, Brasil. · . Radiotherapy Department of the AC Camargo Hospital, São Paulo/SP, Brasil. · . Radiotherapy Department of the Regional Integrated Oncology Center, Fortaleza-CE. · . Radiotherapy Department of the Moinhos dos Ventos Hospital, Porto Alegre-RS. · . Radiotherapy Service of the José Alencar Gomes da Silva National Cancer Institute, Rio de Janeiro/RJ, Brasil. · . Radiotherapy Department of the Brasilia State University Hospital and representative of the Ministry of Health, Brasíli/DF, Brasil. · . Radiotherapy Department of the Felicio Rocho Hospital, Belo Horizonte/MG, Brasil. · . Radiotherapy Department of the Charity Hospital of Florianópolis, Florianópolis/SC, Brasil. · . Radiotherapy Department of the Rio Grande do Norte State League Against Cancer, Natal/RN, Brasil. · . Department of Radiation Oncology, Fundação Centro de Controle de Oncologia Manaus- AM. · . Mastology Program of the Goias Federal University, Goiânia-GO and representative of the Brazilian Mastology Society, São Paulo/SP, Brasil. · . Centro de Tratamento em Radio-Oncologia (CTR) and Ribeirão Preto Medical School (FMRP) da Universidade de São Paulo (USP) - Ribeirão Preto/SP; Hospital Márcio Cunha (HMC) - Ipatinga/MG, Brasil. ·Rev Assoc Med Bras (1992) · Pubmed #30672995.

ABSTRACT: This recommendation consensus for hypofractionated whole-breast radiotherapy (RT) was organized by the Brazilian Society of Radiotherapy (SBRT) considering the optimal scenario for indication and safety in the technology applied. All controversies and contraindication matters (hypofractionated RT in patients who underwent chemotherapy [CT], hypofractionated RT in lymphatic drainage, hypofractionated RT after mastectomy with or without immediate reconstruction, boost during surgery, hypofractionated RT in patients under 50 years old, hypofractionated RT in large breasts, hypofractionated RT in histology of carcinoma in situ [DCIS]) was discussed during a meeting in person, and a consensus was reached when there was an agreement of at least 75% among panel members. The grade for recommendation was also suggested according to the level of scientific evidence available, qualified as weak, medium, or strong. Thus, this consensus will aid Brazilian radiotherapy experts regarding indications and particularities of this technique as a viable and safe alternative for the national reality.

8 Guideline Recommendations on screening for breast cancer in women aged 40-74 years who are not at increased risk for breast cancer. 2018

Klarenbach, Scott / Sims-Jones, Nicki / Lewin, Gabriela / Singh, Harminder / Thériault, Guylène / Tonelli, Marcello / Doull, Marion / Courage, Susan / Garcia, Alejandra Jaramillo / Thombs, Brett D / Anonymous851067. ·Department of Medicine (Klarenbach), University of Alberta, Edmonton, Alta. · Department of Family Medicine (Lewin), University of Ottawa, Ottawa, Ont. · Departments of Internal Medicine and Community Health Sciences (Singh), University of Manitoba, Winnipeg, Man. · Department of Family Medicine (Thériault), McGill University, Montréal, Que. · Department of Medicine (Tonelli), University of Calgary, Calgary, Alta. · Public Health Agency of Canada (Sims-Jones, Courage, Doull, Jaramillo Garcia), Ottawa, Ont. · Department of Psychiatry (Thombs), McGill University, Montréal, Que. ·CMAJ · Pubmed #30530611.

ABSTRACT: -- No abstract --

9 Guideline No. 366-Gynaecologic Management of Hereditary Breast and Ovarian Cancer. 2018

Jacobson, Michelle / Bernardini, Marcus / Sobel, Mara L / Kim, Raymond H / McCuaig, Jeanna / Allen, Lisa. ·Toronto, ON. ·J Obstet Gynaecol Can · Pubmed #30473125.

ABSTRACT: OBJECTIVE: This Committee Opinion outlines the gynaecologic management recommendations for women diagnosed with hereditary breast and ovarian cancer syndrome (HBOC) with respect to screening, contraception, chemoprophylaxis, fertility considerations, risk-reducing surgery, and post-oophorectomy care. INTENDED USERS: This Committee Opinion is designed for gynaecologic oncologists, general gynaecologists, family physicians, genetic counsellors, registered nurses, nurse practitioners, residents, and health care providers. TARGET POPULATION: Adult women (18 years and older) with a pathogenic germline variant in the BRCA1, BRCA2, and other ovarian cancer-associated genes. EVIDENCE: While reviewing evidence, databases searched include Medline, Cochrane, and PubMed. Medical Subject Heading search terms used include BRCA AND gynaecology management, hormone replacement therapy, risk reduction, chemoprophylaxis, fertility from 01/2010 and 10/2017. Literature search was begun 07/2017 and finalized 10/2017. In total 183 studies were identified, and 101 were used. VALIDATION METHODS: The content and recommendations were drafted and agreed upon by the principal authors. The Board of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication. The quality of evidence was rated using the criteria described in the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology framework (Table 1). The interpretation of strong and conditional (weak) recommendations is described in Table 2. The Summary of Findings is available upon request. BENEFITS, HARMS, AND COSTS: We may expect a risk reduction of up to 90% in women predisposed to HBOC who undergo risk-reducing bilateral salpingo-oophorectomy. The harms of iatrogenic premature menopause are offset by the benefits of risk reduction. By minimizing potential tubal/ovarian/peritoneal cancers, we can expect savings to the health care system. GUIDELINE UPDATE: Evidence will be reviewed 5 years after publication to decide whether all or part of the opinion should be updated. However, if important new evidence is published prior to the 5-year cycle, the review process may be accelerated for a more rapid update of some recommendations. SPONSORS: This guideline was developed with resources funded by the Society of Obstetricians and Gynaecologists of Canada.

10 Guideline Breast Cancer Screening and Diagnosis, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology. 2018

Bevers, Therese B / Helvie, Mark / Bonaccio, Ermelinda / Calhoun, Kristine E / Daly, Mary B / Farrar, William B / Garber, Judy E / Gray, Richard / Greenberg, Caprice C / Greenup, Rachel / Hansen, Nora M / Harris, Randall E / Heerdt, Alexandra S / Helsten, Teresa / Hodgkiss, Linda / Hoyt, Tamarya L / Huff, John G / Jacobs, Lisa / Lehman, Constance Dobbins / Monsees, Barbara / Niell, Bethany L / Parker, Catherine C / Pearlman, Mark / Philpotts, Liane / Shepardson, Laura B / Smith, Mary Lou / Stein, Matthew / Tumyan, Lusine / Williams, Cheryl / Bergman, Mary Anne / Kumar, Rashmi. · ·J Natl Compr Canc Netw · Pubmed #30442736.

ABSTRACT: The NCCN Guidelines for Breast Cancer Screening and Diagnosis have been developed to facilitate clinical decision making. This manuscript discusses the diagnostic evaluation of individuals with suspected breast cancer due to either abnormal imaging and/or physical findings. For breast cancer screening recommendations, please see the full guidelines on NCCN.org.

11 Guideline ACR Appropriateness Criteria 2018

Anonymous7190967 / Niell, Bethany L / Lourenco, Ana P / Moy, Linda / Baron, Paul / Didwania, Aarati D / diFlorio-Alexander, Roberta M / Heller, Samantha L / Holbrook, Anna I / Le-Petross, Huong T / Lewin, Alana A / Mehta, Tejas S / Slanetz, Priscilla J / Stuckey, Ashley R / Tuscano, Daymen S / Ulaner, Gary A / Vincoff, Nina S / Weinstein, Susan P / Newell, Mary S. ·H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. Electronic address: bethany.niell@gmail.com. · Alpert Medical School of Brown University, Providence, Rhode Island. · Panel Vice-Chair, NYU Clinical Cancer Center, New York, New York. · Roper St Francis Physician Partners Breast Surgery, Charleston, South Carolina; American College of Surgeons. · Northwestern University Feinberg School of Medicine, Chicago, Illinois; American College of Physicians. · Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. · New York University School of Medicine, New York, New York. · Emory University Hospital, Atlanta, Georgia. · The University of Texas MD Anderson Cancer Center, Houston, Texas. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · Women and Infants Hospital, Providence, Rhode Island; American Congress of Obstetricians and Gynecologists. · Mecklenburg Radiology Associates, Charlotte, North Carolina. · Memorial Sloan Kettering Cancer Center, New York, New York. · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York. · Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania. · Panel Chair, Emory University Hospital, Atlanta, Georgia. ·J Am Coll Radiol · Pubmed #30392600.

ABSTRACT: Although the majority of male breast problems are benign with gynecomastia as the most common etiology, men with breast symptoms and their referring providers are typically concerned about whether or not it is due to breast cancer. If the differentiation between benign disease and breast cancer cannot be made on the basis of clinical findings, or if the clinical presentation is suspicious, imaging is indicated. The panel recommends the following approach to breast imaging in symptomatic men. In men with clinical findings consistent with gynecomastia or pseudogynecomastia, no imaging is routinely recommended. If an indeterminate breast mass is identified, the initial recommended imaging study is ultrasound in men younger than age 25, and mammography or digital breast tomosynthesis in men age 25 and older. If physical examination is suspicious for a male breast cancer, mammography or digital breast tomosynthesis is recommended irrespective of patient age. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

12 Guideline ACR Appropriateness Criteria 2018

Anonymous7150967 / Holbrook, Anna I / Moy, Linda / Akin, Esma A / Baron, Paul / Didwania, Aarati D / Heller, Samantha L / Le-Petross, Huong T / Lewin, Alana A / Lourenco, Ana P / Mehta, Tejas S / Niell, Bethany L / Slanetz, Priscilla J / Stuckey, Ashley R / Tuscano, Daymen S / Vincoff, Nina S / Weinstein, Susan P / Newell, Mary S. ·Emory University Hospital, Atlanta, Georgia. Electronic address: anna.holbrook@emoryhealthcare.org. · Panel Vice-Chair, NYU Clinical Cancer Center, New York, New York. · George Washington University Hospital, Washington, District of Columbia. · Roper St. Francis Physician Partners Breast Surgery, Charleston, South Carolina; American College of Surgeons. · Northwestern University Feinberg School of Medicine, Chicago, Illinois; American College of Physicians. · New York University School of Medicine, New York, New York. · The University of Texas MD Anderson Cancer Center, Houston, Texas. · Alpert Medical School of Brown University, Providence, Rhode Island. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. · Women and Infants Hospital, Providence, Rhode Island; American Congress of Obstetricians and Gynecologists. · Mecklenburg Radiology Associates, Charlotte, North Carolina. · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York. · Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania. · Panel Chair, Emory University Hospital, Atlanta, Georgia. ·J Am Coll Radiol · Pubmed #30392596.

ABSTRACT: Breast pain is a common complaint. However, in the absence any accompanying suspicious clinical finding (eg, lump or nipple discharge), the association with malignancy is very low (0%-3.0%). When malignancy-related, breast pain tends to be focal (less than one quadrant) and persistent. Pain that is clinically insignificant (nonfocal [greater than one quadrant], diffuse, or cyclical) requires no imaging beyond what is recommended for screening. In cases of pain that is clinically significant (focal and noncyclical), imaging with mammography, digital breast tomosynthesis (DBT), and ultrasound are appropriate, depending on the patient's age. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

13 Guideline ACR Appropriateness Criteria 2018

Anonymous7140967 / diFlorio-Alexander, Roberta M / Slanetz, Priscilla J / Moy, Linda / Baron, Paul / Didwania, Aarati D / Heller, Samantha L / Holbrook, Anna I / Lewin, Alana A / Lourenco, Ana P / Mehta, Tejas S / Niell, Bethany L / Stuckey, Ashley R / Tuscano, Daymen S / Vincoff, Nina S / Weinstein, Susan P / Newell, Mary S. ·Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire. Electronic address: rmda@hitchcock.org. · Beth Israel Deaconess Medical Center, Boston, Massachusetts. · Panel Vice-Chair, NYU Clinical Cancer Center, New York, New York. · Roper St Francis Physician Partners Breast Surgery, Charleston, South Carolina; American College of Surgeons. · Northwestern University Feinberg School of Medicine, Chicago, Illinois; American College of Physicians. · New York University School of Medicine, New York, New York. · Emory University Hospital, Atlanta, Georgia. · Alpert Medical School of Brown University, Providence, Rhode Island. · H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida. · Women and Infants Hospital, Providence, Rhode Island; American Congress of Obstetricians and Gynecologists. · Mecklenburg Radiology Associates, Charlotte, North Carolina. · Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Manhasset, New York. · Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania. · Panel Chair, Emory University Hospital, Atlanta, Georgia. ·J Am Coll Radiol · Pubmed #30392595.

ABSTRACT: Breast imaging during pregnancy and lactation is challenging due to unique physiologic and structural breast changes that increase the difficulty of clinical and radiological evaluation. Pregnancy-associated breast cancer (PABC) is increasing as more women delay child bearing into the fourth decade of life, and imaging of clinical symptoms should not be delayed. PABC may present as a palpable lump, nipple discharge, diffuse breast enlargement, focal pain, or milk rejection. Breast imaging during lactation is very similar to breast imaging in women who are not breast feeding. However, breast imaging during pregnancy is modified to balance both maternal and fetal well-being; and there is a limited role for advanced breast imaging techniques in pregnant women. Mammography is safe during pregnancy and breast cancer screening should be tailored to patient age and breast cancer risk. Diagnostic breast imaging during pregnancy should be obtained to evaluate clinical symptoms and for loco-regional staging of newly diagnosed PABC. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.

14 Guideline [Contraception and cancer: CNGOF Contraception Guidelines]. 2018

Pragout, D / Laurence, V / Baffet, H / Raccah-Tebeka, B / Rousset-Jablonski, C. ·Service de gynécologie obstétrique, unité d'orthogénie, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France. · Département d'oncologie médicale, Institut Curie, 26, rue d'Ulm, 75005 Paris, France. · Service de gynécologie médicale, orthogénie et médecine du couple, hôpital Jeanne-de-Flandre, CHRU de Lille, avenue Eugène-Avinée, 59037 Lille cedex, France. · Service de gynécologie-obstétrique, hôpital Robert-Debré, AP-HP, 75019 Paris, France. · Département de chirurgie, centre de lutte contre le cancer Léon Bérard, 28, rue Laënnec, 69008 Lyon, France; Service de chirurgie gynécologique et oncologique - obstétrique, centre hospitalier Lyon Sud, 165, chemin du grand Revoyet, 69310 Pierre Bénite, France. Electronic address: christine.rousset-jablonski@lyon.unicancer.fr. ·Gynecol Obstet Fertil Senol · Pubmed #30385358.

ABSTRACT: OBJECTIVES: To synthesize knowledge on cancer risks related to hormonal contraception and to propose recommendations on contraception during treatment and after cancer. METHODS: A systematic review of the literature about hormonal contraception and cancer was conducted on PubMed/Medline and the Cochrane Library. RESULTS: Overall, there is no increase in cancer (all types together) incidence or mortality among hormonal contraceptive users. Estroprogestin combined contraceptive use is associated with an increased risk of breast cancer (during use), and with a reduced risk of endometrial, ovarian, lymphatic or hematopoietic cancers that persist after discontinuation, and a decreased risk of colorectal cancer. Information on cancer risk is part of the systematic information given to patients wishing contraception. However, these data will not influence its prescription, considering the positive risk/benefit balance in women without specific cancer risk factor. Contraception is required during and after cancer treatment in every non-menopausal woman at cancer diagnosis. Specific thromboembolic, immunologic or vomiting risks due to the oncological context should be taken into account before the contraceptive choice. All hormonal contraceptives are contra-indicated after breast cancer, regardless of the delay since treatment, hormone receptor status and histological subtype. There is no data in the literature to limit hormonal or non-hormonal contraceptive use after colorectal or thyroid cancer. There was insufficient data in the literature to propose recommendations on contraceptive choice after cervical cancer, melanoma, lung cancer, tumor of the central nervous system, or after thoracic irradiation. If an emergency contraception is needed in a woman previously treated for a hormone-sensitive cancer, a non-hormonal copper intrauterine device should be preferred. CONCLUSIONS: Information on cancer risk is part of the patient's information but does not influence the prescription of contraception in the absence of any specific risk factor. Contraception should be proposed in every woman treated or previously treated for cancer. The whole context should be taken into account to choose a tailored contraception.

15 Guideline [The French Genetic and Cancer Consortium guidelines for multigene panel analysis in hereditary breast and ovarian cancer predisposition]. 2018

Moretta, Jessica / Berthet, Pascaline / Bonadona, Valérie / Caron, Olivier / Cohen-Haguenauer, Odile / Colas, Chrystelle / Corsini, Carole / Cusin, Véronica / De Pauw, Antoine / Delnatte, Capucine / Dussart, Sophie / Jamain, Christophe / Longy, Michel / Luporsi, Elisabeth / Maugard, Christine / Nguyen, Tan Dat / Pujol, Pascal / Vaur, Dominique / Andrieu, Nadine / Lasset, Christine / Noguès, Catherine / Anonymous4350963. ·Institut Paoli-Calmettes, oncogénétique clinique, département d'anticipation et de suivi des cancers, 232, boulevard Sainte-Marguerite, 13009 Marseille, France. Electronic address: morettaj@ipc.unicancer.fr. · Centre François-Baclesse, oncogénétique clinique, département de biopathologie, 14000 Caen, France. · Centre Léon-Berard, unité clinique d'oncologie génétique, 69008 Lyon, France; Université Lyon 1, CNRS, LBBE UMR 5558, 69622 Villeurbanne, France. · Gustave-Roussy hôpital universitaire, département de médecine, 94800 Villejuif, France. · GH Saint-Louis-Lariboisière-Fernand-Widal, oncogénétique, 75010 Paris, France. · Institut Curie, oncogénétique, 75005 Paris, France. · CHRU de Montpellier, hôpital Arnaud de Villeneuve, service d'oncogénétique, 34090 Montpellier, France. · Hôpital Pitié-Salpêtrière-Charles-Foix, service de génétique, 75013 Paris, France. · ICO-Centre René-Gauducheau, unité d'oncogénétique, 44800 Nantes, France. · Centre Léon-Berard, unité clinique d'oncologie génétique, 69008 Lyon, France. · Unicancer, 75654 Paris France. · Institut Bergonié, oncogénétique, Inserm U 1218, 33000 Bordeaux, France. · CHR de Metz Thionville, oncogénétique, 57100 Metz, France. · CHU de Strasbourg, oncogénétique clinique, oncogénétique moléculaire, évaluation familiale et suivi, laboratoire d'oncobiologie, 67000 Strasbourg, France. · Institut Jean-Godinot, oncogénétique, 51100 Reims, France. · Centre François-Baclesse, laboratoire de biologie et de génétique du cancer, 14000 Caen, France. · Inserm, U900, Institut Curie, PSL Research University, Mines ParisTech, 75005 Paris, France. · Université Lyon 1, CNRS, LBBE UMR 5558, 69622 Villeurbanne, France; Centre Léon Bérard, département de santé publique, unité de prévention et épidémiologie génétique, 69008 Lyon, France. · Institut Paoli-Calmettes, oncogénétique clinique, département d'anticipation et de suivi des cancers, 232, boulevard Sainte-Marguerite, 13009 Marseille, France; Aix-Marseille université, Inserm, IRD, SESSTIM, 13000 Marseille, France. ·Bull Cancer · Pubmed #30268633.

ABSTRACT: INTRODUCTION: Next generation sequencing allows the simultaneous analysis of large panel of genes for families or individuals with a strong suspicion of hereditary breast and/or ovarian cancer (HBOC). Because of lack of guidelines, several panels of genes potentially involved in HBOC were designed, with large disparities not only in their composition but also in medical care offered to mutation carriers. Then, homogenization in practices is needed. METHODS: The French Genetic and Cancer Group (GGC) - Unicancer conducted an exhaustive bibliographic work on 18 genes of interest. Only publications with unbiased risk estimates were retained. RESULTS: The expertise of each 18 genes was based on clinical utility criteria, i.e. a relative risk of cancer of 4 and more, available medical tools for screening and prevention of mutation carriers, and pre-symptomatic genetic tests for relatives. Finally, 13 genes were selected to be included in a HBOC diagnosis gene panel: BRCA1, BRCA2, PALB2, TP53, CDH1, PTEN, RAD51C, RAD51D, MLH1, MSH2, MSH6, PMS2, EPCAM. The reasons for excluding NBN, RAD51B, CHEK2, STK11, ATM, BARD1, BRIP1 from the HBOC diagnosis panel are presented. Screening, prevention and genetic counselling guidelines were detailed for each of the 18 genes. DISCUSSION: Due to the rapid increase in knowledge, the GGC has planned a yearly update of the bibliography to take into account new findings. Furthermore, genetic-epidemiological studies are being initiated to better estimate the cancer risk associated with genes which are not yet included in the HBOC diagnosis panel.

16 Guideline 4th ESO-ESMO International Consensus Guidelines for Advanced Breast Cancer (ABC 4)†. 2018

Cardoso, F / Senkus, E / Costa, A / Papadopoulos, E / Aapro, M / André, F / Harbeck, N / Aguilar Lopez, B / Barrios, C H / Bergh, J / Biganzoli, L / Boers-Doets, C B / Cardoso, M J / Carey, L A / Cortés, J / Curigliano, G / Diéras, V / El Saghir, N S / Eniu, A / Fallowfield, L / Francis, P A / Gelmon, K / Johnston, S R D / Kaufman, B / Koppikar, S / Krop, I E / Mayer, M / Nakigudde, G / Offersen, B V / Ohno, S / Pagani, O / Paluch-Shimon, S / Penault-Llorca, F / Prat, A / Rugo, H S / Sledge, G W / Spence, D / Thomssen, C / Vorobiof, D A / Xu, B / Norton, L / Winer, E P. ·European School of Oncology (ESO), European Society for Medical Oncology (ESMO) and Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation, Lisbon, Portugal. · European Society for Medical Oncology (ESMO) and Department of Oncology and Radiotherapy, Medical University of Gdansk, Gdansk, Poland. · European School of Oncology, Milan, Italy. · Europa Donna Cyprus, Nicosia, Cyprus. · Oncology Department, Clinique de Genolier, Genolier, Switzerland. · Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France. · Breast Centre, Department of Obstetrics and Gynaecology, University of Munich (LMU), Munich, Germany. · Direction Office, ULACCAM (Union Latinoamericana Contra el Cáncer de la Mujer), Mexico DF, Mexico. · Department of Oncology, PURCS School of Medicine, Porto Alegre, Brazil. · Department of Oncology-Pathology, Karolinska Institute & University Hospital, Stockholm, Sweden. · European Society of Breast Cancer Specialists (EUSOMA) and Department of Medical Oncology, Nuovo Ospedale di Prato - Istituto Toscano Tumori, Prato, Italy. · CB Boers Organization, Wormer, The Netherlands. · Breast Unit, Champalimaud Clinical Center/Champalimaud Foundation and Nova Medical School, Lisbon, Portugal. · Department of Hematology and Oncology, UNC Lineberger Comprehensive Cancer Center, Chapel Hill, USA. · Department of Oncology, Vall d' Hebron University, Barcelona, Spain. · Division of Early Drug Development, Department of Oncology and Hemato-Oncology, European Institute of Oncology, University of Milano, Milano, Italy. · Gynaecology and Breast Department, Centre Eugène Marquis, Rennes, France. · Breast Center of Excellence, American University of Beirut Medical Center, Beirut, Lebanon. · Breast Cancer Department, Cancer Institute Ion Chiricuta, Cluj-Napoca, Romania. · SHORE-C, Brighton & Sussex Medical School, University of Sussex, Brighton, UK. · Division of Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia. · Medical Oncology Department, BC Cancer Agency, Vancouver, Canada. · Department of Medicine, The Royal Marsden, Sutton, UK. · Department of Oncology, Sheba Medical Center, Ramat Gan, Israel. · Department of Medical Oncology, Bombay Hospital Institute of Medical Sciences, Mumbai, India. · Breast Oncology Center Dana-Farber Cancer Institute, Boston, USA. · Advanced BC.org, New York, USA. · Advocacy Department, UWOCASO (Uganda Women's Cancer Support Organization), Kampala, Uganda. · European Society of Radiation Oncology (ESTRO) and Department of Experimental Clinical Oncology & Department of Oncology, Aarhus University Hospital, Aarhus, Denmark. · Cancer Institute Hospital, Breast Oncology Centre, Tokyo, Japan. · Institute of Oncology of Southern Switzerland, Geneva University Hospitals, Swiss Group for Clinical Cancer Research (SAKK), International Breast Cancer Study Group (IBCSG), Bellinzona, Switzerland. · Oncology Institute, Shaare Zedek Medical Centre, Jerusalem, Israel. · Department of Pathology, Centre Jean Perrin, Clermont-Ferrand Cedex, France. · IDIBAPS (Institut d'Investigacions Biomèdiques August Pi iSunyer), Hospital Clínic of Barcelona, Translational Genomics and Targeted Therapeutics in Solid Tumor, Barcelona, Spain. · Breast Oncology Clinical Trials Education, UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, USA. · Oncology Division, Stanford University Medical Center, Stanford, USA. · Policy Department, Breast Cancer Network Australia, Camberwell, VIC, Australia. · Department of Gynaecology, Martin Luther University Halle-Wittenburg, Halle, Germany. · Oncology Department, Sandton Oncology Centre, Johannesburg, South Africa. · Department of Medical Oncology, Cancer Hospital Chinese Academy of Medical Sciences, Beijing, China. · Breast Cancer Medicine Service, Memorial Sloan-Kettering Cancer Center, New York. · Dana-Farber Cancer Institute, Susan Smith Center for Women's Cancers, Breast Oncology Center, Boston, USA. ·Ann Oncol · Pubmed #30032243.

ABSTRACT: -- No abstract --

17 Guideline Recommendations on Disease Management for Patients With Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer and Brain Metastases: ASCO Clinical Practice Guideline Update Summary. 2018

Ramakrishna, Naren / Temin, Sarah / Lin, Nancy U. ·University of Florida Health Cancer Center at Orlando Health, Orlando, FL; American Society of Clinical Oncology, Alexandria, VA; and Dana-Farber Cancer Institute, Boston, MA. ·J Oncol Pract · Pubmed #29989840.

ABSTRACT: -- No abstract --

18 Guideline Systemic Therapy for Patients With Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: ASCO Clinical Practice Guideline Update Summary. 2018

Giordano, Sharon H / Temin, Sarah / Davidson, Nancy E. ·The University of Texas MD Anderson Cancer Center, Houston, TX; American Society of Clinical Oncology, Alexandria, VA; Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA. ·J Oncol Pract · Pubmed #29989839.

ABSTRACT: -- No abstract --

19 Guideline Guidelines for early detection of breast cancer in Brazil. II - New national recommendations, main evidence, and controversies. 2018

Migowski, Arn / Silva, Gulnar Azevedo E / Dias, Maria Beatriz Kneipp / Diz, Maria Del Pilar Estevez / Sant'Ana, Denise Rangel / Nadanovsky, Paulo. ·Instituto Nacional de Câncer José Alencar Gomes da Silva, Rio de Janeiro, Brasil. · Instituto Nacional de Cardiologia, Rio de Janeiro, Brasil. · Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil. · Instituto do Câncer do Estado de São Paulo, São Paulo, Brasil. · Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil. ·Cad Saude Publica · Pubmed #29947654.

ABSTRACT: Breast cancer is the leading cause of cancer mortality in Brazilian women. The new Brazilian guidelines for early detection of breast cancer were drafted on the basis of systematic literature reviews on the possible harms and benefits of various early detection strategies. This article aims to present the recommendations and update the summary of evidence, discussing the main controversies. Breast cancer screening recommendations (in asymptomatic women) were: (i) strong recommendation against mammogram screening in women under 50 years of age; (ii) weak recommendation for mammogram screening in women 50 to 69 years of age; (iii) weak recommendation against mammogram screening in women 70 to 74 years of age; (iv) strong recommendation against mammogram screening in women 75 years or older; (v) strong recommendation that screening in the recommended age brackets should be every two years as opposed to shorter intervals; (vi) weak recommendation against teaching breast self-examination as screening; (vii) absence of recommendation for or against screening with clinical breast examination; and (viii) strong recommendation against screening with magnetic resonance imaging, ultrasonography, thermography, or tomosynthesis alone or as a complement to mammography. The recommendations for early diagnosis of breast cancer (in women with suspicious signs or symptoms) were: (i) weak recommendation for the implementation of awareness-raising strategies for early diagnosis of breast cancer; (ii) weak recommendation for use of selected signs and symptoms in the current guidelines as the criterion for urgent referral to specialized breast diagnosis services; and (iii) weak recommendation that every breast cancer diagnostic workup after the identification of suspicious signs and symptoms in primary care should be done in the same referral center.

20 Guideline Recommendations on Disease Management for Patients With Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer and Brain Metastases: ASCO Clinical Practice Guideline Update. 2018

Ramakrishna, Naren / Temin, Sarah / Chandarlapaty, Sarat / Crews, Jennie R / Davidson, Nancy E / Esteva, Francisco J / Giordano, Sharon H / Kirshner, Jeffrey J / Krop, Ian E / Levinson, Jennifer / Modi, Shanu / Patt, Debra A / Perlmutter, Jane / Winer, Eric P / Lin, Nancy U. ·Naren Ramakrishna, University of Florida Health Cancer Center at Orlando Health, Orlando · Jennifer Levinson, Ponte Vedra Beach, FL · Sarah Temin, American Society of Clinical Oncology, Alexandria, VA · Sarat Chandarlapaty and Shanu Modi, Memorial Sloan Kettering Cancer Center · Francisco J. Esteva, New York University Langone Medical Center, New York · Jeffrey J. Kirshner, Hematology/Oncology Associates of Central New York, East Syracuse, NY · Jennie R. Crews, Seattle Cancer Care Alliance, Seattle, WA · Nancy E. Davidson, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA · Sharon H. Giordano, University of Texas MD Anderson Cancer Center, Houston · Debra A. Patt, Texas Oncology, Austin, TX · Ian E. Krop, Eric P. Winer, and Nancy U. Lin, Dana-Farber Cancer Institute, Boston, MA · and Jane Perlmutter, Ann Arbor, MI. ·J Clin Oncol · Pubmed #29939840.

ABSTRACT: Purpose To update the formal expert consensus-based guideline recommendations for practicing oncologists and others on the management of brain metastases for patients with human epidermal growth factor receptor 2-positive advanced breast cancer to 2018. Methods An Expert Panel conducted a targeted systematic literature review (for both systemic treatment and CNS metastases) and identified 622 articles. Outcomes of interest included overall survival, progression-free survival, and adverse events. In 2014, the American Society of Clinical Oncology (ASCO) convened a panel of medical oncology, radiation oncology, guideline implementation, and advocacy experts, and conducted a systematic review of the literature. When that failed to yield sufficiently strong quality evidence, the Expert Panel undertook a formal expert consensus-based process to produce these recommendations. ASCO used a modified Delphi process. The panel members drafted recommendations, and a group of other experts joined them for two rounds of formal ratings of the recommendations. Results Of the 622 publications identified and reviewed, no additional evidence was identified that would warrant a change to the 2014 recommendations. Recommendations Patients with brain metastases should receive appropriate local therapy and systemic therapy, if indicated. Local therapies include surgery, whole-brain radiotherapy, and stereotactic radiosurgery. Treatments depend on factors such as patient prognosis, presence of symptoms, resectability, number and size of metastases, prior therapy, and whether metastases are diffuse. Other options include systemic therapy, best supportive care, enrollment in a clinical trial, and/or palliative care. Clinicians should not perform routine magnetic resonance imaging to screen for brain metastases, but rather should have a low threshold for magnetic resonance imaging of the brain because of the high incidence of brain metastases among patients with HER2-positive advanced breast cancer. Additional information is available at www.asco.org/breast-cancer-guidelines .

21 Guideline Systemic Therapy for Patients With Advanced Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: ASCO Clinical Practice Guideline Update. 2018

Giordano, Sharon H / Temin, Sarah / Chandarlapaty, Sarat / Crews, Jennie R / Esteva, Francisco J / Kirshner, Jeffrey J / Krop, Ian E / Levinson, Jennifer / Lin, Nancy U / Modi, Shanu / Patt, Debra A / Perlmutter, Jane / Ramakrishna, Naren / Winer, Eric P / Davidson, Nancy E. ·Sharon H. Giordano, The University of Texas MD Anderson, Houston · Debra A. Patt, Texas Oncology, Austin, TX · Sarah Temin, American Society of Clinical Oncology, Alexandria, VA · Sarat Chandarlapaty and Shanu Modi, Memorial Sloan Kettering Cancer Center · Francisco J. Esteva, New York University Langone Medical Center, New York · Jeffrey J. Kirshner, Hematology/Oncology Associates of Central New York, East Syracuse, NY · Jennie R. Crews, Seattle Cancer Care Alliance · Nancy E. Davidson, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA · Ian E. Krop, Nancy U. Lin, and Eric P. Winer, Dana-Farber Cancer Institute, Boston, MA · Jennifer Levinson, Ponte Vedra Beach · Naren Ramakrishna, Orlando Health University of Florida Health Cancer Center, Orlando, FL · and Jane Perlmutter, Ann Arbor, MI. ·J Clin Oncol · Pubmed #29939838.

ABSTRACT: Purpose To update evidence-based guideline recommendations for practicing oncologists and others on systemic therapy for patients with human epidermal growth factor receptor 2 (HER2)-positive advanced breast cancer to 2018. Methods An Expert Panel conducted a targeted systematic literature review (for both systemic treatment and CNS metastases) and identified 622 articles. Outcomes of interest included overall survival, progression-free survival, and adverse events. Results Of the 622 publications identified and reviewed, no additional evidence was identified that would warrant a change to the 2014 recommendations. Recommendations HER2-targeted therapy is recommended for patients with HER2-positive advanced breast cancer, except for those with clinical congestive heart failure or significantly compromised left ventricular ejection fraction, who should be evaluated on a case-by-case basis. Trastuzumab, pertuzumab, and taxane for first-line treatment and trastuzumab emtansine for second-line treatment are recommended. In the third-line setting, clinicians should offer other HER2-targeted therapy combinations or trastuzumab emtansine (if not previously administered) and may offer pertuzumab if the patient has not previously received it. Optimal duration of chemotherapy is at least 4 to 6 months or until maximum response, depending on toxicity and in the absence of progression. HER2-targeted therapy can continue until time of progression or unacceptable toxicities. For patients with HER2-positive and estrogen receptor-positive/progesterone receptor-positive breast cancer, clinicians may recommend either standard first-line therapy or, for selected patients, endocrine therapy plus HER2-targeted therapy or endocrine therapy alone. Additional information is available at www.asco.org/breast-cancer-guidelines .

22 Guideline Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer: ASCO Clinical Practice Guideline Focused Update Summary. 2018

Denduluri, Neelima / Somerfield, Mark R / Giordano, Sharon H. ·Virginia Cancer Specialists, the US Oncology Network, Arlington, VA; American Society of Clinical Oncology, Alexandria, VA; University of Texas MD Anderson Cancer Center, Houston, TX. ·J Oncol Pract · Pubmed #29924666.

ABSTRACT: -- No abstract --

23 Guideline HER2 Testing in Breast Cancer: American Society of Clinical Oncology/College of American Pathologists Clinical Practice Guideline Focused Update Summary. 2018

Wolff, Antonio C / Hammond, M Elizabeth Hale / Allison, Kimberly H / Harvey, Brittany E / McShane, Lisa M / Dowsett, Mitchell. ·Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Intermountain Healthcare and University of Utah School of Medicine, Salt Lake City, UT; Stanford University School of Medicine, Stanford, CA; American Society of Clinical Oncology, Alexandria, VA; National Cancer Institute, Bethesda, MD; and The Royal Marsden NHS Foundation Trust, London, United Kingdom. ·J Oncol Pract · Pubmed #29920138.

ABSTRACT: -- No abstract --

24 Guideline Integrative Therapies During and After Breast Cancer Treatment: ASCO Endorsement of the SIO Clinical Practice Guideline. 2018

Lyman, Gary H / Greenlee, Heather / Bohlke, Kari / Bao, Ting / DeMichele, Angela M / Deng, Gary E / Fouladbakhsh, Judith M / Gil, Brigitte / Hershman, Dawn L / Mansfield, Sami / Mussallem, Dawn M / Mustian, Karen M / Price, Erin / Rafte, Susan / Cohen, Lorenzo. ·Gary H. Lyman and Heather Greenlee, Fred Hutchinson Cancer Research Center and University of Washington, Seattle, WA · Kari Bohlke, American Society of Clinical Oncology, Alexandria, VA · Ting Bao and Gary E. Deng, Memorial Sloan Kettering Cancer Center · Dawn L. Hershman, Columbia University Medical Center, New York · Karen M. Mustian, University of Rochester Medical Center, Rochester, NY · Angela M. DeMichele, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA · Judith M. Fouladbakhsh, Oakland University, Rochester, MI · Brigitte Gil, Lahey Hospital and Medical Center, Burlington, MA · Sami Mansfield, Cancer Wellness for Life, Shawnee, KS · Sarah Cannon Cancer Institute, Kansas City, MO · Dawn M. Mussallem, The Mayo Clinic, Jacksonville, FL · Erin Price, Smith Center for Healing and the Arts, Washington, DC · Susan Rafte, Houston, TX · and Lorenzo Cohen, The University of Texas MD Anderson Cancer Center, Houston, TX. ·J Clin Oncol · Pubmed #29889605.

ABSTRACT: Purpose The Society for Integrative Oncology (SIO) produced an evidence-based guideline on use of integrative therapies during and after breast cancer treatment that was determined to be relevant to the American Society of Clinical Oncology (ASCO) membership. ASCO considered the guideline for endorsement. Methods The SIO guideline addressed the use of integrative therapies for the management of symptoms and adverse effects, such as anxiety and stress, mood disorders, fatigue, quality of life, chemotherapy-induced nausea and vomiting, lymphedema, chemotherapy-induced peripheral neuropathy, pain, and sleep disturbance. Interventions of interest included mind and body practices, natural products, and lifestyle modifications. SIO systematic reviews focused on randomized controlled trials that were published from 1990 through 2015. The SIO guideline was reviewed by ASCO content experts for clinical accuracy and by ASCO methodologists for developmental rigor. On favorable review, an ASCO Expert Panel was convened to review the guideline contents and recommendations. Results The ASCO Expert Panel determined that the recommendations in the SIO guideline-published in 2017-are clear, thorough, and based on the most relevant scientific evidence. ASCO endorsed the guideline with a few added discussion points. Recommendations Key recommendations include the following: Music therapy, meditation, stress management, and yoga are recommended for anxiety/stress reduction. Meditation, relaxation, yoga, massage, and music therapy are recommended for depression/mood disorders. Meditation and yoga are recommended to improve quality of life. Acupressure and acupuncture are recommended for reducing chemotherapy-induced nausea and vomiting. Acetyl-l-carnitine is not recommended to prevent chemotherapy-induced peripheral neuropathy because of a possibility of harm. No strong evidence supports the use of ingested dietary supplements to manage breast cancer treatment-related adverse effects. Additional information is available at: www.asco.org/supportive-care-guidelines .

25 Guideline None 2018

Marzo-Castillejo, Mercè / Vela-Vallespín, Carmen / Bellas-Beceiro, Begoña / Bartolomé-Moreno, Cruz / Melús-Palazón, Elena / Vilarrubí-Estrella, Mercè / Nuin-Villanueva, Marian. ·Especialista en Medicina Familiar y Comunitaria y especialista en Medicina Preventiva y Salud Pública, Unitat de Suport a la Recerca de Costa de Ponent, IDIAP Jordi Gol, Direcció d'Atenció Primària Costa de Ponent, Institut Català de la Salut, Barcelona. · Especialista en Medicina Familiar y Comunitaria, EAP Riu Nord i Riu Sud, Santa Coloma de Gramenet, SAP Barcelona Nord i Maresme-ICS, Unitat Docent Metropolitana Nord, Barcelona. · Especialista en Medicina Familiar y Comunitaria, Complejo Hospitalario Universitario de Canarias y Unidad Docente de Atención Familiar y Comunitaria La Laguna-Tenerife Norte, Servicio Canario de Salud, Santa Cruz de Tenerife. · Especialista en Medicina Familiar y Comunitaria, Centro de Salud Goya de Zaragoza y Unidad Docente de Medicina Familiar y Comunitaria Sector Zaragoza I, Servicio Aragonés de Salud, Zaragoza. · Especialista en Medicina Familiar y Comunitaria, Centro de Salud Actur Oeste, Zaragoza, y Unidad Docente de Medicina Familiar y Comunitaria Sector Zaragoza I, Servicio Aragonés de Salud, Zaragoza. · Especialista en Medicina Familiar y Comunitaria, Servicio de Gestión Clínica y Sistemas de Información, Dirección de Atención Primaria, Servicio Navarro de Salud, Pamplona. · Grupo de Prevención del Cáncer del PAPPS. ·Aten Primaria · Pubmed #29866358.

ABSTRACT: -- No abstract --

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