A new section focusing on the treatment of patients with inflammatory breast cancer (IBC) has been added. IBC is a rare, aggressive form of breast cancer estimated to account for 1% to 6% of breast cancer cases in the United States. IBC is characterized by redness and swelling of the skin of the breast due to blockage of lymph vessels by cancer cells. Recommendations from the NCCN Guideline Panel for treatment of IBC (without evidence of metastases) involve a combined modality approach including preoperative chemotherapy with an anthracycline with or without a taxane followed by total mastectomy and radiation therapy for patients responding to preoperative chemotherapy.

In the latest version of the NCCN Guidelines, the option of using a gene-based assay of tumor tissue (Oncotype DX^®, Genomic Health) to help guide chemotherapy treatment decisions is now included within the systemic adjuvant treatment decision pathway for patients with hormone receptor-positive, HER2-negative tumors that are 0.6 to 1.0 cm and moderately/poorly differentiated or with unfavorable features, or greater than 1 cm.

Bevacizumab (Avastin^®, Genentech) continues to be a recommended therapy in combination with paclitaxel for the treatment of recurrent or metastatic breast cancer.

The NCCN Breast Cancer Guideline V.2.2008 now includes new sections covering principles of breast reconstruction following mastectomy and principles of radiation therapy.

About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network (NCCN), a not-for-profit alliance of 21 of the world’s leading cancer centers, is dedicated to improving the quality and effectiveness of care provided to patients with cancer. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The primary goal of all NCCN initiatives is to improve the quality, effectiveness, and efficiency of oncology practice so patients can live better lives.

For more information, visit www.nccn.org.

The NCCN Member Institutions are: City of Hope, Los Angeles, CA; Dana-Farber/Brigham and Women’s Cancer Center - Massachusetts General Hospital Cancer Center, Boston, MA; Duke Comprehensive Cancer Center, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; Arthur G. James Cancer Hospital & Richard J. Solove Research Institute at The Ohio State University, Columbus, OH; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Memorial Sloan-Kettering Cancer Center, New York, NY; H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children’s Research Hospital/University of Tennessee Cancer Institute, Memphis, TN; Stanford Comprehensive Cancer Center, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; UNMC Eppley Cancer Center at The Nebraska Medical Center, Omaha, NE; The University of Texas M. D. Anderson Cancer Center, Houston, TX; and Vanderbilt-Ingram Cancer Center, Nashville, TN.