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Sách: Early and locally advanced breast cancer - Diagnosis and treatment

Synthetic progestogens (administered orally or parenterally) are recommended as first-line ther- apy for the management of troublesome hot flushes. If oral therapy is used, it should be given for 2 weeks, and re-started, if effective, on recurrence of symptoms. Men starting long-term bicalutamide monotherapy ( 6 months) should receive prophylactic radiotherapy to both breast buds within the first month of treatment. A single fraction of 8 Gy using orthovoltage or electron beam radiotherapy is recommended. If radiotherapy is unsuccessful in preventing gynaecomastia, weekly tamoxifen should be con- sidered. Inform men starting androgen withdrawal therapy that regular resistance exercise reduces fatigue and. | NHS National Institute for Health and Clinical Excellence Issue date February 2009 Early and locally advanced breast cancer Diagnosis and treatment This guideline updates and replaces NICE technology appraisal guidance 109 docetaxel 108 paclitaxel and 107 trastuzumab NICE clinical guideline 80 Developed by the National Collaborating Centre for Cancer NICE clinical guideline 80 Early and locally advanced breast cancer diagnosis and treatment Ordering information You can download the following documents from www.nice.org.uk CG80 The NICE guideline this document - all the recommendations. A quick reference guide - a summary of the recommendations for healthcare professionals. Understanding NICE guidance - a summary for patients and carers. The full guideline - all the recommendations details of how they were developed and reviews of the evidence they were based on. For printed copies of the quick reference guide or Understanding NICE guidance phone NICE publications on 0845 003 7783 or email publications@nice.org.uk and quote N1792 quick reference guide N1793 Understanding NICE guidance . NICE clinical guidelines are recommendations about the treatment and care of people with specific diseases and conditions in the NHS in England and Wales. This guidance represents the view of NICE which was arrived at after careful consideration of the evidence available. Healthcare professionals are expected to take it fully into account when exercising their clinical judgement. However the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient in consultation with the patient and or guardian or carer and informed by the summary of product characteristics of any drugs they are considering. Implementation of this guidance is the responsibility of local commissioners and or providers. Commissioners and providers are reminded that it is their responsibility to implement the .