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Recommendation
Neoadjuvant chemotherapy – Indications
Consider neoadjuvant chemotherapy for suitable patients with breast cancer whose disease type is likely to show rapid response to chemotherapy and whose disease burden as assessed preoperatively indicates a need for chemotherapy. Suitable patients may include those with triple negative breast cancer, HER2-positive breast cancer, or luminal B hormonal cancer.
Offer neoadjuvant chemotherapy to people with ER-negative invasive breast cancer as an option to reduce tumour size.
Offer neoadjuvant chemotherapy to people with HER2-positive invasive breast cancer in line with the NICE technology appraisal on pertuzumab for the neoadjuvant treatment of HER2-positive breast cancer
Consider neoadjuvant chemotherapy for people with ER-positive invasive breast cancer as an option to reduce tumour size if chemotherapy is indicated.
How this guidance was developed
This recommendation was adapted from three source recommendations in the NICE 2018 guidelines (UK). The source recommendations were based on a systematic review of the evidence conducted up to September 2017. Two of the source recommendations used wording (‘Offer’) indicative of a ‘strong’ recommendation and one used wording (‘Consider’) indicative of a conditional recommendation (using GRADE methods) by the source guideline authors. The source recommendations were merged, and the guidance was made less directive by replacing 'offer' with 'consider' for all indications.
Neoadjuvant chemotherapy – Indications
Recommendation
Consider neoadjuvant chemotherapy for suitable patients with breast cancer whose disease type is likely to show rapid response to chemotherapy and whose disease burden as assessed preoperatively indicates a need for chemotherapy. Suitable patients may include those with triple negative breast cancer, HER2-positive breast cancer, or luminal B hormonal cancer.
Principles in action
Patient-centred care
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Safe and quality care
This recommendation was adapted from three source recommendations in the NICE 2018 guidelines (UK). The source recommendations were based on a systematic review of the evidence conducted up to September 2017. Two of the source recommendations used wording (‘Offer’) indicative of a ‘strong’ recommendation and one used wording (‘Consider’) indicative of a conditional recommendation (using GRADE methods) by the source guideline authors. The source recommendations were merged, and the guidance was made less directive by replacing 'offer' with 'consider' for all indications.