Authors' objectives: Breast cancer arises from the tissues of the ducts or lobules of the breast. Metastatic breast cancer describes disease that has spread to another part of the body, such as the bones, liver, or lungs. In 2014 in England, around 46,417 people were diagnosed with breast cancer, and there were approximately 9,554 deaths from breast cancer (1),(2). The 5-year survival rate for people with metastatic breast cancer in England is 15%(3). Approximately 5% of women with invasive breast cancers have locally advanced or metastatic disease when they are diagnosed(4), and around 35% of people with early or locally advanced disease will progress to metastatic breast cancer in the 10 years following diagnosis(5),(6). Current treatments for metastatic breast cancer aim to relieve symptoms, prolong survival and maintain a good quality of life with few adverse events. Treatment may depend on whether the cancer cells have particular receptors (hormone receptor status or HER2 status), the extent of the disease and previous treatments. NICE Clinical Guideline 81 recommends that endocrine therapy should be offered as first-line treatment for the majority of people with hormone receptor-positive metastatic breast cancer. In clinical practice, people who are post-menopausal with hormone receptor-positive metastatic breast cancer often receive first-line treatment with an aromatase inhibitor (anastrozole or letrozole). People who are pre- or peri-menopausal will receive first-line treatment with tamoxifen and ovarian suppression if they have not previously received tamoxifen. Chemotherapy is usually offered as first-line treatment only for people with hormone-receptor positive advanced breast cancer whose disease is imminently life-threatening or requires early relief of symptoms because of significant visceral organ involvement, providing they understand and are prepared to accept the toxicity. References 1. Office for National Statistics (2016) Cancer registration statistics, England, 2014. Accessed July 2016. 2. Cancer Research UK (2015) Breast cancer mortality statistics. Accessed July 2016. 3. Cancer Research UK (2014) Breast cancer survival statistics. Accessed July 2016. 4. Cancer Research UK (2015) Breast cancer incidence statistics. Accessed July 2016. 5. NICE (2009) Costing report for clinical guideline 81: advanced breast cancer. Accessed September 2015. 6. Dewis R and Gribbin J (2009) Breast cancer: diagnosis and treatment, an assessment of need. Cardiff: National Collaborating Centre for Cancer. Accessed October 2015.

Project Status: Completed

URL for project: https://www.journalslibrary.nihr.ac.uk/programmes/hta/1519407/#/summary-of-research

Year Published: 2016

URL for published report: https://njl-admin.nihr.ac.uk/document/download/2009994

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England, United Kingdom

Organisation Name: NIHR Health Technology Assessment programme

Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK

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Contact Email: journals.library@nihr.ac.uk

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