These are common side effects experienced during additional years taking endocrine therapy. In postmenopausal women, switching to an aromatase inhibitor may be more effective at reducing recurrence than continuing with tamoxifen Lower rates of breast cancer recurrence compared with 5 years of tamoxifen therapy Low risk may include people with lymph node-negative breast cancer, with smaller or lower-grade tumoursĮvidence shows lower rates of breast cancer recurrence compared with 5 years of tamoxifen therapy in women Medium or high risk may include people who have lymph node-positive breast cancer, with tumours that are T2 or greater and higher grade. For people with a low risk of recurrence, the benefits may not outweigh the risks or side effects The benefit for an individual person will depend on the risk of their cancer returning. Postmenopausal women with ER-positive invasive breast cancer People with ER-positive invasive breast cancer Switching to an aromatase inhibitor after 5 years of tamoxifen therapy Table 2 Effects of extended endocrine therapyĮxtended tamoxifen therapy (after an initial 5 years of tamoxifen therapy)Įxtended endocrine therapy with an aromatase inhibitor (after 5 years of tamoxifen therapy)Ĭontinuing to take tamoxifen after 5 years of tamoxifen therapy For example, may not be able to have MRI scans and may need modified radiotherapy planningĬomplications can also occur after mastectomy alone, which may delay chemotherapy or radiotherapy May need adaptions to scans if a tissue expander is used. Immediate reconstructions using implants may be more affected by radiotherapy than immediate flap reconstructions Radiotherapy or chemotherapy can be given but may be delayed if there are complications from the mastectomy or reconstruction Reconstruction and adjuvant therapy (including radiotherapy and chemotherapy) No clear differences in satisfaction with completed reconstructions May need to interrupt hormone therapies (tamoxifen) for further surgery Surgical complications can occur after any breast reconstruction and will vary by type of procedure and personal risk factorsįlap or implant failure (which may lead to delayed reconstruction and flat appearance for a period of time)Ĭapsular contracture (a scar layer around the implant that may lead to pain if severe) Procedures (and associated recovery) can be planned around other commitments Lifestyle changes (such as losing weight and taking regular exercise) may be possible, which increase the options and lower the risks of reconstruction surgery More time to make a decision (which may include not having a reconstruction) and to plan reconstructionīreast shape remains, which may help maintain body image and have subsequent psychological benefits
#Sentinel lymph node biopsy breast skin
Limited time to make a decision about options (which may include not having a reconstruction) before surgeryĬertain options that spare or preserve the breast skin may not be available Options may be available that spare or preserve the breast skin (which may mean less scarring and a more natural look) Travel to a different hospital may be needed for a specific option Not all hospitals or surgeons can offer all procedures. These will vary depending on personal preferences (such as breast size desired), current body shape, other health conditions, previous operations and lifestyle factors (such as hobbies)
Personal preferences (such as whether a nipple reconstruction is requested) Type of reconstruction (for example, some are planned in stages a prosthesis may be worn until reconstruction is complete)
#Sentinel lymph node biopsy breast professional
Making decisions using NICE guidelines explains how we use words to show the strength (or certainty) of our recommendations, and has information about prescribing medicines (including off-label use), professional guidelines, standards and laws (including on consent and mental capacity), and safeguarding. Healthcare professionals should use their clinical judgement when implementing gender-specific recommendations, taking into account the individual's circumstances, needs and preferences, and ensuring all people are treated with dignity and respect throughout their care. Only a very limited number of recommendations have been updated in direct response to new evidence or to reflect a change in practice. The evidence has been reviewed, but the information available for some groups at the time of development was too limited to make specific recommendations, or The evidence for the recommendation has not been reviewed and it is not certain from expert opinion whether it can cover more groups, or
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